Critical drug vanishes, pushing millions of Indian women into risk
A few months ago, the government passed new rules restricting the manufacture and sale of oxytocin. Amid other developments, the news might have passed by our Facebook feeds inconspicuously, but what if we were to tell you that without oxytocin, millions of expecting women in India will be put at high risk? Here's all you need to know.
What is oxytocin?
Oxytocin is naturally secreted by the human body. Among its most crucial functions, it causes contraction of the uterus during labor, and stimulates milk production in breasts. It helps induce labor in women and pause postpartum bleeding. It is popular in India as it is cheap (Rs. 12-13) and commonly available. The 'love hormone' is also associated with positive emotions like happiness, empathy, trust, and sexual intimacy.
Is it really that important in India?
India has brought down maternal mortality rate from 167 in 2011-13 to 130 in 2014-16, and medical experts have given oxytocin a large portion of the credit. This is because the largest reductions in mortality rate have been achieved in rural areas, which will be impacted the most when this ban goes live. 3cr ampoules of oxytocin are consumed annually in India.
So why is the government banning it?
In April, the Health Ministry issued a notification banning import of oxytocin formulations. In June, it banned its retail sale. From September 1, only the Karnataka Antibiotics & Pharmaceuticals Ltd (KAPL) will be allowed to manufacture it. It cited the abuse of oxytocin by the dairy industry- cattle is injected the drug to boost their milk production, which is toxic for humans- as the reason.
How will the ban affect things on the ground?
In India, many gynaecologists source the drug from distributors of companies like Pfizer, or from pharmacies. Now that the supply for the entire country will come from just one supplier, doctors are worried for their patients. They are worried about themselves too. Dr Jaideep Malhotra, president, Federation of Obstetric and Gynaecological Societies of India, said gynaecologists may now be blamed for deaths caused due to lack of oxytocin.
What if the government ensures adequate supply?
There will be other problems too. Even if there was no shortage, "there could be more paperwork from the administrative side that the hospital has to deal with," a gynaecologist told Scroll. The substitute for most gynaecologists would be misoprostol, said Malhotra, which is expensive. Lack of oxytocin in the market would mean a potential black market.
Why was KAPL chosen?
Doctors are also confused why KAPL was chosen. The PSU doesn't have distributors in as many as 19 states, Malhotra said. Moreover, they have said "they will not take small orders and will only deliver orders above 1,000 ampoules of oxytocin. This is just bizarre." KAPL is even selling it at a higher price of Rs. 17.5. "We aren't able to understand why."
So what's happening now?
Stakeholders are continuing their fight. Wednesday, a group of doctors met health ministry officials in Delhi to convey their concerns. "We are also contacting MPs, who have promised to bring up the issue in the House," said Malhotra. The TN government challenged the ban today. The issue of misuse in dairy is the Animal Husbandry and drug regulators' responsibility, not the Health Department's, it submitted.
