2.3 lakh vials of Amphotericin-B to be procured from six countries, Centre informs Delhi HC

"Out of the sources that have been presently identified abroad, the Ministry of Health and Family Welfare on May 24, 2021, has called upon the MEA to take steps to procure 2,30,000 vials of Liposomal Amphotericin-B from Australia, Russia, Germany, Argentina, Belgium, and China. The MEA has also been called upon to procure 50,000 tablets of Isavuconazole. Steps in this regard are being taken by the MEA," the Centre government said in an affidavit.

Additional Solicitor General Chetan Sharma apprised a Division Bench of Justice Vipin Sanghi and Justice Jasmeet Singh about the steps taken by the Centre government to import Amphotericin-B, drugs used for black fungus treatment.

After taking note of the Centre's consolidated status report, the High Court directed the Central government to file detailed current status of these imports and listed the matter for Monday for consideration.

"In order to augment domestic manufacture, the Union of India is continuously engaging with manufacturers to resolve issues related to raw materials. In this regard, the Ministry of External Affairs (MEA) is playing a critical role in reaching out to various players abroad," the Centre said in an affidavit filed by its advocates Amit Mahajan, Kirtiman Singh, and Nidhi Mohan Parashar.

The Centre also told the court that with the active participation of MEA, several important and critical steps have been taken to augment domestic production and imports.

"Vide OM dated 16.05.2021, Ministry of Health and Family Welfare had called upon the Ministry of External Affairs to explore all possibilities of sourcing Amphotericin B/Liposomal Amphotericin B injection from abroad through Indian Mission. Accordingly, MEA has also instructed Indian Missions all over the world to immediately identify additional sources of the drug and alternative drugs for the treatment of Mucormycosis," the affidavit said.

The hearing that went for hours had also dealt with various issues relating to Black Fungus and other issues that arose out due to COVID-19 infection.

The court said that nobody even had heard of Black Fungus a month ago. It also denied passing any specific order on an individual plea seeking medicine and said that they can get the medicine anywhere in the world, as they do not have to pay customs and it will not pass an order saying your patient should get and deny it to other patients.

The court also sought to know from Professor Sanjay Dhir of IIT Delhi whether he has looked into aspects of what contributes to Black Fungus.

Professor Dhir suggested not to use industrial oxygen for patients as there are chances of contamination and recommended medical oxygen and setting medical oxygen plants in Delhi. He also opined not to give an overdose of oxygen and said that oxygen saturation should be kept up to 94, not 96/ 97.

Professor Dhir was asked by the Delhi High Court to compile a report suggesting his opinion on the improvement required in infrastructure to such a crisis that arose due to COVID cases, in the future.

Professor Sanjay Dhir, IIT Delhi told the Delhi High Court he has identified nine challenges assuming that if a third wave comes, and will be more severe. Professor Dhir said that the first issue is dealt with oxygen storing capacity as Delhi did not have any manufacturing unit He also told the Court that most of Liquid Medical Oxygen was also allocated to 51 hospitals, and these 51 hospitals can be made more self-dependent by maintaining a buffer of oxygen. He stressed to consider generating some amount of oxygen in these hospitals and opined that Delhi Government should step in setting up these manufacturing plants.

He also suggested increasing the number of refillers or capacity oxygen to maintain queues as scores of people were seen queuing for refilling cylinders. He also said that hospitals can consider setting up a local refilling station.