As cases of mucormycosis or black fungus increase in Delhi, hospitals are facing a shortage of amphotericin B, an antifungal drug used in treatment of the rare but sometimes fatal disease.
Mucormycosis is a rare fungal infection caused by a group of moulds called mucormycetes, with symptoms such as face numbness, nose obstruction, swelling in the eye or cheeks, and black dry crusts in the nose.
According to doctors in the capital, these cases are being seen in some Covid patients who were administered steroids to treat symptoms, and particularly among those who are suffering from diabetes and cancer.
“At present, we have around 70 cases in our hospital. Around 50 of them are admitted, while the others are waitlisted. The cases are being seen mostly among people who are suffering from diabetes and cancer,” said Dr D S Rana, chairperson, Sir Ganga Ram Hospital.
Other hospitals in the city are also seeing a rise in cases, with 25 admitted in Max Hospital branches across the city, 10 in Indraprastha Apollo Hospital, and three cases at Fortis Vasant Kunj.
While smaller hospitals and pharmacies were earlier facing trouble in procuring the medicine, bigger hospitals have also been affected now.
“The whole country is facing a shortage and so are we. We have written to the government and told them what our requirement is. Our doctors are trying to source it, but it is a big challenge for them as well,” Dr Rana said.
In an effort to deal with the problems of procurement, the Delhi government has appointed a three-member technical expert committee to “streamline and systemise” the distribution of amphotericin B.
All notified Covid hospitals requiring the drug will have to apply to this committee, and following approval, the Directorate General of Health Services (DGHS) shall issue the drug to the representative of the hospital. The Indian Express had earlier reported how pharmacies in the city are reporting unavailability of the drug while attendants of mucormycosis patients have been struggling to procure it after it has been prescribed to them.
An order issued by Special Secretary Health and Family Welfare Raj Kumar stated that the committee has been formed to “prevent the indiscriminate use of this injection and to establish a transparent, efficient and time-bound system of distribution of this drug on clinically approved evidence-based grounds and ethical principle of distributive justice across Delhi…”
The committee will be chaired by Dr M K Daga, pulmonologist at Lok Nayak hospital, and Dr Manisha Aggarwal, Dr S Anuradha and Dr Ravi Mehar from Maulana Azad Medical College, from the anesthesia, medicine and ENT branches respectively.
According to the order, the committee will meet once in the morning and again in the evening every day to scrutinise the applications, and the decisions of these meetings will be shared with stakeholders, including the rationale in case of rejections.
It also states that the DGHS “will ensure the issuance of drug on the same day to the government and private hospitals concerned”. The distribution will be done as long as the allocation made by the central government remains, it added.