Bombay High Court: The Division Bench of Sunil B. Shukre & Avinash G. Gharote, JJ. addressed various Mucormycosis related issues prevalent in Maharashtra.  The Bench warned,

“This is a sort of war like situation for Maharashtra and in particular city of Nagpur, which calls for rapid response and mighty one. We hope that these entreaties would be positively answered by the Central Government and if not, further loss of lives of a few more patients, unfortunate as it may be, may be a fait accompli.”

The Indian Medical Association (IMA) had submitted a report before the Court pertaining to prevalence and spread of fungal infections. It not only highlighted types of fungal infections but also the causes, symptoms, precautions, which the Bench opined that if considered seriously and implemented by all the hospitals presently treating the Covid patients and also patients with fungal infections, there will be a considerable reduction in prevalence and spread of the fungal infections.

Shortage of Drugs

Noticing that raw materials used for manufacturing drugs to cure Mucormycosis which are Amphotericin B (Lipid Complex) and Amphotericin (Liposomal) are imported for their bigger part, the Bench stated that the State Government, as well as the Central Government, need to take the issue of shortage of drugs available for treating the fungal infections seriously. The Bench reminded the governments,

“After all, such invaders; fungii are the invaders; require speedy action and they do not wait for anybody to respond to them. It’s not the case that once they raid a house i.e. body of the patient, they would lie dormant and wait for the house owner to make his preparations and then have a word or duel of resistance with them. The response to be given in such situations is akin to a response given in a war like situation.”

Believing that unless quick action is taken, destruction is inevitable, the Bench directed the Central and the State Government to take immediate steps for increasing the production capacity of Indian manufacturers involved in producing these drugs and if needed, press the entire State machinery into service for increasing of the production capacity.

Reportedly, number of patients suffering from Mucormycosis in Nagpur alone was 1584 on 29-05-2021 and out of these patients 830 patients had been operated on.  The data further showed that out of 1584 patients, eye exenteration had taken place in 74 cases and so far 69 patients had succumbed to Mucormycosis. The Bench expressed alarm over the situation and remarked that in Nagpur city the situation is no longer a rare fungal infection, that it has already assumed a form of an epidemic. Therefore, the Bench reiterated that the Central Government and State Government, and additionally, Indian Society in general need start taking effective measures for restricting the spread of fungal infections. These measures would be of maintaining of individual cleanliness and hygiene through improvement of immunity levels by remaining on good diet and also keeping contributing ailments like Hyperglycemia, diabetes and the like under control to making available in sufficient quantities drugs required for treating these infections.

Deficit Allocation of Drugs to Maharashtra

Raising concerns on inefficient method of drug allocations, the Bench expressed concerns that the State of Maharashtra and in particular city of Nagpur having very high prevalence of Mucormycosis infection remain in crying state for Amphotericin B and the patients were not getting enough number of vials per day for the treatment because of deficit allocation and short supply to State of Maharashtra; due to which many patients had lost organs of their body while others had even lost their eyes and a sizable number of patients were dead. Hence, the Bench reiterated that the situation could be improved by sensible allocation of Amphotericin B to the State of Maharashtra.

“But, the steps that it (Central Government) had to take or it must take, considering the fundamental duty of the State and also the concept of welfare State in the Directive Principles of State Policy, its response appears to be not on the expected lines.”

Import of Raw Material

Some public spirited importers from Nagpur who had forward to extend their helping hands had highlighted their problem in importing of the raw-material required for manufacturing of the required drugs. Noticing that major hurdles that these interested importers were facing were in respect of the delay occurring at the level of Drugs Controller General of India (DCGI) in granting registration to the private players, the Bench directed the Central government to actively consider the suggestion of interested importers that procedure for obtaining registration of DCGI for making import of the drugs or raw material should be done away with atleast during the pandemic and the Authority to grant permission for import of the drugs and/or raw material for drugs be delegated to the Food and Drugs Administration of individual States.

In the backdrop of above, the Bench directed the Divisional Commissioner, Collector and Commission of Nagpur to extend all the help to make available the requisite man power and paraphernalia for increasing the check-ups and survey of all the hospitals in Nagpur city in order to find out any deficiency, lacunae, and other incidental factors which contribute to spread of fungal infections. The State government was also directed to invoke relevant provisions of Section 136, Companies Act, 2013 for dealing with erring companies which are unwilling, defaulting and non-responsive regarding their CSR and are reluctant to make contributions at this hour of need.[Court on its own motion v. Union of India, 2021 SCC OnLine Bom 790, order dated 02-06-2021]

Kamini Sharma, Editorial Assistant has reported this brief.

Appearance before the Court by:

Amicus Curiae: S.P.Bhandarkar

For Union of India: ASGI U.M.Aurangabadkar with Adv.Santok Singh Sokhi and Adv. Deshmukh
For Respondents: GP. Ketki Joshi Addl. GP D.P. Thakare and AGP N.S. Rao

For Respondent 4 and 10: Adv. S.M.Puranik and Adv. B.G.Kulkarni, respectively

For MADC:  Adv. C.S.Samundra

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