Stern action must be taken against erring doctors and other health professionals at a government hospital in Krishnarajapuram in Bengaluru where medicines that are well past their expiry date were being dispensed to patients. This was discovered when Bengaluru Urban Deputy Commissioner B M Vijay Shankar went to the hospital on a surprise visit. Not only was the doctor missing from duty, but also medicines, including antibiotics like azithromycin tablets, that were past the sell-by date were being handed out to patients. The hospital’s pharmacy was stocked with expired medicines, some of them life-saving drugs and amoxicillin oral suspension drops for paediatric use. The hospital did not have a register of the medicines stocked. Expired medicines are ineffective. Especially in the case of antibiotics, they fail to arrest the spread of infection and worsening of the patient’s health. Severely infected wounds and serious injuries that are not treated swiftly and with the potent antibiotics could lead to gangrene, even resulting in patients losing a limb or a toe. The state of affairs at the government hospital in Krishnarajapuram is not unusual. Several such cases have come to light from time to time. It is important that health authorities conduct surprise checks on hospitals, whether private or run by the government, in urban and rural areas.
According to recent studies, the expiry date on medicine bottles does not mean that the tablets are ineffective from the specified date onwards. That is, the expiry date doesn’t really indicate a point at which it is no longer effective. Rather the potency of the drug begins to decline. Its effectiveness begins to wear off. The medicine can be used even some months after expiry, but it will be less effective after the use-by date. What makes the discovery of expired medicines at the Krishnarajapuram hospital alarming is that several of the medicines were 4-5 years past the expiry date.
The sale of expired medicines in hospitals and health centres lays bare our rather insensitive and dismissive attitude to the health of the poor. Those who go for treatment to government hospitals are from the weaker sections of society. Providing them with less effective medicines is unconscionable. Do pharmacists and doctors consider their lives to be less valuable than their own? The authorities must take public health more seriously. Regular inspections of drug supplies at medical stores as well as hospital pharmacies are necessary. The monsoon months are likely to see the outbreak of several epidemics. Health authorities cannot claim preparedness when the drugs they stock are not the most effective.