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HC says Centre, Delhi must take call on priority among black fungus patients

The court took note of Delhi government’s decision to distribute the drug on a pro rata basis among hospitals and leaving the decision to doctors.

THE DELHI High Court on Monday said the Centre and Delhi government need to come out with a policy on distribution of anti-fungal drug Amphotericin-B, which is being used to treat patients who contracted black fungus, and decide the category of patients who can be excluded from the distribution chain on account of shortage of the drug.

“We say that we believe in ‘Vasudhaiva Kutumbakam’, that we all are one family. Now in one family let’s say there are two people who need the same medicine which is in short supply. There is an 80-year-old and there is a 35-year-old. What will the decision of the family be if there is only dose available. Who will you chose. It is not easy decision to take but this is a bullet you have to take,” said the division bench of Justices Vipin Sanghi and Jasmeet Singh.

The court took note of Delhi government’s decision to distribute the drug on a pro rata basis among hospitals and leaving the decision to doctors. “That is completely unacceptable. You are just pushing off your responsibility as a state to take that decision. You must come out with a policy,” added the court.

It said the authorities, including the Centre, will have to say that as a matter of policy, unless it is available in sufficient quantity, it will not be given to a certain category of people. “You will have to exclude. If we have to make that cruel choice, we have to make it. We are faced with that situation. We will have to cross this bridge. Will you give it to the 80-year-old or will you give it to the 35-year-old who has two children to support,” added the bench.

The court said the Centre will have to make a list of priority. “The allocation is being made by you from the central pool. Your allocation has to be on the basis of priority. Medically, if you require six vials to be able to beat the fungus, you cannot say make do with two… never mind if you lose the eye… that cannot be the attitude,” it added.

It said that the decision can be taken only by the political leadership in consultation with medical experts. “You have to take this. How can you leave it to the doctor on ground to say that this hospital has five patients and have given them 10 vials, now he should decide whom to give six vials. You lay down the policy. Why do you leave it to that doctor? He will be lynched in the hospital by the other four,” the court said further.
The government counsel said they would seek instructions. The court will hear the matter on Tuesday.

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