Economically weaker sections and underprivileged people of Sandur Taluk fail to benefit from the Janaushadhi stores under the ‘Pradhan Mantri Bharatiya Janaushadhi Pariyojana’ (PMBJP).
By Batchu Rushali
As the day kicks off, Mariamma, a 40-year-old vegetable vendor walks out of her home and sits at her usual place with a basket full of vegetables. After days of hard work at the end of the month, she hardly earns enough to fulfil her needs. But since she sits in the market throughout the day, she is constantly exposed to the dust particles that flow while the heavy trucks pass in front of her. And it has been long now that her pouch of medicines help her fight her heart illness.
Is Mariamma the only one?
Mariamma is not alone. Along with her, several people have no access to the benefits of the Janaushadhi scheme.
People in the Sandur Taluk are continually exposed to mining, which causes diseases such as tuberculosis, asthma, skin irritation, chronic lung diseases, eye irritation or even simple cough regularly, and medicines take half of their income.
The Janaushadhi scheme promotes quality medicines which help in the growth of quality and provide branded medicines at a cheaper price but as it doesn’t reach the people, they avoid the expensive medicines and rely on limited free medicines from the government hospitals.
The Janaushadhi store in the town of Bellary district is not accessible to the people of Sandur Taluk and other villages like Yeshwantnagar, Anakammahal, 55 Mallapur, Kalingere, Bandri, Taranagar and Chornoor due to lack of proper transportation and long-distance. On the other side, the store inside the government hospital provides them with free medicines but that is limited. Once the medicines are over, they have to buy it from the regular stores.
Ravi Kumar from Taranagar is frustrated due to his long medical bills and said, “I earn Rs 10,000 but more than half of my money goes on the medicines for my family. Our total medicine expenditure goes around Rs 5,000 to Rs 6,000 per month because my mother is an asthma patient, I recently got treated for tuberculosis and my children usually suffer from skin irritation and these medicines are not cheap and we have no clue how we will survive through this.”
He added, “While half of my earning goes away for medicines, my family runs on the ration card.”
Kumarswamy, a resident of Chornoor village has been suffering from tuberculosis for one year now and his wife has been facing skin irritation due to dust allergy while his two-year-old son has been suffering from cough twice since last month. He said, “My medical expense for the entire family ranges around Rs 3000 on an average. I have taken a loan from other people to bear the expenses and repay through the money I earn from farming.”
Dr Daya Prasad Kulkarni, a public health specialist and development consultant who also provides free healthcare services to the poor believes that the scheme is yet to reach the people as the stores are set up in selected areas. He said that along with the operation of a store, all the medicines should also be available. The supply of medicines needs to be improved by developing the technology used in the central database.
Dada Saheb, a member of Gram Panchayat in Chornoor said, “The scheme was announced by the government but till now the funds are not allocated and the people are still buying medicines at regular prices.”
Jan Aushadhi scheme, a step towards better healthcare facilities
On September 2015, the ‘Janaushadhi Scheme‘ was revamped as ‘Pradhan Mantri Janaushadhi Yojana’ (PMJAY). In November 2016, to give further impetus to the scheme, it was again renamed as “Pradhan Mantri Bhartiya Janaushadhi Pariyojana” (PMBJP).
Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) is a campaign launched by the Department of Pharmaceuticals to provide quality medicines at affordable prices to the masses. PMBJP stores have been set up to provide generic drugs, which are available at lesser prices but are equivalent in quality and efficacy as expensive branded drugs.
Under the Pradhan Mantri Bhartiya Janaushadhi Kendra (PMBJK) launched by the Department of Pharmaceuticals, Ministry of Chemicals and Fertilizers and Government of India on November 2008, the people in different districts are supposed to get quality generic medicines at affordable prices.
To make generic medicines available to everyone, the Pharma Advisory Forum agreed at its meeting of 23 April 2008 to initiate the Janaushadhi Campaign starting with the selling of generic medicines through dedicated distribution outlets and at least one store will be open in each of the 630 districts of the country to be expanded to sub-divisional levels as well as to major towns and villages.
The Jan Aushadhi stores can be a vital part for the people of Sandur taluk as they can cut on their necessary expenses and get themselves treated.
Like Mariamma, Illamma and Devibai from Shushilnagar are constantly exposed to dust and have been spending on medicine more than their earning as they are suffering from breathing difficulties for a year and more now.
Illamma, who lives in Shushilnagar said the doctors of government hospital give the same medicines to everyone but that doesn’t affect them so they have to visit the private hospitals and when they buy the medicines suggested they are left with nothing.
DeviBai, a resident of Sushilnagar who earns Rs 100 per day stopped taking medicines for her lung issues because she couldn’t afford it after a while. They don’t see any other way of getting medicines other than the pharmacies because the lack of transportation makes it difficult for them to reach the JAS in the town.
Bharat Bhushan, a senior marketing manager of the Bureau of Pharma PSUs of India (BPPI), which is the implementing agency of the Pradhan Mantri Bhartiya Janaushadhi Pariyojana asserted that they are planning and initiating the opening of new stores. He said that the organisation aims to provide generic medicines at an affordable price to alleviate the lack of proper health care facilities.
Is Janaushadhi store necessary?
However, the National Sample Survey Office survey on healthcare, 2014 shows that medicines are a crucial section in total health expenses- 72 per cent in rural areas and 68 per cent in urban areas.
PMBJP has resulted in 50 to 90 per cent savings to patients in the area of healthcare by selling generic medicines through its PMBJP Kendras across the country. For example, the average market price of Amlodipine 5 mg, a medicine for hypertension, and 10 tablets is Rs 23 but the medicine price in a Jan Aushadhi store is Rs 4. Cetrizine 10 mg 10 Tablets is Rs. 15.30 while the PMBJP’s price of Cetrizine 10 mg 10 Tablets is Rs. 1.84 and Clopidogrel 75 mg, a medicine for reducing the risk of heart disease and stroke, 10 tablets are Rs 45 but it is Rs 7 in a Jan Aushadhi store.
Though the Janaushadhi stores are limited and distant from the people, the product Basket of the scheme now covers more than 800 medicines and 154 surgical and consumables in all major therapeutic categories such as anti-infective, anti-allergic, anti-diabetic, cardiovascular, anti-cancer, gastro-intestinal medicines and more.
The Janaushadhi scheme was introduced for the benefit of the people and to alleviate the plight of patients who have been draining their salary behind expensive medicines, but it remains a distant dream for a lot of people.
For the people in Sandur, even a penny counts.
Guruswamy, a native of Taranagar, has already visited the government hospital in Sandur three times, but his heart condition remains constant. For future observation, he was asked to attend a private hospital in the area. He said, “The medicine charges were around Rs 3,000 for two months along with the treatment cost which was around Rs 8,000 and I have no one to bear my medical costs.”
M Sattar Sav, a tailor from Vaddu is agitated by his monthly expense of medicine but is left with no option. He believes that because the government hospital is far from the village they choose not to be treated. But on the other side, the treatment and medicines in the nearest private hospital ‘Sanjeevani’ gets expensive. Their worries have forced them to ignore their illnesses. His wife has been constantly coughing for three months now, and all they are doing is spending a huge amount of money only to witness no change in her health.
Enakkamma, a resident of Kamthur, had to spend Rs 10,000 on medicines and treatment when she went to the private hospital of Bellary.
The shop owners of the Janaushadhi store in Bellary informed that people are quite sceptical about the efficiency of the medicine but they fail to understand that it is equally effective yet cheaper than the medicines available in generic stores.
Sreenath, the shop owner of the Janaushadhi store in the town said, “The people in the villages of the Bellary district are not even aware of the scheme. They are doubtful about the quality of the medicines since it’s cheaper than the market price and the medicines don’t have the name on it except the composition is same. That’s why they don’t prefer travelling so far to buy the medicines from here.”
Dr Kulkarni believes that questioning the effectiveness of the medicines is easy since it is cheaper than what is available in the market. But he believes that the medicines are effective and he said, “If they are abiding by the proper manufacturing practices and are carrying out bio-reliability studies, then they should be at par.”
“If the regulatory mechanisms are followed then there is no chance of failure. Though the medicines are efficient, it is the pharma lobby which is distorting the reputation of the medicines. ”
Shivanna, the senior pharmacist of the Sandur government hospital said, “We don’t have any contact with the store and the medicines don’t reach to any of the hospitals of stores in the entire taluk.”
Under PMBJP, the target of the opening of 3,000 PMBJP Kendras across the country was achieved on December 8, 2017, and by November 15, 2018, 4,410 PMBJP Kendras are functional in 35 States/Union Territories of the country.
Dr Ramshetty, Chief Medical Officer asserted that they are still under the process of having a Janaushadhi store in the taluk.
He said, “The government has planned for a store near the government hospital in Sandur but till now we don’t have any so people depend on the medicines they get from the hospital or they have to get it from a store outside.”
And along with Mariamma, thousands of people from Sandur taluk wake up with a hope that someday, buying the medicines won’t be as painful as it is now. And maybe someday they would be able to afford the medicines without compromising on their necessities.