Medicine Shortages, Administrative Failure

The J&K and Ladakh High Court's latest directive, summoning the Managing Director of the J&K Medical Supply Corporation Limited to explain the non-supply of Factor VIII and Emicizumab personally, ought to have felt like a decisive moment. Instead, it feels wearily familiar. This is not the first time the court has intervened. It is not even the second. Haemophilia patients across the Union Territory have watched this case wind through hearing after hearing, order after order, while the medicines they need to survive remain, more often than not, unavailable.

What makes this crisis particularly indefensible is the existence, on paper, of a robust system designed to prevent exactly this outcome. J&K operates a centralised procurement model precisely so that medicines and medical equipment can be bought in bulk at uniform, reasonable prices, with quality assured through a structured tendering process. JKMSCL exists as the single agency entrusted with this responsibility. The logic of centralisation is sound: it should mean better bargaining power, consistent standards, and predictable supply chains. However, the practical experience of patients at Government Medical College Srinagar and GMC Jammu reveals a different reality - one of chronic, recurring shortages that no amount of policy architecture seems able to resolve.

Haemophilia is not an ordinary condition. It is a rare bleeding disorder in which patients require immediate clotting-factor replacement the moment a bleed occurs; hours, not weeks, determine whether a joint is saved or permanently damaged, and in severe cases, whether a patient lives. Compounding the tragedy is the fact that these medicines are not freely available over the counter or through private pharmacies in adequate quantities. When the Centralised Government channel fails, there is often no realistic alternative for ordinary families, particularly the poor, who cannot afford to import expensive medicines from outside the Union Territory.

So where, precisely, is the breakdown occurring? Logically, there are only a handful of plausible explanations. The first - that the drug is simply unavailable anywhere in the country - does not hold, since other States and Central institutions continue to procure and dispense these very medicines without comparable disruption. That leaves the more troubling possibility: JKMSCL itself is unable to procure. This could stem from financial backlogs, where outstanding dues to suppliers have led to a refusal of fresh consignments, or from previously blacklisted vendors leaving a procurement vacuum that nobody has swiftly moved to fill with alternatives. If the delay is genuinely rooted in the sluggishness of tendering procedures, then interim solutions already exist and are used elsewhere: sourcing medicines at rate contracts negotiated by AIIMS or through supply arrangements available to neighbouring states and Central Government Departments. These are not exotic remedies. They are standard administrative workarounds, and their absence here suggests not a lack of options but a lack of will.

That, ultimately, is the heart of the matter. Where there is a will, there is a way - yet in this case, patients continue to suffer while the corporation offers explanations rather than solutions. Another date has now been fixed, and the Managing Director has been asked to appear in person. One hopes, as one has hoped after every previous hearing, that this will finally settle the matter and ensure timely, uninterrupted supply. It bears repeating that courts exist to interpret and enforce the law, not to run hospitals or manage supply chains. The Government and its administrative machinery must recognise that this responsibility is theirs alone and that outsourcing it, in effect, to the judiciary is itself an admission of failure. What is needed now is not another affidavit or another compliance report, but a genuine audit of JKMSCL's procurement failures, fixed accountability for the officials responsible, and a real-time inventory and alert system that flags shortages before they become emergencies rather than after patients have already suffered. The lives of Haemophilia patients in Jammu and Kashmir cannot remain hostage to the whims, delays, and internal dysfunctions of a Medical Supplies Department. The sooner this is understood at the highest levels of Government, the fewer patients will have to bleed.