Executive Summary:
The Ministry of Health and Family Welfare addresses concerns regarding the availability of insulin under the Free Drugs Service Initiative (FDSI) and the Essential Medicines List (EML). Financial support is provided to States/UTs under the National Health Mission (NHM) for essential medicines. The Ministry monitors and supports states in maintaining adequate stock levels, while States have the flexibility to enhance their drug lists and procurement processes.
Key Points / Main Content:
* **Free Drugs Service Initiative (FDSI) and Essential Medicines List (EML):**
* Financial support is provided to States/UTs under NHM for free essential medicines based on their Programme Implementation Plans (PIPs).
* The Ministry recommends facility-wise Essential Drugs Lists (EDL), with flexibility for States to add more medicines.
* Recommended medicine numbers: District Hospital (DH) - 381, Sub-District Hospital (SDH) - 318, Community Health Centre (CHC) - 300, Ayushman Arogya Mandir Primary Health Centre (AAMPHC) - 172, Ayushman Arogya Mandir Sub Centre - 106.
* Specific insulins for paediatric and adolescent patients are included in the EML.
* **Availability and Monitoring:**
* Drug availability depends on State-level procurement systems.
* The Ministry monitors and supports States in maintaining adequate stock levels.
* A multilayered monitoring approach is adopted to identify gaps in procurement, supply chain, and stock management.
* **Strengthening the FDSI:**
* Financial support is provided to States under NHM for drug procurement, warehousing, and supply chain systems.
* Guidelines have been issued for States to maintain buffer stocks and strengthen last-mile delivery.
* States can include glucometers, insulin pumps, and related consumables under extended essential drug lists or other health programs.
* Digital platforms like Drugs and Vaccine Distribution Management System (DVDMS) are used to track procurement, consumption, and replenishment.
* The Government conducts reviews, issues advisories, and supports infrastructure development for drug warehouses and logistics.
* **Incident in Uttar Pradesh:**
* The State Government of Uttar Pradesh has no knowledge of a video related to an individual committing suicide due to the unavailability of insulin for their diabetic daughter.
Impact Analysis:
* **States/Union Territories:**
* Impact: Receive financial support for essential medicines, have flexibility in procurement, and are monitored for stock levels.
* Action Required: Develop and implement Programme Implementation Plans (PIPs), maintain adequate stock levels, consider including additional items in essential drug lists, and utilize digital platforms for tracking.
* **Public Health Facilities:**
* Impact: Expected to provide free essential medicines as per the EDL.
* Action Required: Ensure the availability of recommended medicines, manage stock effectively, and implement last-mile delivery systems.
* **Patients (particularly juvenile Type 1 diabetes patients):**
* Impact: Aims to improve access to essential medicines like insulin.
* Action Required: Utilize available services and report any inconsistencies in the availability of essential medicines to relevant authorities.
Key Entities Referenced
Ministry of Health and Family Welfare: The Indian government ministry responsible for health policy.
National Health Mission: A centrally sponsored scheme of the Indian government to improve healthcare delivery.
Essential Medicines List: A list of medications that meet the priority health care needs of a population.
Uttar Pradesh: A state in Northern India, mentioned in the context of a reported suicide due to unavailability of insulin.
Free Drugs Service Initiative: A government initiative under the National Health Mission to provide free essential medicines in public health facilities.
SHRI RAJABHAU PARAG PRAKASH WAJE: Member of Parliament who raised the question about the availability of insulin.
SHRIPRATAPRAO JADHAV: The Minister of State in the Ministry of Health and Family Welfare who answered the question.
Drugs and Vaccine Distribution Management System: A digital platform used to track procurement, consumption, and replenishment of drugs and vaccines.
GOVERNMENT OFINDIA
MINISTRYOFHEALTH AND FAMILYWELFARE
DEPARTMENT OFHEALTH AND FAMILYWELFARE
LOK SABHA
UNSTARREDQUESTION NO. 2264
TO BE ANSWERED ON1st AUGUST,2025
FREE DRUGS SERVICE INITIATIVE
2264. SHRI RAJABHAU PARAG PRAKASH WAJE:
Will the Ministerof HEALTH AND FAMILYWELFAREbe pleased tostate:
(a) whether the Government has taken cognizance of fact that despite the Free Drugs
Service Initiative under National Health Mission and the Essential Medicines List
(EML), insulin for juvenile Type-1 diabetes patients is not consistently available in
manyGovernment hospitals andif so, the detailsthereof;
(b) whether the Government has taken note of the tragic incident in Uttar Pradesh
where a man died by suicide after recording a video stating he could not afford
insulin for hisdiabeticdaughter andif so, the detailsthereof;
(c) the steps taken/proposed to be taken by the Government to strengthen
implementation of Free Drugs Service Initiative so that free insulin, glucometers,
insulin pumpsandrelatedconsumables reachpoor andneedypatientsasenvisaged;
(d) whether there is any plan to review gaps in State-level procurement, stock
monitoringanddeliverymechanisms; and
(e) if so, the details thereof and the timeline for ensuring reliable supply across all
public healthfacilities?
ANSWER
THE MINISTER OFSTATE IN THE MINISTRYOFHEALTH & FAMILY
WELFARE
(SHRIPRATAPRAO JADHAV)
(a) to (e): Under NHM, financial support is provided to States / UTs for provision of
free essential medicines in public health facilities based on the requirements posed
by States/UTs in their Programme Implementation Plans (PIPs) within their overall
resource envelope. Ministry has recommended facility wise Essential Drugs List
(EDL) tobe made available at the public healthcare facilitiesin the countryto ensure
widespread access toessential medicines. The numberof medicines recommended at
variousfacilitiesare givenbelow.However States have the flexibilitytoaddmore.
Sr. Name of No. of essential
No. Facility Medicine
1 DH 381
2 SDH 318
3 CHC 3004 AAM-PHC 172
5 AAM-Sub 106
Centre
The following insulins essential for paediatric and adolescent patients’ glycaemic
control are includedin the Essential Medicine List:
Insulin (Soluble)Injection 40IU/ml2
Insulin LenteBasal
InjectionInsulin Rapid
InjectionInsulin Mixtard
PremixInsulin 30:70Injection (Regular: NPH)
PremixInsulin 30:70Injection 40 IU/ml3
The availability of these drugs depends on State-level procurement systems, and the
Ministry continues to monitor and support States in maintaining adequate stock
levels.
Regardingthe reportsof anindividual committingsuicide due tothe unavailability of
insulin for their diabetic daughter's treatment, the State Government of Uttar Pradesh
hasinformedthattheyhave novideorelatedtosuch anincidentintheirknowledge.
To strengthen Free Drugs Service Initiative (FDSI) and improve access to essential
medicineslike insulin, the Government has:
Provided financial support to States under NHM for drug procurement,
warehousing, andsupply chainsystems.
Issued guidelines for States to maintain buffer stocks and strengthen last-mile
delivery.
States have the flexibility to include glucometers, insulin pumps, and related
consumables under their own extended essential drug lists or through other health
programmes such as non-communicable disease (NCD) initiatives or relevant State-
sponsored schemes.
The Ministry has adopted a multi-layered monitoring approach to identify and
address gaps in procurement, supply chain, and stock management. Many States
have adopted digital platforms like Drugs and Vaccine Distribution Management
System (DVDMS) to track procurement, consumption, and replenishment. The
Government conducts reviews, issues advisories, and supports infrastructure
developmentfor drug warehouses andlogistics.
*****