India’s falling maternal mortality has been commended globally—though it must nearly halve from the current 130 by 2030 for India to realise the Sustainable Development Goal on this, the effort India has made is indeed praiseworthy. It is, thus, difficult to see why the government would move to curb production of oxytocin, a hormone that is used during delivery to reduce maternal mortality, without having ensured that supply to hospitals doesn’t come under pressure. Oxytocin is also abused—injecting milch animals, such as cows, to increase milk production is the most common form of abuse; vegetables and fruit, too, are injected with the substance for them to become plumper. Worse, it is also used in illegal and unsafe abortions—it induces labour—and to force premature puberty in trafficked girls. In view of this, the government has banned all production of oxytocin other than by the public sector Karnataka Antibiotics and Pharmaceuticals Ltd (KAPL). KAPL alone can supply oxytocin to registered public and private sector hospitals from September.
While KAPL has, according to a couple of news reports, assured that it can produce well over the volume needed medically, bodies of medicos say this will be tested only when the PSU starts distribution. If there is a shortage eventually, it would leave rural healthcare, that bears the brunt of shortages, especially vulnerable. Women in rural areas benefit from institutional deliveries, but given the shortage of high quality public healthcare infrastructure in most states, as well as other problems of accessibility, many end up delivering at home. The restrictions on sale make such deliveries even more fraught. A better way of controlling oxytocin abuse would have perhaps been to link sale to verifiable patient details, leading to a system of tracking. The least the government could have done is to spread the production burden by allowing some private manufacturers to continue manufacturing. Also, the curbs will prove futile if the public sector/registered private hospitals themselves become channels for illegal oxytocin trade.