Bangladesh markets running out of IV saline

Amid rising dengue cases, government hospital authorities in Dhaka have downplayed the crisis. Private hospitals and pharmacies in and outside the capital, however, have reported a serious dearth of saline.



September 21, 2023

DHAKA – Abdur Rob, from Khulna’s Rupsha, started a frantic search for intravenous (IV) saline after his daughter, aged 13, was admitted to a local private hospital with dengue on Monday.

He did not find even a single bag of the saline, which is essential in dengue treatment, at the hospital’s drug store and 14-15 large medicine shops in a wholesale medicine market in the southern city for two days. The desperate father then approached a middleman.

“The broker managed a one-litre saline bag for Tk 210. I tipped him Tk 30,” Rob told The Daily Star.

Amid rising dengue cases, a similar shortage of IV saline has been affecting patients in different districts of Dhaka, Chattogram, Rajshahi, Barishal, Mymensingh, Rangpur and Sylhet divisions. Retail prices have also gone up from Tk 85-89 to Tk 150-300 in different districts, including Dhaka.

Four salespersons of as many drug stores in the capital’s Shahbagh said the demand for IV saline has skyrocketed, but supplies from manufacturing companies are inadequate.

“If we place an order for 100 bags, supplying companies provide 20-30 bags. We are buying saline from other sources and wholesale medicine market at Mitford at higher prices.”

— Dr MH Choudhury Lelin

In Chattogram, some medicine shops were receiving up to 10 percent of their orders, while it is as low as 5 percent in Barishal in some cases, our correspondents report.

However, government hospital authorities in Dhaka downplayed the crisis.

Ashraful Alam, assistant director at Dhaka Medical College Hospital, said demands for IV saline has increased greatly. But so far, they have been able to meet the demand.

But private hospitals and pharmacies in and outside the capital have reported serious dearth of saline, which helps maintain the fluid balance in the body.

Public health expert Dr MH Choudhury Lelin, also chairman of Health and Hope Hospital in the capital, said the hospital has been facing a severe crisis of the item due to supply shortages.

“If we place an order for 100 bags, suppliers provide only 20-30 bags. We are buying saline from the wholesale medicine market at Mitford and other sources at higher prices,” he said.

The demand-supply gap has been affecting other patients as well.

Naseema Akhtar of Narayanganj has cancer. Doctors at Narayanganj General Hospital where she is being treated advised that she be injected two litres of saline every day. On Tuesday, Naseema’s son Al Amin said he could not find any saline bag even after visiting 10-12 drug stores.

Md Nurul Alam, deputy director of Directorate General of Drug Administration, acknowledged the crisis, but blamed it on the syndicates of hoarders.

The situation did not improve even after the drug administration recently asked the six drug companies to increase saline production. Against this backdrop, the government has decided to import 2 million bags of IV saline, officials said.

Prof Ehsanul Kabir, managing director & CEO, Essential Drugs Company Limited, which supplies saline to government hospitals, said his company placed an order to import 7 lakh bags of saline from India. They received 70,000 bags until Tuesday.

“They should be available in retail drug stores in Dhaka and elsewhere in a week,” he told The Daily Star yesterday.

He said the local companies have reached their limit amid the rising demand. “This is why we have been instructed to import.”

Khairul Bashar, assistant vice-president of Orion Infusion Ltd, one of the six local producers of IV saline, said the firm increased its daily production by up to 1.7 lakh bags.

“But the demand has increased so significantly that we can meet only 90 percent of the demand,” he told The Daily Star yesterday.

“If the government imports saline, we will increase supply to retail shops. Government hospitals currently procure 60 percent of our total production,” he added.

The five other saline producers are Beximco, Libra, Opsonin, Popular and ACME.

Meanwhile, the Cabinet Committee on Economic Affairs yesterday approved a direct procurement proposal to buy 1.2 million bags of sodium chloride and 800,000 bags of glucose saline.

Among the 11 types of injectable saline, sodium chloride solution is the one most commonly used.

Prof Ahmedul Kabir, additional director general (planning and development) at the Directorate General of Health Services, said civil surgeons and divisional directors have been instructed to check market manipulations by unscrupulous traders.

The country has seen a huge surge in demand for injectable saline due to the soaring number of dengue patients across the country over the past few months. The mosquito-borne disease has so far claimed at least 867 lives and infected 1,76,810 so far this year, making this the deadliest year since the disease was first reported in Bangladesh in 2000.

(Our district correspondents from Chattogram, Barishal, Rajshahi, Mymensingh, Rangpur, Khulna, Noakhali and Narayanganj contributed to the report.)

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