Bengaluru: Across Bengaluru and Karnataka’s districts, government hospitals tout free medicines as a vital support for the economically vulnerable. However, for countless patients, this assurance crumbles at the dispensary window. Ongoing stockouts, unreliable supply networks, and handouts of soon-to-expire medications compel individuals to seek remedies from private outlets, incurring expenses that deepen debt and hardship. Intended as relief for the impoverished, this system has morphed into an added strain, igniting concerns over equity, cost barriers, and oversight in the state’s public health apparatus.
A swift assessment in 11 districts laid bare the crisis’s magnitude. Activists positioned themselves for merely half an hour near private pharmacies adjacent to public hospitals, conversing with more than 600 patients clutching government-issued prescriptions. Within that brief period, these people expended a collective ₹5 lakh on drugs meant to be complimentary. For families subsisting on ₹10,000 monthly, such outlays are ruinous, compelling agonizing trade-offs between medical needs and essentials like food and shelter.
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The Toll on Chronic Disease Sufferers
The ordeal intensifies for those grappling with long-term ailments. Blood pressure pills, at ₹80 for a 10-tablet strip, demand 30 per month; diabetes drugs run ₹1,200; and thyroid treatments add ₹500, catapulting monthly costs beyond ₹4,000. This economic pressure frequently postpones care when funds fall short. Pushpa, 49, from Bengaluru’s Okalipuram, recounts her hardship: “My husband is a daily wage earner, and I make ₹6,000 as an Anganwadi worker. We spent ₹4,000 on my cardiac meds last month. How do we manage rent and meals? We forgo food or defer utility payments. Some days, I think about quitting the treatment—it’s just too costly.”
Sayeed Jaffer, 69, from Majestic, endures an unyielding battle. Afflicted with heart issues while his wife contends with diabetes and hypertension, he frequents Victoria Hospital every two weeks, often encountering barren shelves. “We fork out ₹5,000 monthly for external purchases. Our sole earnings are ₹800 pensions each, supplemented by ₹500 to 1,000 from our kids. Half vanishes on pills. What’s left for sustenance? How do we endure?” he questions, voice quivering. “Nutritious eats are off the table. Medicines dominate our existence.”
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Issues with Drug Quality and Timely Access
Complaints extend to the subpar quality of supplied items. Ganesh, a 70-year-old managing a non-communicable disease, protests: “They dispense pills expiring in a fortnight. How are we to stretch them a month?” Many describe deferred treatments from inability to buy privately. A woman queued at a Bengaluru drugstore confides: “Lacking cash, I endure two or three days without. My blood pressure and glucose surge—it’s petrifying each instance.”
Pushing for Systemic Change
On August 30, 2025, around 70 community advocates and health campaigners convened with the Director of the Karnataka State Medical Supplies Corporation Limited (KSMSCL), the entity overseeing medicine acquisition and distribution to state-run centers. They relayed these poignant accounts and tendered a memorandum urging immediate overhauls, such as adaptive purchasing, localized delivery, stringent quality assurance, and digital openness in procurement records.
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KSMSCL representatives pledged advancements, including wrapping up bids for over 800 vital drugs and committing to online publication of procurement info. An updated protocol will quarantine stocks pending quality verification, with suppliers mandated to deliver in compact lots to sidestep expiration woes. Nonetheless, for those idling by public dispensaries, these vows seem abstract, as they persist in shouldering monthly fees—via borrowings, meal omissions, or care postponements.
In a related move, the state has shuttered Jan Aushadhi Kendras within government hospital grounds, aiming to bolster the free medicine initiative and prevent reliance on these affordable generic outlets, which officials argue dilute the core promise of no-cost access. Health Minister Dinesh Gundu Rao has defended this, emphasizing it reinforces direct free supply through public channels.
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Diminishing Confidence in the System
“We’re powerless,” Pushpa concedes. “Free meds are deemed a entitlement, yet facilities cite shortages. It’s as if we’re invisible.” Prasanna Saligram of the Drug Action Forum-Karnataka (DAF-K) observes: “Folks are compelled to purchase what’s promised gratis. This transcends finances—it erodes faith in healthcare. For households like Jaffer’s, visits evoke dread of invoices. Some shun treatment. Meds sustain life, yet they impoverish.”
Bridging the Policy-Reality Divide
While dialogues unfold in bureaucratic arenas, the chasm between intent and execution expands. The Chief Minister-directed memorandum advocates efficient sourcing with live monitoring, compulsory batch evaluations, public online revelation of pricing and data (emulating Tamil Nadu), and supplier responsibility via rewards for promptness and sanctions for lags. Absent these enactments, Karnataka’s most destitute will keep footing the bill for an illusory free healthcare vow.
Activists’ Key Demands
The group’s appeals encompass agile procurement and dispersed allocation with instant oversight, robust quality safeguards via required lot inspections, web-based clarity on drug costs and acquisitions per Tamil Nadu’s blueprint, and vendor incentives for timeliness alongside fines for tardiness.
