Explainer: bortion pills on the black market a major challenge for Health Dept

WITH the seizure of 5,805 medical termination of pregnancy (MTP) kits in Kaithal, the Health Department, Food and Drugs Administration (FDA), and the Haryana State Narcotics Control Bureau (HSNCB) have jointly exposed deep-rooted irregularities in the supply chain of abortion medication. A large quantity of these kits was allegedly stocked in Kaithal to facilitate illegal sex-selective abortions, an issue for which Haryana was infamous. The widespread availability of such kits in the open market without a regulated supply chain also poses a major challenge to the Prime Minister’s Beti Bachao, Beti Padhao campaign, which was launched from Panipat, Haryana, on January 22, 2015. This is not the first case in the state. Earlier, on Tuesday, three more cases were reported –one each in Hisar, Sonepat and Faridabad, in which supply and sale of MTP kits were involved.

What is an MTP kit?

An MTP kit is a combination of one mifepristone (200 mg) tablet and four misoprostol (200 mcg) tablets. These medications are used to medically terminate pregnancies up to 8–10 weeks. As per law, the MTP kits are allowed only under the supervision of registered gynaecologists and within centres approved by the Health Department. Selling these kits without a prescription from a registered doctor is illegal under the MTP Act. Distributors must maintain records of the prescribing doctor or healthcare institution. The kits cannot be sold by wholesalers or clearing and forwarding (C&F) agents to retail chemists.

 Why is the illegal sale of such kits a serious concern?

The illegal sale of MTP kits is a significant concern for the Health Department because it can be used to terminate pregnancies without proper medical supervision. This may include attempts to avoid unwanted pregnancies or for sex-selective abortions. The misuse of these kits can result in severe complications, including excessive bleeding, hormonal imbalance, infections and even death.

What are the penalties under MTP Act?

The unauthorised sale or use of the MTP kits violates the MTP Act. The penalties can vary depending on the nature and severity of the offence, and may include imprisonment for up to seven years and a fine. The Act mandates that only registered medical practitioners may carry out the MTP procedures in approved facilities.

Why does the department view the involvement of a medical representative in nexus as a serious issue?

As per Dr Gaurav Punia, Nodal Officer, PC-PNDT, Kaithal, the accused, Vikas Bansal, is a medical representative. The authorities recovered 5,805 MTP kits of different manufacturers from his residence. As many as 5,745 kits were sealed and seized, while 60 were taken for sampling. He says when a trained medical professional is involved in such illegal activities, it becomes even harder to uncover the entire network. The medical representatives often have close ties with the doctors and make these kits readily available to them.

Is this the first such major case in Kaithal?

No, earlier on November 23, 2021, over 300 MTP kits were recovered from Dhand village in Kaithal district. In that case, two people were arrested and later charged under Sections 3, 4, and 5 of the MTP Act by a Kaithal court.

Where did the MTP kits come from?

Preliminary findings suggest that the accused procured the kits from a person in Karnal, who is currently absconding. The authorities will verify the batch numbers and check whether the boxes were genuine or counterfeit, and whether they were officially released from a manufacturing unit in Haridwar. An FIR has been registered under the MTP Act, and further investigation is being carried out by the FDA under the Drugs and Cosmetics Act.

How many registered MTP centres are there in Haryana?

In addition to government facilities, there are around 1,200 registered MTP centres across Haryana. Despite this, many persons seek illegal abortions from unqualified or unregistered practitioners using MTP kits acquired outside the authorised supply chain.

What other challenges does the department face?

Officials acknowledge that, apart from bulk illegal supply, MTP kits are also readily available through online platforms. In a previous operation on April 15, 2021, the Kaithal Health Department successfully blocked the sale of such kits on a major e-commerce platform. Many of these kits were being sourced from Goa, Bihar, Uttar Pradesh, Odisha and other states and sold for Rs 500 to Rs 1,500 each.

What steps are being taken to prevent such incidents?

The Health Department takes steps to raise awareness about legal, safe and hygienic pregnancy termination practices. Registered institutions have been directed to maintain the confidentiality of women seeking abortions. The violation of privacy under Section 5(A) of the MTP Act is punishable by up to one year of imprisonment and a fine.