District drug stores

To ensure smooth and timely distribution of anti-tuberculosis drugs within the state, store facilities at the district level in all the states are built as per the National TB Elimination Programme (NTEP) guidelines. These facilities under the programme are called District Drug stores (DDS).

DDS is responsible for ensuring an uninterrupted supply of good quality first & second line anti-TB medicines and other supplies to the mapped TB Units (TUs) and Peripheral Health Institutes (PHIs).

Structure and Human Resource

The number of these DDSs within a state would depend upon the population and geography of that particular state.

The human resource requirement at DDS is similar to that of State Drug Store (SDS) and includes:

• 1 Pharmacist cum storekeeper
• 1 Store Assistant (In case monthly Patient-wise Box (PWB) are prepared at DDS)

Functions of NTEP DDS 

1. Receipt of drugs and lab-related logistics at DDS and the subsequent updating of stock records
2. Issue/ dispatch of drugs and logistics to TUs and PHIs
3. Inventory Management (procedure for tracking and replenishment of drug inventory at the DDS and subordinate stocking points within the state)
4. Drug expiry management
5. Physical verification & reconciliation of drug stocks
6. Digitization of NTEP drug and logistic records into Ni-kshay Aushadhi
7. Ensuring space and storage arrangements as per NTEP guidelines
8. Secure custody of anti-TB drugs and logistics
9. Following the guidelines for storage and distribution of first- and second-line anti-TB drugs, paediatric drugs, lab consumables and Nucleic Acid Amplification Test (NAAT) related logistics, etc.
10. Arrangements for transportation of drugs from the DDS to the subordinate stocking units in the district
11. Quality Assurance of anti-TB drugs

Figure: Storage of Supplies in a Store

Infrastructure Required for DDS

• Accessibility: Located on a wide road, providing easy access to transportation vehicles, and facilitating free movement of drugs to and from the store
• Space for staff, equipment, and records: Adequate space for accommodating staff, office equipment (computer, printer, etc.) and store records and registers
• Space required for storing drugs: Depends upon the population to which the store caters, as well as the number of months for which stocks are to be stored 
• Other specifications: One large room with a ceiling height of at least 5 metres, a lockable door, at least one window with grill, proper lighting, and even level concrete floor, plastered walls, and a ceiling with whitewash. The room should not have any kind of seepage in it.
• Storage shelves: Should be made of 40 mm bore mild steel pipes, ensuring sufficient gap between cartons from the ceiling, floor, and walls, facilitating ventilation and free movement of air
• Temperature and humidity regulations: Hydro thermometers should be installed to monitor humidity and temperature regularly. The recommended temperature for storage of drugs is below 25°C and humidity levels are below 60%.
• Power supply: Regular power supply should be available in the DDS. Arrangements for backup power supply should also be made through solar panels or fuel-based power generators.
• Telecommunications: Each DDS should have an independent telephone connection, a computer with internet connectivity, specific email address for communication.

Resources

• Standard Operating Procedure Manual Procurement & Supply Chain Management, Central TB Division, Ministry of Health and Family Welfare; Government of India. 

Assessment