State drug stores

Each state needs to have one fully operational State Drug Store (SDS) for every 5 crores of population.

In larger states/ difficult terrain, more than one SDS can be established as per National Tuberculosis (TB) Elimination Program (NTEP) guidelines.

It is responsible for effective management of medicines and other logistics and ensuring an uninterrupted supply of good quality 1st & 2nd line anti-TB medicines for adult and paediatric patients.

Structure and Human Resource

In most states, NTEP SDS is part of the state TB cell. However, few states have more than one SDS.

The SDS Pharmacist under the overall guidance of the State TB Officer (STO) is responsible for procurement and supply chain management activities at the state/ SDS level.

Available human resources at SDS include:

• 1 Pharmacist cum Storekeeper
• 1 Store Assistant (additional post if >1800 second-line monthly boxes preparation per month)

Functions of NTEP SDS 

1. Receipt of drugs and lab-related logistics at SDS and the subsequent updating of stock records
2. Issue/ dispatch of drugs and logistics to District Drug Stores (DDS)
3. Inventory Management (procedures for tracking and replenishment of drug inventory at the SDS and subordinate stocking points within the state)
4. Drug expiry management
5. Physical verification & reconciliation of drug stocks
6. Digitisation of NTEP drug and logistic records into Ni-kshay Aushadi and monitoring of the performance of DDS, TB units and other health units
7. Ensure space & storage arrangements as per NTEP guidelines
8. Secure custody of anti-TB drugs and logistic
9. Follow 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 SDS to various stocking units in the State
11. Reconstitution of second-line anti-TB drugs, especially new drugs like Bedaquiline
12. Quality Assurance of anti-TB drugs.

Figure: State Drug Store; Source: Tamilnadu Medical Services Corporation Limited Web Portal.

Infrastructure Required for SDS

• 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 SDS. Arrangements for backup power supply should also be made through solar panels or fuel-based power generators.
• Telecommunications: Each SDS 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, 2018.
• Standard Operating Procedures Manual for State Drug Stores, Central TB Division, MoHFW, GoI, 2012.

Assessment