Last summer, L. Jaichand Singh ordered 10,000 morphine tablets — about six months’ worth for cancer patients at Imphal’s Regional Institute of Medical Sciences (RIMS). What should have been a straightforward process, has now taken over a year. Singh, a professor in RIMS’ department of radiotherapy, has chased multiple government departments for licences that will permit him to receive the drug. Rigorous laws govern the stocking, transport and supply of morphine and all other opiates (drugs derived from opium) in India.

“By the time I got the licences, the company’s godown ran out of stock,” says Singh. He now hopes the morphine will arrive by mid-August. What shocks is that Singh’s hospital faces these problems despite being designated a regional cancer treatment centre and receiving funds from the government.

Morphine is endorsed by the World Health Organisation and other international agencies as a safe and effective treatment for severe pain. The International Narcotics Control Board (INCB) accepts that “opiates, and above all, morphine, are indispensable for the treatment of severe pain related to cancer”. It is definitely the cheapest.

Yet, according to the INCB, in 2004, heavily-populated, developing countries like India obtained a mere 6 per cent of the world’s supply of legal morphine. Paradoxically, India is among the world’s top producers of legal opium, which gives morphine. “We export poppy by the truck loads, yet our people are denied it,” says M.R. Rajagopal, a palliative care physician in Thiruvananthapuram, who has co-authored an article about morphine in the British medical journal The Lancet. The INCB attributes this paradox to “unnecessarily strict rules and regulations”, among other things. In a country where rash driving kills nearly 100,000 people annually, many would baulk at a law restricting fast cars or hard liquor. So, why can’t 2.5 million Indian cancer patients get access to an internationally endorsed drug?