During his mother’s illness, Ghooi, a pharmacologist, was posted in the capital as a medical adviser to a pharmaceutical company. He gave up trying to get the transport permits and exploited this connection for all it was worth. He even got friends to virtually smuggle in morphine tablets from the United Kingdom. Still, supplies were patchy. Ghooi recalls his mother wondering aloud about the plight of ordinary people who had no such influence. He had also found out that it was not just individuals, but even hospitals and hospices that were struggling to get their licences. He decided to do something about it. In 1998, a little before his mother’s death, Ghooi went to court. In response to his writ petition, the Delhi High Court ordered the government to “expeditiously” dispose off pending licences of doctors and chemists for storing and dispensing morphine and grant more.

“Why is it that the junkies get the drugs, but the patients who need it don’t?” he asks. Ghooi filed a public interest litigation (PIL) in the Supreme Court in February this year. It demands that state governments simplify their cumbersome narcotics laws and licensing procedures to obtain morphine and other opiates for medical use. His co-petitioners include Rajagopal, co-author of the Lancet article, and Poonam Bagai, a cancer survivor who runs a Delhi-based NGO, CanKids...KidsCan, for children with the disease.

They have a strong case. Before the judgement, but after his petition, N.K. Singh, the then revenue secretary in the union government, wrote to states advising them to simplify their laws and establish procedures that allowed recognised institutes to stock and sell morphine. That, theoretically, should have included regional cancer centres such as RIMS.

Singh’s request and the High Court order led to reform in some states such as Kerala. But most did not, including Uttar Pradesh, India’s most populous state. “We don’t get it freely; at times it gets really difficult,” says J.K. Gupta, medical superintendent at the Kamla Nehru Memorial Hospital in Allahabad, also a regional cancer centre. Piyush Gupta, principal executive officer in Lucknow’s Cancer Aids Society, has been conducting workshops to sensitise government agencies on the subject. He says the state’s excise department has resisted suggestions that at least some government hospitals be exempt from needing licences. This department issues various licences for possession, transit and inter-state movement.