Supply chain disrupted

• Restocking delayed due to travel restrictions
• MSD admits to shortage of several pharmaceuticals

By Sarah Hannan A shortage of some pharmaceuticals has come to light, with consumers also complaining that they are unable to purchase medication even from the private sector. The Government Medical Officers’ Association (GMOA) has on several occasions in the past few weeks also pointed to a shortage of certain essential pharmaceuticals. It seems panic buying has affected the pharmaceutical industry as well, since most government clinics shut its doors to patients after curfew was imposed. On the instructions of the Ministry of Health, hospitals dispatched enough prescription medicine to last two months, for persons routinely medicated. While many who could afford to were able to stock up on their medicines, some had to make do with medicine supplies sufficient for just a week. Persons prescribed medication for non-communicable diseases (NCDs) and cancer treatment experienced a supply shortage pertaining to some of their medication over the past weeks. With travel restricted, many were unable to obtain certain antibiotics and other necessary medicines prescribed. The Sunday Morning spoke to state and private entities to find out whether this issue has been resolved. “Pharmacies would have run out of their inventory as people were excessively purchasing their prescription drugs to last a period of two months once the curfew was imposed. This would have created an unexpected stock shortage. However, there is no visible shortage of pharmaceuticals in the country at the moment,” Sri Lanka Chamber of the Pharmaceutical Industry (SLCPI) President Kasturi Chellaraja Wilson explained. Suppliers had not said that they have insufficient stocks, but as a result of border restrictions, they would have delays in restocking their inventory. Furthermore, Wilson assured that the international suppliers have continued to supply the necessary medicines to Sri Lanka as required and as importers, they have not faced any issues so far. Manufacturers might face shortages in sourcing active pharmaceutical ingredients (APIs) during this period due to border closures and would see delays in their manufacturing processes. Even so, Sri Lanka will not necessarily face a price increase in essential drugs as most of the imported pharmaceuticals are price controlled. The last price adjustment was in May 2019, and the next one was due on 1 May this year. Therefore, there is no price adjustment due to currency devaluations. The Government usually sets the rate for price control purposes when purchasing pharmaceuticals; last year, the rate for tenders was Rs. 178. The Government should have adjusted it on 1 May this year and devalued the currency by about 18%, to match with the rupee depreciation, stated Wilson. She shared that this would have been a policy decision; it could impact imports if the suppliers refuse to release stocks going forward. “In such a situation, local manufacturers will be asked to adjust pricing which will result in the consumer having to pay high prices for essential medicines. In the worst-case situation, the medicines will come through illegal channels and consumers will have to pay exorbitant amounts to obtain medication,” Wilson opined. Local manufacturers an option Since Sri Lanka’s pharmaceutical manufacturing industry is yet to improve its research facilities and employ scientists for the task, 80% of the country’s pharmaceutical requirement has to be fulfilled through imports. The State Pharmaceuticals Manufacture Corporation (SPMC) is only capable of producing 12-15% of the requirement. Wilson suggested that the State Pharmaceuticals Corporation (SPC) should look at sourcing through local manufacturers. “There isn’t going to be a shortage in the private market, but the state sector might face a shortage as they have defaulted and not paid for the stocks that were purchased. Mismanagement of their procurement process is to be blamed, as they should focus on sourcing from local manufacturers as much as possible. However, local manufacturers at the moment are facing issues in sourcing APIs as they mainly rely on China, which in return has affected their production.” With the border restrictions being somewhat relaxed, allowing essential goods to be transported, this issue should clear up, Wilson believes. Medical Supplies Division (MSD) Director Dr. Kapila Wickramanayake, meanwhile, admitted that the there was a short supply of certain brands. However, with the alternative brands that are available, the shortage can be tackled. “For the moment, we can manage with the available stocks. However, if the travel restriction continues and we fail to import the necessary stocks, there will be a shortage.” With the airports and seaports opening routes for the movement of essential goods, over the last two weeks, Sri Lanka received much-awaited shipments of medical supplies and pharmaceuticals. The SPC informed The Sunday Morning that 480 varieties of medicines have been ordered and once the shipments arrive, the country will have pharmaceutical supplies that would be enough for a six-month period. “Out of the 310 essential drugs, we have received 300 varieties of drugs that were required; anaesthetics, non-communicable disease medication, antibiotics, and medication for respiratory disease. Considering the health threat imposed by the Covid-19 pandemic, we have taken measures to order sufficient stocks,” SPC Chairman Dr. Prasanna Gunasena said. Procurement lapses When The Sunday Morning inquired from Ministry of Health and Indigenous Medical Services Secretary Bhadrani Jayawardena the reason behind the somewhat frequent occurrence of drug shortages, she said: “Shortages in medicines and medical supplies do not take place suddenly. The public needs to understand that there is a procurement process involved. The Ministry calls for tenders in the middle of the year and interested suppliers are allowed to bid and the supplier that gets awarded the tender has to then supply the medicines or medical instruments for the whole of the following year.” According to Jayawardena, there has been a lapse in the procurement process, and delays that are caused during the process are reflected in the ability to purchase the necessary pharmaceuticals on time. In 2019 alone, the MSD and SPC had spent Rs. 20 billion over the allocated budget to purchase medicines. She further stated that the procurement process is to be streamlined by the present Government with the assistance of the relevant institutions, to avoid incurring losses and drug shortages in the future. All attempts to contact the GMOA proved futile.