The Ministry of Health is preparing a new regulatory process to vet medicine and pharmaceuticals in the face of mounting pressure and fall out from the human intravenous immunoglobulin (IVIG) import scam, it is learnt. While state institutions and the Government have in the past used the term reforms and pledged to formulate new regulatory mechanisms, post incident, few such promises have materialised. Given the state of the public health system, let us hope that this claim is not just another smoke screen and tangible efforts are genuinely made to improve accountability, transparency and mitigate corruption, in this most noble field of looking after those who are unwell.

The outpouring of public anguish over the last year about medicine supply, purchase, and the corruption involved with the pharma industry, and the use of substandard medicines by the National Health Service has been monumental. The IVIG scandal is not the first medicine procurement scandal and is unlikely to be the last. The scandal has cast a dark shadow on the National Medicines Regulatory Authority (NMRA), the State Pharmaceutical Corporation (SPC) and the Medical Supplies Division (MSD), and the Ministry of Health. For decades Sri Lankans have faced one health procurement scandal after the other, but few have been held accountable for the “pharma mafia” and the “medicines mafia” that many believe exists.

With judicial proceedings underway, and orders issued to the Police to expedite investigations and arrest suspects, it seems that the bureaucracy at the Ministry of Health has finally felt threatened enough to take steps to save face. However, will the new regulations change anything, until the deep-seated culture of impunity within the political and public official community remains unaddressed? Part of the issue is that with some policy makers, state officials and regulators ready to play ball, the pharmaceutical industry has also been a participant in such inhumane rackets. At times, these industry participants in corruption and malpractice also represent the local interest of global pharmaceutical conglomerates. As such, there is a wider international dynamic to such “mafias”.

If the Government of Sri Lanka was serious about rebuilding credibility, especially in the public health system, they could allow the Auditor General’s Department and a foreign independent auditor to audit all medicine and pharmaceutical purchases over the last decade or so. A separate audit about how licences for import of pharmaceuticals, quality testing and the practice of issuing waivers or exceptions to import unregistered medicines can also be looked into. Further, if Sri Lanka is keen on getting policy makers to declare their assets, shouldn’t we start doing the same with senior state officials, regulators and their families?

Another glaring tactic used by many companies, both foreign and local when competing for state tenders, be it in the pharmaceuticals sector or in energy, is to abuse regulations on fairness by filing legal action on certain tenders, with the intention of delaying the tenders being awarded. Also, it has been noticed that many local and agents of foreign suppliers to state institutions, are reluctant to supply when the funding comes from international organisations such as the World Health Organisation or the Asian Development Bank. It is learnt that the transparency and thorough regulatory procedure which such international organisations follow when funding high – corruption states like Sri Lanka, really do make life harder for the “mafias”. And therein lies a clue for the Government, if they are serious about mitigating corruption, and giving the average Jo the best bang for his tax rupee, the State can adopt some of those practices followed by the ADB, WHO and FAO when purchasing supplies. But let's not hold our breath.