Despite various efforts by the political and public authorities, Sri Lanka’s health sector continues to remain a crisis-hit sector, with increasing reports of various inadequacies in the sector – with some of the major ones being the scarce supply of medicines, the lack of facilities available for treatments including for surgeries and the lack of specialised doctors. Former and current health authorities as well as health professionals’ trade unions and their professional bodies have flagged this situation, questioning as to why the health sector does not appear to recover at the same rate as other crisis hit sectors.
The authorities seem to have prioritised donations and allocating more money for the health sector. While that should be a priority, the idea that economic revival, which also includes reviving the sectors affected by the economic crisis, is not merely a matter of having money – including foreign reserves – but also a matter of how the money is utilised, how scientifically institutions are managed, and how mistakes and irregularities are prevented, which is applicable to the health sector as well. In fact, the results of whatever resources including financial ones that the authorities are sourcing, depend largely on those reform and management-related aspects, and therefore, health sector reforms should receive more attention and not just the maintenance.
Alleviating the burden of the prevailing medicines shortage should be a top priority, and to achieve that, the authorities should pay attention to reforming, regulating and streamlining the operations of the existing medicines-related public institutions such as the State Pharmaceuticals Corporation (SPC), the State Pharmaceuticals Manufacturing Corporation (SPMC) and the National Medicines Regulatory Authority (NMRA). While one might argue that there are very few allegations of corruption or inefficiency levelled against these entities, the prevailing challenges have raised an undeniable need to improve these entities’ services and performance in order to obtain the maximum benefit from the limited resources. Therefore, even a little inadequacy should not be left unaddressed.
As the country relies on sourcing medicines from outside the country to a great extent, the NMRA’s role in this regard takes a special place. Among other issues, the time consuming process through which medicine importers have to go through in order to obtain the relevant approvals is a pressing concern. While it delays the importation of medicines at a time when the country has only limited stocks of medicines, it also has the potential to discourage the limited number of such importers that are coming forward. While we cannot deny the rigorous vetting process that such a stern process requires, what needs to be done is to accelerate this process without compromising the quality-related aspects of it.
A major improvement in this regard is streamlining the tender process, with a focus on obtaining more registered medicine importers to bid when there is a call. This is aimed at not only strengthening this process, but also at preventing the need to get unregistered importers to import medicines when the registered ones do not actively play their role. The simple message that obtaining such registration comes with a certain unofficial responsibility of actively taking part in the process of importing medicines should be promoted, and to deter such reluctance, the authorities could take somewhat stern measures such as imposing a fine on those who remain inactive despite having been registered with the NMRA. This is an urgent need, as the country is no longer in a position to allow emergency medicine purchases without regard for price limitations. At the same time, allowing both local and foreign importers who can in reality contribute to the said process to obtain registration is crucial.
Scores of people are in distress due to the medicines shortage, while that situation has in turn become a breeding ground for the medicines black market. The authorities should pay attention to alleviating that situation by ensuring that the available resources deliver what is expected of them.