• MOH to introduce simplified method to expedite med imports
• Medicines ordered in March under Indian LOC yet to arrive 
• Shortage of about 110 items, Indian LOC getting delayed: Rambukwella
• Med imports delayed due to delays in granting approvals: Kumudesh
• Not just medicines, huge shortage of equipment too: Mediwatte
• Still don’t get stocks from SPC: Gankanda

By Maheesha Mudugamuwa  As pharmaceutical imports under the Indian Line of Credit (LOC) face further delays, the Health Ministry is moving to introduce a simplified method to expedite the importation of urgently-needed essential medicines directly from Indian suppliers, The Sunday Morning learns. It is learnt that the move was initiated due to the excessive time taken by the relevant stakeholders to approve the necessary documentations required to import the medicines. This, while some health sector unions allege that the MOH owes suppliers nearly Rs. 5 billion in service charges for equipment.   Meds ordered in March yet to arrive   The Sunday Morning reliably learns that certain medicines ordered in March under the Indian LOC are yet to be received, even after the lapse of many months.    It is also learnt that, under the new system, the Health Ministry will directly purchase urgently-needed medicines that are in short supply from Indian institutions under the Indian LOC on a different credit financial formula. Accordingly, it is understood that the Ministry plans to put a cap on the prices of the medicines to be purchased directly from Indian institutions. Therefore, the prices of each pharmaceutical item imported under the new scheme may be less than that of the previous purchase price of the same product. According to medical experts, there is a shortage of around 120 essential medicines, including several life-saving and cancer medicines. However, the Health Ministry’s decision to introduce a new mechanism instead of the already-established mechanism has drawn criticism from health unions, which allege that it will further delay the process.   Delays must be identified   The Academy of Health Professionals (AHP) is urging the Minister of Health to identify the sources for the current delay in procedures and to eliminate them and expedite the process without introducing new mechanisms. Speaking to The Sunday Morning, AHP President Ravi Kumudesh claimed that the process had been delayed mainly due to the delays in approvals being granted by certain authorities to import medicines and that the Minister should identify them instead of introducing a new mechanism. “When a new mechanism is established, it will take more time to proceed and if we have already made the necessary procurements under the current mechanism, the Minister can expedite the procedure. If he likes, we can tell him what he should do,” Kumudesh stressed. Kumudesh went on to explain that the mechanism for which the goods were imported under the LOC had been established by the Government and not by India and therefore, if there was a delay in the process, the Government should be able to expedite it without pointing fingers or introducing systems to rectify the issue. Highlighting that the entire process was rife with corruption, Kumudesh alleged that corruption was the main reason for the people’s suffering. “The process is used to create an entity to earn profits. When the profits are not coming, the goods are restricted in that step. This is a very simple process. India wants it to be items that are produced in India. This process is unnecessarily convoluted with several institutions attached to the Health Ministry. All these officials representing each step should take responsibility for the delay in the entire process,” Kumudesh alleged.   He stressed that the current crisis faced by the healthcare sector was due to bad policy decisions taken by the Ministry of Health as well as the Government. “The Indian LOC is a very simple mechanism which is like a credit card. As soon as we order we can get goods. If corruption is not involved, all the shortages would have been sorted out by now,” he alleged.     Arrogant policy decisions   Kumudesh noted that all decisions regarding medicines and other essential health supplies required for this year should have been planned and allocated before December last year, but policy decisions had not been made at the right time. He added that the health service was dependent on arrogant policy decisions that were under the control of a few. He said the debt owed by the Ministry of Health as a result of bad decisions had exceeded Rs. 12 billion. The debt owed by the Ministry of Health for equipment maintenance alone is Rs. 5 billion. “Many companies have decided to suspend supplies due to debt. We still do not have a way to talk about debt consolidation, price controls, or spending cuts.” As learnt by The Sunday Morning, the shortages are now prevalent in major hospitals including the National Hospital of Sri Lanka (NHSL) and other teaching hospitals countrywide while the hospitals in remote areas are said to have been affected severely as they lack certain basic medicines and medical equipment due to the massive shortage in the country. It is learnt that shortages include basic medical gauze, equipment, and drugs needed for major surgeries. Health trade unions stressed that patients had been severely affected by the extreme shortages as they had been asked to bring the necessary medical equipment and drugs for their scheduled surgeries. As a result, they warned that the country’s healthcare system was on the verge of collapse and needed an immediate solution.   Meds should be supplied immediately   Meanwhile, All Ceylon Nurses’ Union (ACNU) General Secretary S.B.  Mediwatte urged the Government to take immediate steps to make sure at least basic medical equipment was supplied to the hospitals in remote areas. “Now it is not just medicines, there is a huge shortage of equipment as well. Some hospitals are finding it really difficult to manage. At NHSL, we are suffering without many essentials. It is always the nurses and other staffers who mainly face these issues,” he alleged. Meanwhile, All-Island Private Pharmacy Owners’ Association (ACPPOA) President Chandika Gankanda told The Sunday Morning that patients were suffering due to the shortages of some medicines and also due to the high prices of certain drugs. “We still don’t get stocks from the State Pharmaceuticals Corporation (SPC). Many patients are coming in search of the SPC brand as it is the least costly brand at present, but almost 90% of these brands are now out of stock. We see how people suffer, not being able to afford medicines,” he lamented. ACPPOA urged the Government and other stakeholders to make sure medicines were affordable to all citizens equally as it was not a luxury item and all citizens suffered equally without medicines.     MOH response   When contacted by The Sunday Morning, Health Minister Keheliya Rambukwella said: “We are short of about 110 items. The Indian credit line is getting delayed. Therefore, we have made arrangements to get specific types of medicines that are urgent directly from institutions in India. The items will be purchased under the Indian LOC on a different formula.” Responding to a question, Minister Rambukwella said the items would be purchased on the assurance of delivering within 30 days and under the cap of less than the last purchase price.  As learnt by The Sunday Morning, Sri Lanka is yet to utilise nearly $ 50 million from the $ 110 million allocation made to the pharmaceutical sector from the $ 1 billion Indian LOC. When contacted, Health Ministry Secretary Janaka Sri Chandraguptha on an earlier occasion said that only around $ 60 million had been utilised from the allocations given to the health sector from the $ 1 billion Indian LOC. “We have already called for tenders from private parties too. There is a very complex process involved with the LOC funds. We have submitted documents to the Indian High Commission too,” he said.