The healthcare industry today is openly described as a ‘mafia’ due to various underhand quotations and tenders that have been passed to issue drugs. Recently the two heads of the NMRA stepped down from their seats since they believed that they had much political interference. In a candid interview with the Dailymirror, Health Minister Dr. Rajitha Senarathne gave his version with regard to the reasons behind the resignation of world renowned medical experts while also giving an insight to the ‘mafia’ today and what needs to be done to bring down the prices of drugs. Excerpts:
Q At a recent press conference you mentioned that Ministers needed luxury vehicles to travel around the country. Wouldn’t it have been better if the same money was used to construct the roads?
In every part of the world, politicians are provided with various facilities. Even in the government where they practice good governance also it’s the same. This is nothing new to Sri Lanka. In India they even provide air tickets for the MPs. In addition to that they provide office facilities for them, where they sometimes have one office in New Delhi and another in their electorate. You must remember that our politicians have to cover more than one electorate. In fact they have to go round an entire district. According to our culture, they have to attend funerals, weddings, sometimes homecomings etc.
These ceremonies go on for generations. Here a parliamentarian will have to supervise all the projects unlike in a developed country. I have discussed the same with MPs in other countries. There they say that not even their residence is known to the electorate. They have an office provided by the party therefore they go there on Saturday morning and dedicate their time for the work in their electorate. But the voters do not know where the MP resides. But the total opposite happens here in Sri Lanka. Certain electorates are mountainous areas and therefore they cannot be reached without four-wheeled vehicles. When you spend money on a good four-wheeled vehicle then it’s durable. These are the official vehicles given to ministers. But during the previous government vehicles were given to ministers on several occasions but there were no media briefings held to announce them. This time what happened was the PM collected all the requirements of the ministers and brought a separate cabinet paper. Two vehicles were given to me during the time of MR but nobody knew it.
Q The GMOA and other health related organisations claim that you have become another controversial Health Minister after Nimal Siripala De Silva. What do you have to say about that?
I was always controversial whatever the portfolio I had because I am dynamically involved with the issues in the country. So whatever the issue I have my own stand. Take the ethnic question for instance, my stand is very controversial to that of the south not to the North. But I have existed. I never used racism, religious harmony or caste systems to win elections. I have worked hard for my electorate and irrespective of my party I know that the people will help me. My voters know that I’m pro-Tamil, pro-Muslim but they all support me.
Q The National Medicinal Regulatory Authority (NMRA) has become quite a controversial topic today mainly with the two chiefs stepping down from their positions. There is an allegation that you are the main reason for their resignation. Is it true?
Who is the main reason for appointing them? If you see their resignation letters the Chairman has thanked me for appointing him to the position. I didn’t want to make too many of statements about them. This is an academic matter. Some people want to use it for their political benefits but it is not political. I’m a professional and they are academics. The issues are entirely academic. When they were appointed I asked them to select the posts but I never nominated anybody. They came and brought me the list which I signed. In fact the CEO was my classmate but that is not the reason for the appointment. It was quite difficult to appoint them to these positions because the previous director didn’t want to leave. There was no provision. He used the elections to remain and finally he got a letter from the Elections Commissioner and he directed me that no appointment transfers could be done during the elections.
Q What did you do then?
Then I explained it to him. I appointed NMRA on July 7, 2015 while the elections were supposed to be on August 17. Then the government was dissolved. During this time period I was clueless whether to contest or not. For 48 hours I was in an indecisive state because of this crisis. I was with the then President, he was weak and he couldn’t take any decisions. So I had no option and couldn’t go ahead with the SLFP. With all these issues I still appointed these two academics to the respective seats.
Q Were they willing to work in these positions?
They first refused because they were not allowed. So I made sure that the previous director was sent away. Ask them whether I have done anything wrong to them? I had my arguments. Every month we meet at the Heads of Institutes meeting in order to monitor all projects. Previous year we have cleared over 2000 files. So we came to an understanding that by next year we would clear about 3000 files. But they couldn’t do that.
Q Did you have any problem with their qualifications?
At the end of the year when they came to me with the files their progress was only 1400. This is when this issue started. Many people were complaining but I was defending these two chiefs. However when the chairman brought me the 1400 files I was shocked. The initial plan was to clear 3000 files.
Q So it was an administrative issue?
They are good academics. In fact there were letters coming in from the Prime Minister’s office that they were inefficient, that they had no knowledge about administration. The CEO was a nice individual but he had no PR. It was when I went through the act that I realised that the position title is mentioned as CEO/Secretary. So it shouldn’t be an academic but an individual with good management skills. Therefore I was thinking of increasing the salary and bringing down a good manager to manage the NMRA. It shouldn’t be a professor. When they came with these files I asked them the alternative way of clearing the remaining files. Then they said we will have to stop registering new drugs. That means no new drugs can come in. Then I agreed to this and they started continuing.
Q Then what happened?
The issue here is then only one drug is registered. Then we have to agree to any amount that person quotes because we can’t use unregistered drugs.
Q Is this where the so-called mafia begins?
Let me explain. There was a tender by the State Pharmaceutical Corporation (SPC) which has quoted for three drugs. One was Rs. 1.15 million, other one Rs. 1.25 million and the other person has quoted Rs. 75.1 million because that was the only registered company. This is the mafia that I have to control. This is the mafia that I have to deal with and I have no time to be making speeches or talking about Professor Bibile. I have to take practical measures. Then I asked them not to give. Then I called the NMRA and pleaded to give the registration to one of the other companies and then thereafter the tender was passed on to one of the other two companies. Then there is another Australian product but we have only one supplier. All these years they were quoting US $30 for one dose. Then I got a list of suppliers and asked the others to get me this drug. This time they sent a quotation for US $ 3. We are spending 2 and a half lakhs for one dose of another cancer drug. This year’s budget for that drug is Rs. 1.7 billion.
Q How are you planning to bring down the prices?
The main thing professed by Prof. Bibile was to bring down the prices. I still haven’t succeeded in bringing down the drug prices in the market and this is my issue with the NMRA. Then I asked the other people to bring another drug to compete with this cancer drug. Any innovative drug has the market for 10 years. But by that time the other competitors will do their research and produce their drugs. Then they introduced a Russian drug which the NMRA didn’t accept. They were of the impression that Russian drugs were not good. Then I asked them to go through Bibile’s National Policy on drugs where he suggested that in order to bring down the prices of drugs, we have to import drugs from Socialist countries and he has listed them. The prices of drugs in these countries are very reasonable when compared to those of other European countries. When I have appointed these two chiefs to work for Bibile’s policy they were talking about Cuba and Russia not being up to standard. I asked them to evaluate and check for themselves. When this Russian drug came these two professors sent it to Professor Asita De Silva despite attacks from the media because he was the chairman of the Drug Evaluation Authority. He is the authority in Sri Lanka.
Q There is an allegation that Professor Asita De Silva cannot be appointed according to the act since he is currently involved in a pharmaceutical company?
I will get there. If Asita is bad why are they sending it to Asita? They could have done it on their own. In five days’ time he sent it back saying that it was 100% efficient. Then the chairman wanted to send another Indian product which was 90% efficient. We have to always give 100% efficient drugs because they are cancer drugs and for them even a 0.1% of the drug is important. So they were not registering the Russian drug and were postponing it while in the meantime they sent the Indian drug. Why was the chairman interested about the Indian drug? The drug was registered under an X Indian company.
This was a company which was allegedly charged for fraud, supplying their cancer drugs to the cancer institute. They supply 5 injections, dilute and use two on patients and return the remaining three to the supplier. Then they were caught and the company was blacklisted. Then another company Y was asking for registration. The funny thing was that they were asking us to register them under the name of the previous company X. At times Prof. Lal Jayakody used to come and tell me that he could not work with the Chairman. They were lecturing students so how can they run a body like this. Then they brought in a price control. But how can they do that? This is an open market economy where we can only regulate the prices.
Q What is the eligibility of Professor Asita De Silva who will be taking up the post as the new Chairman?
He is connected to a company called RemediumOne Pvt. Ltd, which was established in 2009 as a public-private partnership and it is affiliated to the Faculty of Medicine, University of Kelaniya (UoK). It is not a pharmaceutical company. It works in collaboration with the Clinical Trials Unit of the UoK. They participate in global healthcare research programmes conducted by centres of academic based excellence and research-based pharma involved with the development of novel therapies. It has many international collaborations as well. This is a company setup by the Kelaniya Medical faculty. He is doing all the research in this country on pharmacology. He is a practical person and he will bring the prices down.
Q The NMRA act says that a person who is engaged in employment in the pharmaceutical industry within a period of three years should not be appointed to the authority. But Prof Asita De Silva is known to be an owner of a pharmaceutical company. How can you explain this?
This is a government research company. So the act doesn’t interfere in his appointment.
Q The Health Ministry has been instrumental in issuing many No Objection Letters (NOLs) for drugs that need not be in stores. What are the criteria to issue a NOL?
I have no power to issue NOLs. They are given to the SPC for their tenders. They sometimes request NOLs because sometimes there is only one applicant for a particular drug. When you issue a NOL then they start the process of registering. By the time the drugs are being ordered it takes 9 months for procurement. Before you bring the drug you get the registration. The registration of a drug is mainly the re-registration. Every five years the registration has to be renewed. So to renew the registration it is unnecessary to go through the entire bio-data of a particular company. The drug should be tested to see if there were any quality failures. If there was no quality failure reported then there is no problem of re-registration. If there are any allegations regarding the drug then the registration could be cancelled at any given time. Therefore no one has to be too strict about registering drugs. Certain drugs have been re-registered for 30-40 years.
If the drug is registered for the past 30 years then the particular supplier is in the queue to re-register. Sometimes even for a new drug if it is unregistered here, one can issue a NOL but it can be cancelled at any moment. When importing drug consignments, if one batch of drugs fail we don’t pay for the entire consignment as per the tender conditions.
Q The Senaka Bibile Commemorative Association has gone to the extent of filing a Fundamental Rights petition against you while also going to the Human Rights Commission for sabotaging the Senaka Bibile Policy. How do you see this?
I have gone through these. I have consulted my legal officer with regard to their actions.
Q You were very vocal about the Avantgarde incident during the elections. Nissanka with all allegations and his name in Panama papers is still free. What are your comments about it?
We won it. There were two incidents. One was the operation. The first call came to me after winning the elections on January 9, from a fisherman from the Galle Harbour. I was told that there were foreigners with weapons. Later only I found that it was Avantgarde. The DIG on operations was also going to be transferred in order to sabotage the inquiry. When I spoke about the Port City then also I was being attacked. I am talking about what can be done and what cannot be done. This is my 40 years in politics. Second part is to conduct investigations and take legal actions on this incident. I hope they are doing that properly. He got hold of all the media and attacked me, but all the complainants are rogues.
Q You were also against appointing Solicitor General Suhada Gamalath as the Attorney General mainly on this case.
Yes. Suhada is my very good friend. But when it comes to issues I have my own stance. I have lost many friends and I have got many friends. I had no personal problems. We formed this government for a change. Not to change the party or the government but to change the country. But we have a limited time to live. We have to complete our journey and we are fighting for a cause. We are not scared of anybody.
Q Has the new AG done anything?
He was given a lot. I told them from the first day onwards that the government has changed but not the state. All these Rajapaksa catchers are there everywhere and it is a difficult battle.
Q There are strong criticisms against your son’s speech against the doctors. Do you agree with his allegations?
Why did he have to use that language? Did you see how that doctor was talking? Being a doctor and an office bearer this particular doctor was addressing in an offensive way.
Q There seem to be many disputes within the government. Is this an example of national unity?
This is a new example. We are a feudalistic society, divided on language, religion, ethnicity and caste but more than that on political parties. Some people think that whatever they do within their party is completely alright. The main two parties are at loggerheads. Sometimes they will even join the LTTE but not the other party. So we have brought these two parties together. The PM said even if we won two thirds we would have the national government. The people who opposed and were fighting with us were brought in to this government. So in one day or one year you can’t solve all the problems.
