If health is wealth, then the government’s healthiest and most generous national New Year gift to the people is the presentation of legislation to the Cabinet to implement the National Medicinal Drugs Policy (NMDP) based on the revered Professor Senaka Bibile’s essential medicines concept.
Essentially, the legislation, when approved by the Cabinet and probably unanimously by Parliament, will make provision for all people to have access to quality medicinal drugs at affordable prices.
The comprehensive NMDP was worked out as far back as 2005 by Professor Krishantha Weerasooriya, the then World Health Organisation’s drug policy adviser for South Asia. At the request of the Health Ministry he held several rounds of discussions with all stakeholders including patients’ rights movements and presented the NMDP to the Ministry in July 2005.
It is known that many varieties of antibiotics are smuggled from cottage industries in India and sold to pharmacies at cut rates. As a result, people suffering from various ailments may be paying Rs. 80 to Rs. 100 for an antibiotic which contains wheat flour
The Cabinet approved the NMDP in October 2005 but since then, parties with vested interests and others have tried secretly or openly to dilute or derail the NMDP. After nine years of delays, broken promises and the mysterious disappearance of the draft legislation from the then Chief Legal Draftswoman’s Department, Health Minister Maithripala Sirisena said in March that the legislation would be approved by Parliament and effectively implemented from this month.
In an announcement to mark Health Week on March 10, Minister Sirisena vowed that he and the Government were determined to implement the legislation despite moves by what he described as a “medicinal drug mafia” to sabotage the NMDP which health rights groups say will be the first step towards restoring a health service where the wellbeing of the patients is given top priority. Minister Sirisena revealed that the drug mafia included transnational pharmaceutical corporations, top Health Ministry officials and sadly or tragically even, some medical consultants.
In terms of the NMDP, the first step will be the appointment of an independent National Medicinal Drug Regulatory Authority (NMDRA), comprising pharmacologists, medical specialists and a representative of patients’ movements. The first major task of the NMDRA will be to review some 15,000 medicinal drugs which have been registered for import. This is believed to be a dubious world record. For instance, about 100 varieties of the widely- used antibiotic Amoxil are registered for import at prices ranging from Rs. 3 for a quality generic variety at Osuhalas to Rs. 100 for some varieties which are imported under highly - expensive brand names. Another instance is the commonly- used drug Paracetemol which is imported under about 40 trade names at different prices.
Under Senaka Bibile’s essential medicines concept, the NMDRA is expected to reduce the number of registered drugs from 15,000 to about 1,000. The factors to be considered are quality, efficacy, safety, the cost of the drug and the need for it. This will enable Sri Lanka to save millions of dollars in foreign exchange by stopping the import of thousands of varieties of nonessential drugs which come under expensive brand names. Additionally, the new state-of-the-art drug quality assurance laboratory will be able to maintain strict quality control and there will also be more effective post-marketing surveillance. At present, because of the huge number of drugs being imported, there is little or no quality control and many people may be buying counterfeit drugs at high prices. For instance, it is known that many varieties of antibiotics are smuggled from cottage industries in India and sold to pharmacies at cut rates. As a result, people suffering from various ailments may be paying Rs. 80 to Rs. 100 for an antibiotic which contains wheat flour. No wonder ailments like the viral flu go on for weeks or months, because most people are taking wheat flour and they end up with stomach upsets too.
For some 40 years after the Bibile policy was scrapped, various governments have promised to re-implement it for the welfare and the wellbeing of patients but vested interests are known to have given millions of rupees in sophisticated bribes to stop this. Now, it appears that the drug mafia is facing death, but the people and health action groups need to keep a close watch to ensure that the law is implemented effectively.