If health is in the market, the poor will die - EDITORIAL

13 September 2015 07:51 pm - 0     - {{hitsCtrl.values.hits}}


ince the legislation for the setting up of the National Medicines Regulatory Authority (NMRA) was passed this year—after a delay of more than ten years  and alleged sabotage by powerful transnational pharmaceutical companies—most people have  been asking what is happening. The 13-member NMRA headed by Prof. Laal Jayakody, head of the Department of Pharmacology in the Colombo Medical Faculty, was set up in July and sworn in by Health Minister Rajitha Senaratne. It was general election campaign time and there were legal problems relating to the  appointments made for the NMRA to begin its massive task of reviewing some 15,000 varieties of drugs that have been registered for import.
The revered Prof. Senaka Bibile’s essential medicines concept, the vision of the new national medicinal drugs policy, required that the number of imported drugs be reduced to a thousand so that quality drugs could be made available to people at affordable prices. Sujeewa Senasinghe, the newly appointed State Minister for International Trade, said last week the National Government hoped to streamline the State Pharmaceutical Manufacturing Corporation so that most of the essential drugs could be produced in Sri Lanka. Such a move would break the stranglehold of the transnational pharmaceutical giants which have been virtually controlling Sri Lanka’s health sector since the United States forced Sri Lanka to scrap the Senaka Bibile policy in 1976.

With the installation of the new National Government this month, the NMRA also has gone into action. Early this month Prof. Jayakody visited the Gampaha district to conduct an awareness programme for about 70 pharmacists who run pharmacies. According to estimates, the number of pharmacies in Sri Lanka is between 3200 and 3500. Reports and surveys indicate that a large number of these pharmacies are running illegally or dangerously because there is no qualified pharmacist in the premises. These have only a pharmacist’s certificate framed on the wall but sales persons do the dispensing and they are prone to make mistakes as they cannot read the fowl scratches of the physicians and have little knowledge of pharmacy.
The NMRA chairman said he had instructed the district’s Food and Drug Inspectors to ensure that a pharmacist or an apprentice pharmacy assistant was present to dispense drugs. But the People’s Movement for the Rights of Patients and other health action groups allege that corruption, rampant in our society mainly during the past five years, has seriously afflicted even the health sector. When some food and drug inspectors make their monthly visit to check pharmacies the owners allegedly keep some money under the counter and get a clearance certificate. As often happens, it is the patients 
who suffer.  

Prof. Jayakody and the NMRA’s chief executive officer Dr. Ananda Wijewickrema have said they would gradually test every registered drug for its quality, efficacy and safety. Two new factors under the new medicinal drugs policy are to examine the cost of the drug and whether Sri Lanka needs it. This process is likely to take a few months and by next year Prof. Bibile in whatever good place he is now will be happy to see his people getting quality drugs at affordable prices—a major step towards  restoring a health service where the wellbeing of the patients is given top priority.
The NMRA chairman also told the Daily Mirror some pricing formula needed to be worked out. With the dollar-rupee rate being allowed to float from this month, imported drug prices are going up. Market economy advocates also do not favour any price control. On this basis, that market forces must be allowed to operate freely. That may be true in most cases. But as the veteran health rights advocate, the late Dr. K. Balasubramaniyam often pointed out, if we put health in the market it means that we are allowing the poor to die. 

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