After many years of delays, dillydallying and mysterious disappearances of draft legislation or gazette notifications, the government now appears to have launched an all-out war on what Health Minister Maithripala Sirisena describes as a powerful drug mafia, comprising transnational drug corporations, pharmacies, some medical specialists and health ministry officials.
Last Monday, in a significant move to mark Health Week, Minister Sirisena handed over to President Mahinda Rajapaksa long-delayed legislation to implement the National Medicinal Drugs Policy (NMDP) based on Professor Senaka Bibile’s essential medicines concept. Minister Sirisena said he believed that cabinet and parliamentary approval would be given within a month and after that Sri Lankans would get a healthy gift for the ‘Avuruddha’ – quality drugs at affordable prices.
Simultaneously, the Consumer Affairs Authority (CAA), under the direction of Minister Johnston Fernando, issued a gazette notification effective from March 4, imposing price control on drugs, wholesale and retail.
The drug price control regulations had been withdrawn in 2002 by the then United National Party (UNP) government’s Trade Minister Ravi Karunanayake who claimed that price control was not in accordance with the globalised capitalist market economic system which Sri Lanka has swallowed wholesale. Mr. Karunanayake who talks a lot about high prices today must be regretting that what he did 12 years ago has led to a wholesale extortion or plunder of helpless patients with drug companies and pharmacies known to be making staggering profits ranging from 150 percent to as much as 800 percent.
Co-operatives and Internal Trade Minister Johnston Fernando told a news conference this week that drug companies and pharmacies would not be allowed to increase prices without the approval of the CAA. For the past few years, especially after the rupee value was allowed to float in relation to the dollar, drug companies and pharmacies have been raising prices almost daily. Many people have complained that a drug for which they paid Rs. 25 last month had soared to Rs. 50 this month and they had no option but to pay whatever the pharmacies demanded or face the danger of their ailment getting worse.
At present, mainly because of the delay in implementing the Bibile policies, some 15,000 varieties of drugs have been registered for import. The People’s Movement for the Rights of Patients (PMRP) and other health action groups have pointed out that it would be difficult, if not impossible, to impose price control and work out a price formula for 15,000 drugs. They believe that while a suspension is imposed on any price increases, the CAA should wait till the Bibile policies are implemented and the number of drugs imported is reduced to about 1,000 before working out a pricing formula.
In terms of the NMDP an independent National Medicinal Drugs Regulatory Authority (NMDRA) is to be set up to review the 15,000 registered drugs and reduce the number to about 1,000 based on factors of safety, quality, efficacy, the cost of the drug and the need for it. After this is done it would not be difficult for the CAA to work out a pricing formula whereby people would have access to quality drugs at affordable prices as part of the new moves to restore a health service where the wellbeing of the patients will be given top priority.
Another issue the CAA would need to look at is the excessive number of pharmacies and reports that hundreds of them are functioning illegally because a qualified pharmacist is not present. Investigations have revealed that in hundreds of cases pharmacies have bought a licence from a pharmacist and only the framed licence is displayed at the pharmacy where there is no qualified pharmacist. Instead drugs are dispensed by unqualified sales people, many of whom cannot read English properly let alone the fowl scratches of general practitioners and medical specialists. As a result there is a grave danger of patients being given wrong drugs or other medicines and ending up in a serious condition.
With so many issues to be tackled in the health service we hope the Rajapaksa government and the Health Minster Sirisena will pursue this war on the drug mafia in a determined and dynamic way for the benefit of the people.