The Peoples Movement for the Rights of Patients (PMRP) is at it again, proposing a restrictive list of drugs for the Sri Lankan health sector. This time of course, it comes in the form of a letter to the Executive painting it as a solution to the economic woes of the country.
In a news item appearing in The Sunday Times of February 1, “Good medicine for import crisis” the PMRP says “With Sri Lanka’s foreign exchange reserves dwindling and import restrictions on the cards, the PMRP yesterday gave President Mahinda Rajapaksa some good medicine for the crisis…” namely, the implementation of the National Medical Drug Policy (NMDP) which they claim would save millions of dollars in foreign exchange for the country. According to the PMRP, the implementation of NMDP will allow Sri Lanka to import only around 1,000 brands of what they term as ‘essential drugs’.
The million dollar question is how a restrictive list of drugs could go towards reducing the amount of foreign exchange spent by the country - unless the PMRP plans on compromising quality and denying patients fundamental right of choice and interfering with a doctor’s right to choose the best medication suitable to his/her patients situation. Restrictions and resulting monopolies could lead to large scale smuggling and the entry of spurious/counterfeit drugs, which this country and its patients have been spared up to now. Medicines are not imposed on patients for no reason; it is the learned doctor who decides what the patient needs.
The PMRP is back to presenting economic ideologies rejected by the people over and over again, reminiscent of a by-gone era when the economy was closed, imports restricted and prices fixed to maintain unproductive state structures. The current Pharma market operates through innovation and competition. The Sri Lankan consumer has the best of both worlds – a state sponsored world class free healthcare system for all and to those who can afford; fast access to high quality medicines and medical care at reasonable prices. The WHO acknowledged low prices are possible even in the private sector due to the vibrancy and intense competition of the Pharma industry. Trying to save foreign exchange through reduction in the number of drugs is short term thinking.
The PMRP’s argument that there are about 7,000 non essential drugs which are imported into the country does not hold water. The Medical Supplies Division of the Ministry of Health which procures by generic name has near 4500 drugs in their essential drugs list. The total number of drugs registered in the country including number of brands for each generic molecule stands around 14,000. This being the case the ratio of generic to brand is approximately 1:3, although this may be many folds greater in some selected molecules which are used in vast quantities thus ensuring good supply.
Any person without a personal agenda will acknowledge that this is a healthy level of competition, without which only monopolists and their front organizations will clamour for further restrictions. Further, if the markets are not open, the million dollar or the billion rupee question is ‘Who will be put in charge of pruning this list and what criteria will be used?’ In this event, will it not leave room for large scale corruption and monopolies that would undoubtedly be formed?
Further imposition of extreme restrictions to legitimate import of drugs into the country would leave room for the black market to operate. Water seeks its own level, if there is a need for a particular drug, the patient will find a way of getting it. The Sri Lanka Chamber of Pharmaceutical Industry (SLCPI) as the accredited representative of the pharmaceutical industry in the country and the credible voice that advocates industry interests, firmly believe that all drugs imported into this country must only be from pre-evaluated sources under the control of the Cosmetics Devices & Drugs Authority. It is a part of that control to provide access to legitimate importation, distribution, promotion and sale of drugs ensuring abundant availability of quality, safe and efficacious drugs.
Every year around this time the PMRP comes up with this call to set up a restrictive drug list. This time they are trying to disguise it in the form of some good advice to the President, in the hopes that by mentioning the Executive’s name they could get some mileage to a scheme which has a questionable motive.
In the recent past, NGOs and even INGOs have been shown the door by the Government. The reason for this is that they have not been accountable and have had serious credibility issues when it came to doing their job. If the PMRP’s claim is to fight for the rights of patients there are so many other areas where they could make themselves useful and truly prove themselves as an NGO which cares for the sick of this nation. If their objective is to cut off access to proper medication for patients and deny the patients and doctors the choice, we wonder whose agenda they seem to work to?
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