Editorial

Sri Lanka’s once-lauded health sector is in dire crisis. In addition to losing qualified medical staff in numbers, hospitals have run out of essential medication. Now, using the cover of urgency—one of the oldest tricks in the corruption playbook—the Health Ministry is procuring hundreds of medicines under the Indian credit line (ICL) bypassing regulation.

But the depletion of medication developed over at least one year. The authorities know it. They also well know that the dollar deficit was just part of the problem. And foisting unregistered, unevaluated medication from walk-in pharmaceutical firms hanging around the Health Ministry’s corridors sniffing for deals is not a solution. It is the start of a new and dangerous trend.

In June 2022, the Auditor General issued a special report on pharmaceuticals shortage (having assessed the situation up to May that year) in Government hospitals. It determined that reasons for the health sector catastrophe included a lack of coordination among relevant offices, outdated computer systems, and, dangerously, a sheer disregard for procurement schedules. In short, they were late.

These were deep-rooted, identified flaws. And procurement could’ve been speeded up within the regulatory framework had there been an interest to do so.  The path taken, however, was to elevate a difficult situation to emergency proportions and eliminate, of all things, oversight.

The Health Ministry’s excuse for popularising unsolicited proposals—procurement without competitive tenders—in the medical sector is that, when it called for bids, the pharmaceutical industry did not come forward. But the devil’s in the detail. Companies are already owed billions in arrears. And it was hinted to them that there was no guarantee of timely payment, even under the ICL.

Professional medical associations vehemently oppose the Health Ministry’s attempts.  Among other things, they are alarmed that a large number of drugs for which waivers of registration have been given are nonessential and non-lifesaving (including Paracetamol). Several others are available in adequate quantities. Why then is Sri Lanka borrowing money on interest to procure nonessential drugs when so many more are listed as critically required?

This process also helped expose defects in the National Medicines Regulatory Authority, the gatekeeper. Waivers were granted freely, ignoring the Medicines Evaluation Committee. The politically-appointed officials accompanied the Health Minister to India on the invitation of one of the shortlisted drug suppliers. There are within the NMRA other interest groups that control authorisations.

The system needs a thorough overhaul. That needs strong Presidential intervention of which the hallmark must be the clear absence of corruption. Public health is at stake.

Whither polls

The holding of local government elections in less than a month seems to have a mercurial life of its own, with prospects of it taking place at all, now seemingly iffy.

The Government is clearly going under the radar to scuttle it. That strategy has nevertheless been spotted, very obviously and adopting a deadly and unprecedented ruse, arguing there are no funds to hold elections these days. Not releasing money to hold an election that is legally due is a dangerous model to adopt. It can justifiably be seen as a step in the wrong direction, a perilous journey on the representative democracy mawatha which can lead to even more dangerous consequences in relation to future elections of a larger and more significant proportion; an excuse for the future quoting this model as a precedent.

The Government benches, however, argue a bad case, that postponing elections, in general, is not unprecedented, and even if the reasons for it are – that these indeed are unprecedented times. Never before has an election been called, or held, when the country was officially declared bankrupt. That, not only is the country without foreign currency for its imports, it does not even have the local currency to settle domestic bills.

On the other hand, it is clear that the Opposition parties are blithely unconcerned about the financial aspects of holding an election. They could not wait till they reformed the local councils’ electoral map. They want elections, period, without ironing out the deficiencies in the system. They feel the time is ripe to do some bottom-trawling to garner votes from the masses currently undergoing great difficulties with the country in turmoil.

To energise their followers and score electoral points is their sole ambition, not so much to secure local councils. For them, this election is all about getting closer to the next stage of winning a Parliamentary election on the foundation of this victory, to be followed by securing the Presidency thereafter. It is an opportunity not to be missed.

There is no major clamour for an election to these councils from the citizenry. Many see no real need – at this stage, to have elected representatives for councils whose role is limited to trash collection, street lighting, catching stray dogs, and giving approval to housing, however much those impact on the daily lives of the average citizen because in many councils, some of these functions are already performed by the private sector.

The Opposition campaigns have nevertheless pitched the bar to a national-level election with platform orators getting carried away to predict the formation of new Governments when the votes are tallied and the dust settles.

While a scheduled election must be held without trotting out excuses, whether the country can afford having three tiers of elected representatives is the ‘elephant in the room’. The middle tier, the Provincial Councils, was thrust upon the country only in 1987 under different circumstances. It is not a system the larger population wanted.

The political parties have shown no thought about cost-cutting, nor the cost-benefit of having a three-tier system of representative government with 225 members of parliament, 450 members of the provincial councils and 8,000 plus local councillors, all sustained by the citizens of a bankrupt country.