EDITORIAL : THE DAILY MIRROR, SRILANKA

Health service: Let their deaths not be in vain

First it was the revered Professor Senaka Bibile whose Essential Medicines Concept formulated more than 40 years ago was hailed by the World Health Organization (WHO) and is being successfully implemented in more than 100 countries. Tragically his own country, apparently giving into pressure from international power groups including the United States, rejected Prof. Bibile’s much acclaimed policy in 1976 and he had no option but to leave the country. One year later he died prematurely,  a sad man because his own country had rejected a policy to restore a health service where the well-being of the patient is given top priority.

More than 30 years after the death of Prof. Bibile, the same fate last week befell his faithful disciple Prof. Kumariah Balasubramaniam who worked closely with Prof. Bibile for about 30 years and then faithfully continued the work for another 30 years till he tragically died last Tuesday. Like Prof. Bibile, Prof. Balasubramaniam also did not seek personal gain or glory, power, popularity or prestige, wealth or possessions.  Instead they worked selflessly, sincerely, sacrificially and quietly for the common good of all people of all races and religions and of generations to come. Essentially Prof. Bibile, Prof. Balasubramaniam and people’s health rights groups have been proposing structural changes that will take away injustices and restore a patient-friendly health service.

Sadly the Health Ministry in Sri Lanka appears to be more interested or involved in tackling the symptoms rather than diagnosing and treating the root causes of the ills of the health service. One of the main structural flaws in Sri Lanka’s health policy is the lack of a National Medicinal Drugs Policy (NMDP) intended mainly to make quality drugs available to all at affordable prices.

As we have said and repeated often, a comprehensive draft, which will benefit millions of people and generations to come was worked out after a dialogue among all stakeholders and submitted to the Health Ministry as far back as July 2005. This dialogue was presided over by Professor Krishantha Weerasuriya, the WHO's South Asian Regional Advisor on Drug policy. Prof. Balasubramaniam who knew not only the vision and goals but also the heart and mind of Prof. Bibile, played a key role in formulating the NMDP.

The Cabinet approved the NMDP in October 2005 and even the Mahinda Chintanaya, the much quoted policy document of President Mahinda Rajapaksa for the November 2005 elections also pledged to implement Prof. Bibile's essential medicines concept whereby Sri Lanka could also save billions in foreign exchange annually by stopping the import ofthousands of non essential drugs that come under highly expensive brand names. The then Health Minister Nimal Siripala De Silva and the present Minister Maithripala Sirisena have repeatedly promised that legislation to implement the NMDP would be introduced in parliament but as in many other cases the promise has remained a promise and they have not walked the talk. Mr. Sirisena in the latest promise has said the legislation for the NMDP will be introduced in July and we hope he will be more faithful than his predecessor and will be able to resist the massive pressure that comes from vested interests including top ministry officials themselves, transnational drug companies and tragically some medical specialists for whom the legendary parable of the Good Samaritan means little and instead money is the god.

The first step in the NMDP is the appointment of a 12-member Drugs Regulatory Authority comprising eminent medical and pharmacological specialists and a representative of the patients' movement. Two eminent Sri Lankans, Prof. Bibile and Prof. Balasubramaniam have already given their lives to this cause and we hope the Health Ministry will implement their vision and goals as a tribute to two of Sri Lanka's great personalities.