With the setting up of the National Medicines Regulatory Authority (NMRA), patients’ rights groups are hopeful it will be the first small but significant step towards restoring a health service where the well-being of patients is given top priority. The NMRA, chaired by Prof. Laal Jayakody with the patient-friendly Dr. Ananda Wijewickreme as the Chief Executive Officer, has a challenging task ahead to implement the long-delayed national medicinal drugs policy worked  out some 45 years ago by the revered Prof. Senaka Bibile.

At present, medicinal-drug prices are soaring because the value of the Sri Lanka rupee has plunged in relation to the United   States dollar and other world currencies. 

More than 3,200 pharmacies have sprung up in all parts of the country with Wellawatta, for instance, having more than 30 pharmacies. Investigations by the NMRA and health rights groups have shown that with only some 1,000 qualified pharmacists available for work, about 70% of the pharmacies are functioning  without a qualified pharmacist. It is like a medical clinic without a medical officer. Often  in pharmacies there are only framed certificates on the wall, while unqualified sales people are dispensing essential and sometimes life-saving drugs. Most of these sales people have little knowledge of pharmacy and less of the English language. Most medical practitioners and specialists are known for their fowl scratches on the prescription and the possibility of the sales people dispensing a wrong drug is dangerously high.

Health rights groups say that after the globalised capitalist market economic system was swallowed wholesale by Sri   Lanka in 1978, upto 15,000 varieties of drugs – including hundreds under highly expensive brand names – have been registered for import and sale. For instance, the sex stimulant Viagra – much in the news last week after the lewd scandle involving a political VIP – is known to be manufactured under about 60 brand names including rhino power. This is a prescription drug because it could cause heart problems and needs to be prescribed by a cardiologist after an eco-cardiogram. But most often this does not happen and pharmacies sell it to old or young people at about Rs.1000 a tablet. If this is not monitored and checked, Sri Lanka, which became a den of corruption and racketeers during the previous regime, might also have to contend with gangs of sex maniacs cum sadists.

NMRA officials say they need time to properly test the quality of the registered drugs. In terms of the new law approved by Parliament in May this year, five factors would be considered in the review and re-registration of medicinal drugs. They are the quality, efficacy and safety, the cost of the drug and the need for it. In the 1970s, when the Senaka Bibile policy was implemented, Sri Lanka obtained grants and expertise from Japan and Norway to set up the National Drug Quality Assurance Laboratory. With the new Government improving its international image and ties with all countries, Japan and Norway could be approached again for aid and expertise in reviving the quality assurance laboratory. In addition we also need to make use of the marvels of modern medical and other technologies for the common good of the people and not only for the rich and ruling elite. 

Expertise is also available in Sri Lanka. For instance, one of the highest qualified pharmacy specialists Dr. Titus de Silva is widely respected for his patient-first approach and would be readily available for such a mission as would Prof. Krishantha Weerasuriya who retired recently after being the World Health Organisation’s South Asian Regional Adviser on medicinal drugs policy. Unfortunately, Dr. K. Balasubramaniam, who fought alongside Prof. Bibile for a patient-first medical policy is now dead. Prof. Bibile and Dr. Balasubramaniam died to save the lives of others. The NMRA must make sure that they did not die in vain.

Prof. Carlo Fonseka, another eminent medical personality and now chairman of the Sri Lanka Medical Council, is also widely admired for his prophetic patient-first principles. The NMRA needs to get his advice also in salvaging what has degenerated into a medical business and transform it into a vocation where the holistic healing of the patients not only comes first but is also considered as sacred.