Beat Drug shortages and Pharma Mafia by Implementing the Bibile Formula

Shortage of drugs in state hospitals has been reported in many parts of the island. A spokesman for Central Medicinal Drug Store have confirmed the above fact. The poor patients are forced to go to the nearest pharmacy, where they have to pay exorbitant prices. Most of them return home empty handed or buy only part of the prescribed doses.  

 The multinational Pharma companies would produce a new molecule for a particular disease, and intentionally add an injurious component which could cause hazardous side effects. They do this with no hesitation as the authorities in charge of examining and highlighting the dangerous effects of the product are already on their pay lists, who would guarantee prompt listing at country of origin, and at importer’s country. The Pharma giants would delay the release of the product until they develop a remedy or a counter-active product as the cure for the side effects caused by the ‘original’. The multinational would not leave a single stone unturned  to ensure that  all ‘stakeholders,’ including some in the Medical practice, academics, drug authority officials, politicians by spending millions of Dollars on them, until  the product  reaches the unsuspecting customer who pays a comparatively low price for it. The next move is evident; where the poor victim has no alternative but to depend on his physician’s prescription written strictly under a Brand name for the remedy, which is sold at an inflated price to cover all costs involved in the process, including bribes paid down the line plus excessive profit margins for the Mafia. They spread bogus info about generics.

Prof. Bibile endeavoured to develop a Rational Pharmaceutical Policy intended to guarantee that poor patients received quality drugs at affordable  prices. Further, the programme aimed towards assuring that doctors prescribe the minimum necessary drugs to care for the sickness. A careful selection of products was imperative according to his policies. He was assigned by the Health Minister in 1960s, to focus on this aspect. Bibile prepared the famous ‘Ceylon Hospital Formulary’ consisting of 625 drugs specifically selected under their generic names. The  NFC [National Formulary Committee ] came into existence as a result.  It consisted of representatives from both the public and private health sectors. A committee under Professor Senaka, entitled, The Medical Schools Formulary Committee’ was also set up for the purpose of preparing formulary notes for the use of medical practitioner or the ‘Prescriber’.  

The private hospitals, a few consultants and many general practitioners in local health services are just the ‘Capos, soldiers and associates’ of the Mafia family: influenced by them, they engage in aiding and abetting their crimes in poor nations, while the controlling  powers of the chain of command, the ‘Bosses or Dons,’ operate  only at transnational planes.  

 Prof. Bibile himself a Marxist, along with Communist Party Leader Dr. S. A. Wickremasinghe worked on a concept known as ‘essential medicines’; a policy for rational use of drugs. There again the mafia attempted to sabotage their endurance using local agents of the Transnationals, a few medical specialists and politicians.  Who is responsible for the life of 57 year-old greatest medical sponsor of poor nations who made the supreme sacrifice on behalf of sufferers of the Medical Mafia?

The Health Ministry laments that all the good work done by them to curb the prices over the years have been in vain. One of the focal points in Bibile proposals was the discrepancy in prices between Brands and Generics.  
During the Rajapaksa era [2010-14], various strange forces enticed by the Transnational Mafia prevented the implementation of National Medicinal Drug Policy, blaming it on the then Health Minister Maithripala Sirisena, who made a great effort to initiate it. The bill that became an act after passing through the legislature was found to be a defective one, which could have ruined many medical processes. The Ministry was unsuccessful in seeking the consent of other stake-holders to guarantee the conformity of the bill with Bibile’s, before it was presented in the parliament for legalization. Late Prof. Carlo Fonseka, a former Chairman of the National Authority on Tobacco and Alcohol [NATA] and President of the Sri Lanka Medical Council (SLMC) ridiculed it as totally unsuitable as it had been drafted far short of the specific structure, compared to the Bibile formula. He further said it was a mockery of Senaka Bibile Principles, where the model of essential medicines had not been addressed. Was it a deliberate attempt by authorities bought over by the Mafia?

The implementation was very much anticipated by the poor and sick that remained anxious to buy ‘quality drugs at affordable prices’.  Many in the profession condemned the bill as well as saying it was not in harmony with Bibile’s: a medical consultant quipped,  “There was neither a concept nor a device for quality assurance nor a regulatory mechanism”. 

Next, the Yahapalana took over. There was ample evidence to corroborate the supposition that the minister put forward a set of ‘show off’ proposals in 2016 ‘Slashing the prices’ of 47 drugs, said to be for the benefit of patients?  It was a political gimmick. Generally, the pharmaceuticals industry is dishonest at best, and deceitful at worst; they are the spinal column of our corrupt ‘health services’. The ‘slashing’ certainly benefitted the ‘high-end’ category of patients, the rich, who used less than 3% of the high cost products of which the prices slipped down to match with the maximum retail price [MRP] fixed by the NMRA [National Medicines Regulatory Authority]. The rest or the large majority who belonged to the middle-income and the poor masses never enjoyed the so-called benefits. The Multi/Transnational Mafia always enjoyed the power to raise the cost of lower end drugs to match the MRP which was very much more than the NMRA prices that existed.  The whole exercise was an agonizing effort or merely, a ‘Day-light Robbery!  

The Billion Dollar question is what prevents our health authorities from working on a formula based on Professor Senaka Bibile’s principles and reforms?  He strongly advocated the inevitability of making it compulsory that the doctors did prescribe only under the Generic name of the product. In 2015 they introduced legislation on prescription habits [generic only], but made a mockery of it by adding, “a brand name also could be mentioned”.   Power of the Mafia!

  Next, and the most vital query, why are they not compiling a list of essential drugs that need to be imported exclusively by the SPC ?
 Until they find valid answers to the above; the foremost obligation of the media is to make the public aware of ‘Big Pharma  or the Mafia’s clandestine ‘operations;’ how the tricksters thrive under public’s ignorance about the extremely harmful properties of unessential ‘drugs’ they use; and educate them on billions of Dollars lost as a result and the unprecedented gains the nation could achieve through the proposed Professor Bibile reforms. There must be civil society pushing for better prices of medicines. There is no such civil society at present - If Prof Bibile’s policies had been implemented properly, a lot of this would not have happened. However, the section that has been implemented is working reasonably well.

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