Drug shortage – emergency in state health sector that needs to be addressed now
Chilling disclosures by powerful SLMA Panel of health experts
Sri Lanka is facing an “emergency” with regard to the shortage of essential medicines. Of around 300 essential medicines, the stocks of about 160 are “zero” at the Medical Supplies Division (MSD).
This was the chilling revelation by a panel of powerful health experts of the Sri Lanka Medical Association (SLMA) on Thursday afternoon.
“Some hospitals may be having limited stocks of these medicines. Of the zero-stock 160 medicines, about 60 medicines are expected to be imported shortly, the Health Ministry has indicated,” said panellist and President of the College of Anaesthesiologists & Intensivists, Dr. Anoma Perera.
She underscored that not only is there a shortage of some essential drugs but there are no stocks at all of others. Some examples are anaesthetics and pain management medicines. Both local and general anaesthetic agents are not available, limiting the options of the doctors.
As Dr. Perera’s college members provide their expertise across the board whether it is a patient in the Intensive Care Unit (ICU), someone who has undergone surgery, an expectant mother who has had a Caesarian section or a victim of an accident, a shortage or lack of medicines would impact them all.
“Whether it is a rural hospital or the National Hospital of Sri Lanka (NHSL), whether it is a state or private hospital, the impact is all over the country. It impacts you and me and if we ignore it anymore, there is a looming dedi asaadya thathvayak (critical situation),” said Dr. Perera, adding it is an avadanam kalayak. In the next few weeks, there would have to be a limitation of all health services, leaving room only for life-saving procedures, if this need is not addressed immediately, right now.
She stressed that the situation can be managed and overcome like Sri Lanka did with the COVID-19 pandemic, “if we act now with the proper use of available resources and strict fiscal discipline”.
Dr. Perera requested people, on their part, to take urgent measures to help overcome this crisis. “Do not throw away any medication prescribed to you but take the full regimen. Control your illnesses, if you are suffering from chronic diseases such as diabetes. Try and prevent accidents whether in your home, on the roads or at your workplace.”
The SLMA Panel told a media briefing on ‘Non-availability of essential medicinal drugs in the health sector’ that the immediate need is to import only essential medicines and halt all imports of non-essential medicines and manage the patients carefully
until the country comes out of this major economic crisis which is impacting heavily on health.
The other members of the panel were SLMA President Dr. Vinya Ariyaratne; the Professor of Pharmacology, Faculty of Medicine, University of Colombo, Prof. Priyadarshani Galappatthy; and Consultant Physician, National Institute of Infectious Diseases (NIID), Dr. Ananda Wijewickrama. The discussion was moderated by SLMA Council Member Dr. Pramitha Mahanama.
On a positive note, the panel said that beginning Tuesday, the Health Ministry has set up a committee comprising all stakeholders such as representatives from professional medical colleges, associations and the Government Medical Officers’ Association (GMOA) and health officials to discuss and find solutions to take prompt action with regard to this situation.
The committee, chaired by the Director General (DG) of Health Services, Dr. Asela Gunawardena, is scheduled to meet weekly, with a monthly meeting with the Health Minister also on the cards. In addition to ministry officials, the committee includes those from the National Medicines Regulatory Authority (NMRA), the Medical Supplies Division (MSD) and the State Pharmaceuticals Corporation (SPC).
Dr. Ariyaratne said that the SLMA had predicted a crisis with regard to a shortage of medicines, in a letter to then President Gotabaya Rajapaksa, in April 2022 (last year) and urged “immediate action”.
Now the crisis is upon us, he said, stressing that if there is a further delay in addressing this critical need, patients would be in grave danger. It is clear that there is an emergency, barapathala thathvayak.
“Like all our experts have pointed out though this is a challenging time, it is also an opportunity to define and introduce a strong drug management system which would be of immense value to the country in the long term,” added Dr. Ariyaratne.
On a positive note, the panel said that beginning Tuesday, the Health Ministry has set up a committee comprising all stakeholders such as representatives from professional medical colleges, associations and the Government Medical Officers’ Association (GMOA) and health officials to discuss and find solutions to take prompt action with regard to this situation.
Prof. Galappatthy who chairs the SLMA’s Sub-committee on Medicinal Drugs said that as the earlier system could not be followed due to the economic crisis, they saw the need to send recommendations (nirdesha) to minimize the import of non-essential medications. Is Sri Lanka using the Indian Credit Line optimally – for the import of essential medicines versus non-essential medicines?
“Seeing shortcomings, we requested a
mechanism to support the Health Ministry because the doctors from all professional colleges are working across the country at all hospitals and dealing with patients on a daily basis. This is why the DG has set up this committee,” she said, pointing out that it would help to focus on critically required medicines, identify whether they can be secured in the form of donations; whether one hospital facing a shortage can borrow any excess stocks another hospital may have; or whether medicines need to be purchased from abroad. The committee discussions
would help show the way forward.
Referring to donations, Prof. Galappatthy said that non-essentials can also come into the country this way, while it may be difficult to maintain standards if there was a flood. Importing medicines cannot be equated to importing something like soap.
She reminded how Sri Lanka faced a similar situation during the tsunami and large stocks not only of non-essential medicines but also expired ones had to be destroyed at great cost. There should be no repetition.