Even as the country is watching closely for guidance from the Supreme Court to take us out of the current political imbroglio, governance must go on and corruption rooted out. And, the uncovering of a massive loss of public funds due to the import of sub-standard pharmaceuticals over the past two years and more, is a reminder to the citizenry that despite distractions, the administration’s sharp eye does not miss such financial muck-ups.
Politicians may rant about the seeming failures of political leadership, but the huge financial trickery and plunder attempted might have gone undetected if not for the vigilance of the administration and its leadership.
In this latest case, the country has apparently lost Rs. 3.8 billion in the import of two types of drugs used in the treatment of cancer because the products were found to be sub-standard and had to be subsequently withdrawn from circulation. The drugs, namely,Trastuzumab and Bevazizumab, are produced in Russia and were imported to Sri Lanka over the past two-and-a-half years. Despite their being declared as substandard, these two drugs continued to be purchased over this period, exposing cancer patients using them to the risk of health complication.
According to reports, the Ministry of Health as well as the State Pharmaceuticals Corporation (SPC) were involved in these imports and the sub-standard nature of the drugs were detected only after their issue had begun.
Who took the decision to select these drugs for purchase? Who decided on the quality standard of these drugs? Were the required quality checks and procedures complied with? Or, were the test results fixed by the scheming perpetrators? Who authorised the issue of these two drugs to patients and, did those officials know of the sub-standard quality of the medicines? Is this, simply, a case of colossal negligence, possibly criminal negligence? Or, is it an act of cruel greed by some for whom the ultimate fate of the drug consumers – cancer patients – was not a concern?
Now, even while criminal investigations are undertaken by the police authorities, the medical authorities must investigate the human toll arising from the issue of these sub-standard pharmaceuticals to cancer patients. This only adds to state expenses in relation to this matter. Whether the full human cost among those already suffering from the deadly disease will ever be wholly ascertained, is itself a question.
Will the personnel involved in both the decision to import these drugs as well as in the issue to patients be identified and prosecuted? The co-operation between administration officials and the drug retailers pertaining to this case should be lauded as a demonstration of the sense of social responsibility and vigilance by the pharmaceuticals private sector.
Sri Lanka’s pharmaeuticals policy has a proud record ever since the late Prof Senaka Bibile’s pioneering endeavour to classify drug types and formulate a comprehensive policy of drug acquisition that ensured maximum patient well-being while drastically curtailing drug import costs. Ultimately, Prof Bibile became a legend in global health circles while his generic drug listing and testing system became a model for the impoverished developing nations under the tutelage of the World Health Organisation.
This rigorous system of drug quality control and equitable distribution contributed significantly to the remarkable achievements of Sri Lanka’s publicly funded and structured health care system.
Today, Sri Lankans expect to enjoy a relatively high standard of health care in comparison with much of the developing world. The state-run medical care system has become a vital support, especially, for the mass of Sri Lankans who yet cannot afford private medical attention. For patients affected by such serious diseases as cancer, for which the drugs are generally of a high cost level, the country’s usually effective quality control system has been a great source of support in their time of affliction.
Such scandalous wastage and abuse of drug quality controls only serve to undermine this trust among Sri Lankans, especially, those seeking recourse from the health care system.
It is now necessary to thoroughly investigate the whole system of quality controls and drug distribution to identify the gaps in methods and the lapses by personnel that citizens are, once again, reassured of the quality medical care they have come to expect. If criminal negligence or, worse, outright intentional criminality is involved, prompt prosecution and retribution is needed.
Will those responsible at the top of the health systems administration be ready to bear some moral responsibility, even if they are cleared of any culpability themselves?
Sri Lankans demand answers to these questions, even as they await the outcomes of the equally weighty problems in the political arena. The physical and mental health of the nation is as important to citizens as the successes and failures of overall governance.