Essential drugs shortage puts patients and hospitals in a spot

By Malik Gunatilleke

Hospitals around the country are facing a serious shortage of drugs, many of them essential drugs, and this is causing deep concern among patients and health workers. Many attribute the shortages to last year’s budgetary cuts in allocations to the Ministry of Health.

According to sources, 300 essential drugs are in short supply in many of the country’s hospitals. Some of these drugs are critical for patients suffering from diabetes, asthma and heart conditions, as well as expectant mothers. Doctors have confirmed that the shortages have affected government hospitals.
Dr. D. D. Wijeykoon, director of the Anuradhapura General Hospital, told the Sunday Times that drug supplies have been irregular, making it difficult for hospitals to give accurate figures on what drugs are available or in short supply at a given time.

“One day we may have stocks of a particular drug, but the next day we may run out and additional stocks may not come,” he said. “Today we might not have enough saline, but the following day we will have enough.”

In the past, the Anuradhapura hospital would receive supplies for three months at a time, while today stocks last for a week or less, Dr. Wijeykoon said.

Dr. W. K. W. Kumarawansa, director of the Matale General Hospital, said the shortages began to be felt early this year, and that antibiotics and anaesthetics are in particularly short supply. The hospital buys drugs locally at the patients’ request, using funds provided by the Central Provincial Council.

Dr. Ravindra Ruberu, Secretary to the Ministry of Health, said the Ministry was studying the reasons for the drugs shortages and looking at ways to prevent shortages from happening in the future. “There are 8,000 drug types in the drugs inventory. Sometimes orders get delayed. For now, we are focusing on getting the drugs that are really necessary, and as soon as possible,” he said.

Dr. Ruberu said he could not confirm at this stage whether insufficient allocations to the Ministry had led to the shortages, but that the matter should be resolved in the next three weeks. Of the 300 drugs in short supply, 45 essential drugs have been already ordered and should be available shortly, while clearance is being awaited for another 95 drug types. He expected these to be purchased within the next two weeks.

A team of professionals has been appointed to look into the matter, following a meeting last Monday between the Health Minister and trade unions. The team is headed by Dr. Palitha Mahipala, deputy director-general, Department of Public Health. Unionists say a report will be submitted to the Minister in two weeks’ time.

Gamini Kumarasinghe, president of the All Ceylon Health Services Union, told the Sunday Times that the drugs in short supply were those used to treat serious medical conditions, and that essential vitamins, surgical gauze and saline were also in short supply. He said some vitamins were essential for pregnant women, and that patients were being given chits to buy drugs from outside dispensaries.
“The funds allocated for the purchase of drugs were obviously insufficient, and the Minister says it will take at least three months to sort out matters,” he said.

The worst affected hospitals are areas outside Colombo, the worst hit being Anuradhapura, Kalutara and Ampara. According to Dr. Jayantha Bandara, secretary of the Senaka Bibile Association, the entire medical system is falling apart because there is no proper drug policy.

“The government should take responsibility,” he said. “We have had this problem for two years now. It is not just drugs that are in short supply. Hospitals are also in desperate need of medical and surgical instruments, as well as chemical reagents.”

Dr. Bandara said some patients were in a life-threatening predicament, that neither the state nor the hospitals were taking responsibility, and that the patients would be the ones to suffer should the situation get worse.

“A diabetic patient who doesn’t get insulin for a month will certainly die. The hospital will record it as a death due to diabetes, but the truth will be that the patient died because there was no access to treatment,” Dr. Bandara said.

Saman Ratnapriya, president of the All Ceylon Health Workers Union, blamed the shortages on poor communication between the Department of Health and the Treasury, which had failed to allocate adequate funds for medicinal drugs.

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