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Drugs crisis: Symptoms dealt with but permanent cure delayed

By Nadia Fazlulhaq

The Health Ministry is to launch a probe to find out the causes that led to a severe drug shortage in public hospitals even as 40,000 bottles of saline were airlifted from India and orders were placed to bring down drugs to the tune of Rs. 450 million as an emergency measure.

Health Ministry Secretary Dr. Ravindra Ruberu told the Sunday Times the ministry would carry out an extensive probe to get to the core of the matter that caused regular drug shortages in public hospitals in recent years.

“We found out that 319 varieties of essential drugs are in short supply in public hospitals,” Dr. Ruberu said. He revealed that a consignment containing 90 varieties of essential drugs had reached Colombo port and would be cleared in the next few days. He said the rest of the essential drugs would be bought from local agents or airlifted from parent companies in India.

On Thursday, Sri Lanka Air Force cargo aircraft brought in 40,000 bottles of saline and the same aircraft left for India to bring in more essential drugs. According to health officials, public hospitals require some 600,000 bottles of saline a month.

Emergency treatment for the drug crisis: Air Force personnel unload bottles of saline airlifted from India

Dr. Ruberu also revealed that the Cabinet had decided to send a team to Mumbai tomorrow to meet registered pharmaceutical companies and place orders. Apart from Health and Finance Ministry officials, the team will also consist of officials from the Medical Supplies Division (MSD), State Pharmaceutical Corporation (SPC) and the Drug Regulatory Authority.

The Health Ministry Secretary said he was confident that within the next two weeks, they would be able to bring the situation back to normal. Asked whether there was a permanent remedy for the drug crisis, Dr. Ruberu said it could come only if the national medicinal drugs policy was implemented.

Meanwhile, another senior Health Ministry official said he believed the drug shortage hit state hospitals after authorities removed sub standard drugs from the stocks last year and banned six Indian companies.

He said another factor that caused the shortage was the lack of coordination between the Medical Supplies Division (MSD) and the State Pharmaceutical Corporation.

When asked to identify the drugs that were in short supply, the official said they included painkillers, antibiotics, drugs given to asthma, diabetic, heart and kidney patients, and drugs that controlled cholesterol and high blood pressure. He said patients undergoing surgery were the worst affected.
He said that as a long-term solution, the State Pharmaceutical Manufacturing Corporation (SPMC), the state’s drug manufacturing arm, should increase its capacity and take steps to produce most of the drugs locally.

SPMC General Manager Sujeewa Jayasundara said if the government provided necessary facilities, they were confident they could produce high quality drugs locally. But she lamented that the orders from the state sector were not encouraging.

“The SPMC manufactures 59 varieties of drugs but only around 20 of them are purchased. Most often, the SPMC bid is rejected when tenders are called. We are unable to compete with multinational drug companies because our manufacturing cost is high. But if we get big orders, we can be competitive,” she said.

The State Pharmaceutical Corporation (SPC) is the sole importer of drugs for public hospitals.
When asked whether the SPC should take the blame for the drug shortage, General Manager Dinusha Dassanayake said the crisis was largely due to supply gaps or delays in MSD tender procedures.

Meanwhile the All Ceylon Health Services Union President Gamini Kumarasinghe said there was an urgent need for the implementation of the national medicinal drugs policy to prevent drug shortages and irregularities. Calling on authorities to streamline tender procedures, he expressed concern over emergency purchases.

“When tenders are called, the technical evaluation committee made up of medical experts checks on quality and other requirements, but in emergency purchases, some companies do not agree to pay back or replace the drugs if sub-standard supplies are sent,” he said.

Mr. Kumarasinghe said his union would meet Health Minister Maithripala Sirisena next week and insist on the implementation national medician drugs policy.

Mega tender gives just 24 hours for bidders

A full-page newspaper advertisement placed by the State Pharmaceutical Corporation, calling on local agents of registered drug manufacturers to submit their bids for the supply of essential drugs, has raised many eyebrows in the health sector.

The advertisement published on May 13 stated that the tender would be closed at 10.30 a.m. on May 14 leaving suppliers with little or no time to submit their bids.

The intended suppliers were also asked to produce a Certificate of Analysis in less than 24 hours.

The notice called on bidders to supply 95 varieties of essential drugs and they included:

  • Cloxocillin 250mg 1,200,000 vials
  • Frusemide 300,000 amps
  • Ampicillin 250mg 2,000,000 vials
  • Cefatoxime 1g 100,000 vials
  • Adrenaline Tarterate 1ml 100,000 amps
  • Captopril 25mg 10,000,000
  • Atrovastatin 10 mg tablets 5,000,000
  • Beclamethazone DP 200 mcg caps 2,500,000
  • Salbutamol Dry Powder caps 200 mcg 1,200,000
  • Salbutamol Dry Powder caps 400 mcg 1,500,000
  • Chlorpheniramine Maleate 4mg tabs 30,000,000
  • Famotidine 20 mg tabs 15,000,000
  • Daxamethazone 0.5mg tablets 4,000,000
  • Isosorbide Dinitrate 10 mg tabs 20,000,000
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