Without investment into laboratories, SL will be plagued by low quality medicine – Expert

By Rathindra Kuruwita

While 80 percent of medicinal drugs are imported, Sri Lanka does not have facilities to test these drugs, and there is nothing to prevent more bad drugs from entering Sri Lanka in the future, former Chief Epidemiologist of the Ministry of Health and former President of the College of Community Physicians of Sri Lanka (CCPSL), Dr. Nihal Abeysinghe, said.

He added that when the National Medicines Regulatory Authority (NMRA) was established in 2015, then Health Minister Rajitha Senarathne promised to establish a laboratory within a short period.

“In the first decades following independence, we spent a lot of money on healthcare. However, this has changed in the past few decades. We have neglected to do things that are of utmost importance. I was at the epidemiology unit for 21 years, and because we know we can’t test drugs or vaccines, we do a lot of desk research before ordering any drug. This is what we have been doing as doctors,” he said.

Dr. Abeysinghe added that when registering a drug in Sri Lanka, a group of experts conducts their own independent survey on the quality of the drug. Those in charge of registration, currently the NMRA, study reports on drug trials, journey articles, reports on whether there have been any side effects, etc.

“This process has been disrupted in the past few years, and we are now seeing the consequences. There are issues with the Indian-made anaesthetic Bupivacaine. A few months ago, Prednisolone eye drops, another Indian drug, made a number of people lose their eyesight. This is a medium-term result of the economic crisis. The short-term consequences were the queues,” he said.

Dr. Abeysinghe said Sri Lanka is facing a serious nutrition crisis, and the consequences of this will be felt in the long term.

“We have got both the above-mentioned drugs from the Indian credit line. Perhaps we need to buy drugs from an Indian manufacturer under the credit line, but we could have done our research and found a good company. There are good drug manufacturers in India,” he said. The former chief epidemiologist said that he has been listening to the statements of senior officials and politicians about the deaths caused by low-quality drugs.

“They are taking it lightly. The NMRA head said that some drugs can have side effects, whether they are registered or not. This is also probably an indication that they know there will be other cases like this. If you look at the circular asking doctors not to use the anesthetic drug, the Health Ministry says that this is an unregistered drug. So they have released an unregistered drug for use in surgeries. How is this acceptable?” he asked.

Dr. Abeysinghe said that Sri Lankan governments have not understood health priorities. Visionaries like Dr. Senaka Bibile have been talking about the need to establish a high-tech lab to test imported medicines since 50–60 years ago, he said.

“These visionaries were ignored. However, thanks to the work of the Sri Lankan medical establishment, the consequences of the lack of testing facilities have not been disastrous until now. However, now we are seeing the consequences of our lack of investment,” he said.

A large number of medical practitioners also left the country following the economic crisis, he said. Most Sri Lankan specialist doctors are trained in the United Kingdom or Australia, so they find it easy to migrate, Dr. Abeysinghe, who was also a WHO consultant, said.

“Regular doctors sat for entrance exams to join the medical services of other countries. Some left after finding jobs, and others left expecting to find jobs. Most doctors have found jobs. A lot of nurses and medical technicians are also leaving the country. We are seeing the impact,” he said.