{"id":93205,"date":"2019-09-21T16:06:19","date_gmt":"2019-09-21T23:06:19","guid":{"rendered":"http:\/\/www.lankaweb.com\/news\/items\/?p=93205"},"modified":"2019-09-21T16:06:19","modified_gmt":"2019-09-21T23:06:19","slug":"health-education-and-yahapalana-part-7","status":"publish","type":"post","link":"https:\/\/www.lankaweb.com\/news\/items\/2019\/09\/21\/health-education-and-yahapalana-part-7\/","title":{"rendered":"HEALTH, EDUCATION AND YAHAPALANA Part 7"},"content":{"rendered":"

KAMALIKA\u00a0 PIERIS<\/em><\/span><\/h2>\n\n\n

DRUG\nSHORTAGE<\/strong><\/p>\n\n\n\n

Doctors held\nmedia conferences on 1.8.19 and 2.8.19 to inform the public of serious shortage\nof drugs. This was shown in television news. The doctors said that there were\ndrug shortages at many hospitals. They included Ampara, Anamaduwa, Balapitiya,\nChilaw, Galle, Kandy, Karapitiya, Kegalle,  Mahiyangana Matara Naula, Puttalam and\nRatnapura. <\/p>\n\n\n\n

Lists of the drugs in short supply were shown. There was a shortage of 36 drugs at Matara general hospital, 30 at Anamaduwa and 15 at Kegalle. They included drugs for diabetes, asthma, heart disease urinary infection and emergency medicine, several cancer drugs were in serious shortage. Cancer hospital, Maharagama lacked a drug that was needed for cancer patients who could be cured. <\/p>\n\n\n\n

There are two reasons for drug shortages, the doctors said. Firstly, drugs are bought when they are nearing the expiry state. After some time, these drugs are discarded, but by then about 90% of these drugs have been given to the patients. In 2015, there were 1334 \u2018no objection\u2019 letters issued by the Health Ministry, permitting such drugs to come in. secondly the drugs are of poor quality and have to be discarded. Health Ministry, however, denied that there was a drug shortage in hospitals.\u00a0 The Ministry also said that when a hospital runs out of a drug, it is permitted to purchase from private sources. <\/p>\n\n\n\n

DRUG\nPURCHASES (1)<\/strong> Trastuzumab<\/p>\n\n\n\n

A tender awarded by Cabinet for the supply of 1,875 vials of Trastuzumab to the lowest bidder, has aroused concern. Conditions that were not part of the original bid document have been imposed after the tender was awarded. State Pharmaceuticals Corporation had introduced a new condition of pre-shipment sample testing at TGA-Australia, which would take three to four months. <\/p>\n\n\n\n

Ministry of Health, when told this,   had directed that no new conditions should\nbe included in the contract. This was ignored. The new specifications included\nthe new condition of TGA laboratory testing. <\/p>\n\n\n\n

GMOA said this was a “delaying tactic”. There are ongoing moves to offer a 15-year \u2018buyback guarantee\u2019 for the product. This was an attempt to buy time until the \u2018buyback guarantee\u2019 agreement was pushed through. Big fish\u2019 were involved in this matter.<\/p>\n\n\n\n

 The\nprice quoted by the supplier for Trastuzumab is Rs. 95,500 + 20% per vial\ntotaling Rs. 115,000 with the \u2018buy back\u2019 price. This would translate into a\nstaggering Rs. 50 billion loss to the country. \u2018<\/em>When there are many globally accepted products offered at more\ncompetitive pricing, why should a \u2018buy back guarantee\u2019 be given to a Russian\nproduct which is not accepted world-wide, asked the doctors.<\/p>\n\n\n\n

The \u2018buy back guarantee\u2019 spanning such a long\nperiod will   deny a level playing field\nto other stakeholders. It will   shut out\nnew technology, modern drugs to treat cancer patients in Sri Lanka. It will\nalso jeopardize the lives of cancer patients by creating a monopoly to allow a\nsingle supplier to import the substandard Russian drugs at relative higher\nmarket prices through a 15-year \u2018buy back guarantee\u2019.  <\/p>\n\n\n\n

This purchase has   come before the Presidential Commission\nprobing corruption  in Yahapalana\ngovernment.  Oncologists told the\nCommission that 85% of patients in the country are being treated for early\nstage breast cancer and therefore an effective drug was needed.<\/p>\n\n\n\n

 <\/em>Oncologists  rejected the Russian made Trastuzumab and\nBevacizumab drugs as they remain unproven in terms of clinical efficacy and\nsafety.  For the registration of a drug,\na Certificate of Pharmaceutical Products (COPP) is issued by an institution\naffiliated to the Health Ministry in a country. However, in the case of\nTrastuzumab, this certificate has been issued by the Industry and Commerce\nMinistry of Russia.  <\/p>\n\n\n\n

The pharmacist who evaluated the Russian drug\ntold the Commission that the product didn\u2019t fulfill many basic regulatory\ncriteria. Among them were the minimum six months stability of the product. The\nproduct was launched in Russia in January 2016 and registered in Sri Lanka in\nFebruary 2016.  <\/p>\n\n\n\n

There was also the requirement to have at least\nthree exporting countries. This was totally overlooked. The Russian\nmanufacturer also did not have the basic WHO GMP.  The Russian manufacturer had withdrawn its\nIndian operations due to possible quality concerns,  said  critics. \n<\/p>\n\n\n\n

DRUG\nPURCHASES (2)<\/strong> Flucloxacillin<\/p>\n\n\n\n

A \ntender for importing 25 million capsules of Flucloxacillin was called in\nMay 2018. The Medical Supplies Division informed the SPC that there was a\npressing need for the antibiotic. The\ntender had been awarded to a company quoting almost double the price of the cheapest\nbidder. Thereby causing a loss of more than Rs. 70 million to the state. <\/p>\n\n\n\n

There were four bids by three companies,\nOrient, Microlabs and Pharmace. Orient\nand Pharmace were both going to import the drug from Bangladesh and  there was no difference in quality, either.\nBut for a card of 10 capsules, Orient quoted Rs. 37 while Pharmace quoted Rs.\n68 .<\/p>\n\n\n\n

The Technical Evaluation Committee (TEC)   rejected Orient, for having a low bid bond,\nand Microlabs for not being a registered company, and awarded the tender to\nPharmace although their quotation was almost twice as Orient\u2019s. <\/p>\n\n\n\n

This \ntender came before Presidential Commission of Inquiry  investigating corruption in the current\nadministration. Commission found that Technical Evaluation Committee had used\nnon-existing specifications to overlook the bidder who had quoted the lowest\nprice <\/p>\n\n\n\n

Orient\u2019s bid had been rejected because it had\nnot provided 2% of the estimate cost as the bid bond, a guarantee that the\nbidder will undertake the contract if selected, and because they had not quoted\nthe price for the \u2018pack size\u2019 that the Ministry wanted.” <\/p>\n\n\n\n

“The estimated cost was Rs. 225 million\nand Orient had not given 2% of the estimate cost as the bid bond. Moreover\nwhile the specifications said that the pack should comprise 10 capsules in a\ncard, Orient had listed another amount, said the  TEC.  <\/p>\n\n\n\n

The Commission wanted the head of the TEC  who was also a  Deputy Director of Health to show the\nsection  in the bid document, where the\nestimated cost and pack size was  \nstated. He could not do so, but instead presented a letter sent by the\nState Pharmaceutical Corporation  to the Ministry,\nstating that the estimated cost was Rs. 225 million. The witness also  failed to find the relevant sections of the\nbid document on the pack size.   He\ncould  not show that these\nspecifications  had been communicated to\nthe bidders, either. <\/p>\n\n\n\n

The\nCommission observed that since there was no evidence to suggest that the  bidders had been informed about estimated\ncost and  pack size, it would have been\nabsurd to expect  a response from the\nbidders. <\/strong><\/p>\n\n\n\n

APPOINTMENTS (1)  <\/strong><\/p>\n\n\n\n

Supreme Court has given two historical\nverdicts\u201d regarding two inappropriate appointments made by the Health\nMinister,  announced GMOA in May 2019. The\ntwo verdicts had been given in connection with appointments made by the Health\nMinister for the posts of the National Medicine Regulatory Authority (NMRA)\nChairman and the Chief Executive Officer. Supreme Court had given a similar\nverdict in connection with the inappropriate appointment made by the Health\nMinister for the  Director, Sri\nJayewardenepura Hospital.<\/p>\n\n\n\n

APPOINTMENTS (2) <\/strong><\/p>\n\n\n\n

GMOA said, in a\nmedia statement, in July 2019 that there had been a delay in appointing Intern\nMedical Officers and that had caused a major crisis in the health\nsector.”This has stopped a lot of medical students who have completed\ntheir education from starting work. It also affects patients because the delay\nin appointing Intern Medical Officers will lead to a shortage of doctors. Moreover\nthose who have completed their intern appointments still have to continue in\ntheir present stations for want of replacements.” <\/p>\n\n\n\n

The final year\nexaminations of all state medical faculties have been conducted and results\nissued. The Act 16 examination for foreign medical graduates has also been\nconducted. There are people who have passed these exams and are waiting to\nstart their professional career.” <\/p>\n\n\n\n

GMOA charged  that there was a \u2018plot\u2019 to appoint medical\ngraduates of South Asian Institute of Technology and Medicine (SAITM) and a\nnumber of foreign graduates who had failed GCE A\/L, as intern medical officers.\nWe insist that intern appointments should be given only to medical graduates\nrecognized by the Sri Lanka Medical Council. \nWe will oppose any attempt to appoint SAITM and foreign graduates to\nthese intern positions.<\/p>\n\n\n\n

GMOA STRIKE<\/strong><\/p>\n\n\n\n

The\nGovernment Medical Officers\u2019 Association (GMOA) announced that would launch a\n24-hour strike on  22.8.19 . The strike is on account of eight\nissues  that relate to medical matters.\nGMOA  said it is  not demanding any salary increases but is\nlaunching this strike in the public interest.<\/p>\n\n\n\n

There are several reasons why we are going on\nstrike, they said.  Among them are drug\nshortages in hospitals and the substandard drugs given to patients, the\nattempts by the Minister to appoint persons who had failed all three subjects\nat GCE A\/L as doctors, for not passing laws specifying the minimum standards\nfor medical education,  attempts to\nweaken the Sri Lanka Medical Council through new regulations, delaying post\nintern appointments  and against the\nactions of the Health Minister, which they alleged were destroying the health\nsector. GMOA also observed that the\npoliticisation of the doctors\u2019 transfer scheme has led to a breakdown of\nservices at rural hospitals.<\/p>\n\n\n\n

The two main\nreasons for the strike, however, is the issue of not introducing the Minimum\nStandards of Medical Education and trying to amend the Service Minute of Doctors.  Health Minister should table the Minimum\nStandard of Medical Education in Parliament and stop the process of amending\nthe \u2018Doctors\u2019 Service Minute\u2019 with immediate effect, GMOA said. <\/p>\n\n\n\n

Health Minister has not brought in the Minimum\nStandards of Medical Education because the standard  very clearly  gives the minimum G.C.E.Advanced Level\nExamination result of a student eligible to enter a medical faculty. It also\ngives the  physical facilities that\nshould be in any medical faculty, the human resources that should be in any\nmedical faculty and especially the required standard of any Teaching Hospital\nattached to any medical faculty. A Teaching Hospital is a must for any medical\nfaculty.<\/p>\n\n\n\n

The main objective of amending the existing\nService Minute of Doctors is  to enable\nunqualified individuals to enter the public service as MBBS doctors. At the\nmoment it cannot be done because of the rules and regulations of the Doctors\u2019\nService Minute,\u201d GMOA said. <\/p>\n\n\n\n

The GMOA has\nthe list of unqualified individuals who have failed all three subjects in the\nGCE Advanced Level Examination in the Science Stream and want to become MBBS\ndoctors. It also has the list of names \nof those who had not studied in the Science stream in G.C.E.Advanced\nLevel Examination,\u201d GMOA added.<\/p>\n\n\n\n

MINISTER\nOF HEALTH <\/strong><\/p>\n\n\n\n

Rajitha is the worst Health Minister we have\nhad in our history,   said the GMOA   at a media conference in August 2019. The\npublic seem to agree. When Senaratne went to open a facility at District\nHospital, Negombo in June 2019, the public were waiting to accost him, complete\nwith placards. Senaratne left by a back door. The   angry public then chased after the cars of\nthe officials who left by the front entrance. Television news showed this.<\/p>\n\n\n\n

Members of the Government Medical Officers\u2019\nAssociation  of the Kandy Teaching\nHospital staged a lunch-hour protest  in\nJune 2019 demanding the removal of Health Minister Dr. Rajitha Senaratne from\nhis post. The demonstrators displayed posters carrying accusations against\nMinister Senaratne. Rajitha Senaratne had no moral right to hold the Ministry\nof Health as there were so many allegations of corruption against him,  they said.<\/p>\n\n\n\n

GMOA  sought an explanation from the World Health\nOrganization in June 2019 as to why Health Minister Dr. Rajitha Senaratne had\nbeen granted the title of Vice President of its Executive Committee.  The GMOA drew the attention of the WHO\nto  two specific issues. importation of\nlow quality cancer drugs not certified by the WHO and the allocation of public\nfunds amounting to nearly Rs. 5 billion to Neville Fernando Hospital, which the\nstate has not  yet acquired.  <\/p>\n\n\n\n

GMOA also brought to the WHO’s notice recent\nthreats to the GMOA and the decision to lodge complaints with police\nheadquarters in that regard.  GMOA\u2008\npointed out that Dr. Senaratne was engaged in such activities while identifying\nhimself as the Vice President of the WHO.<\/p>\n\n\n\n

Further, \nDr. Seneratne has  brazenly used\nthe title given by the WHO, in support of personal political projects,\nincluding an ongoing image building exercise. The GMOA has sought a\nclarification from the WHO Country Office in Colombo whether it had funded an\nevent held in Colombo to celebrate Dr. Senaratne’s achievements. GMOA raised\nthis issue because Senaratne had said in Parliament that the event was\nsponsored by the WHO.<\/p>\n\n\n\n

The GMOA sent copies of its complaint to WHO\nGeneva,  to the President’s Secretary, to\nthe PM’s Secretary, Health Secretary and Director General Health Services. The\nGMOA has sought an urgent meeting with the WHO to make further representations\non the issue. (CONCLUDED)<\/p>\n","protected":false},"excerpt":{"rendered":"

KAMALIKA\u00a0 PIERIS DRUG SHORTAGE Doctors held media conferences on 1.8.19 and 2.8.19 to inform the public of serious shortage of drugs. This was shown in television news. The doctors said that there were drug shortages at many hospitals. They included Ampara, Anamaduwa, Balapitiya, Chilaw, Galle, Kandy, Karapitiya, Kegalle,  Mahiyangana Matara Naula, Puttalam and Ratnapura. Lists […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":true,"template":"","format":"standard","meta":{"footnotes":""},"categories":[104],"tags":[],"class_list":["post-93205","post","type-post","status-publish","format-standard","hentry","category-kamalika-pieris"],"_links":{"self":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/93205","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/comments?post=93205"}],"version-history":[{"count":0,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/93205\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/media?parent=93205"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/categories?post=93205"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/tags?post=93205"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}