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Acute shortages: Healthcare sector to flatline? 

30 Apr 2022

  • Securing LCs for pharma remains challenging
  • Pvt. importers complain of unsustainable losses
  • 6 lifesaving, 239 essential medicines out of stock: SGP
By Maheesha Mudugamuwa Medical experts continue to warn that the country’s healthcare sector will come to a standstill in mid-May due to a severe shortage of essential and lifesaving pharmaceuticals. The prevailing foreign exchange crisis that has affected the pharmaceutical supply chain has now forced State and private hospitals to utilise their emergency stocks, which will only be sufficient for the next two weeks, The Sunday Morning learns.  Medical experts The Sunday Morning spoke to stressed that unless the Government comes up with a long-term solution to resolve the existing foreign exchange shortages and aids in restoring pharmaceutical supply chains for both private and State sectors immediately, the country will be facing a medical catastrophe that will put the lives of many Sri Lankans at risk.   Forex woes Severe shortages are looming in a backdrop where the private pharmaceutical importers as well as the State pharmaceutical supplier, the State Pharmaceutical Corporation (SPC), are currently facing extreme difficulties in establishing Letters of Credit (LCs) to enable a continuous supply of essentials to the local market. This is despite a recent World Bank grant of $ 10 million to Sri Lanka, aimed at facilitating rapid replenishment of depleted stocks. The acute shortages of foreign exchange and the dollar rate fluctuations have forced pharmaceutical importers to cut down their imports so as to avoid massive losses. Importers claimed that even though the Government had allowed a price increase, they would still be incurring losses due to the ongoing market volatility. According to private sector pharmacists, around 25% of the total medicines in Sri Lanka had gone out of stock as of last week and they claimed the number was growing day by day.  In the meantime, State pharmacists warned that 38.7% of medicines and 62.9% of the surgical supplies had run out of stock and another 50% of medicines which should have been available in the Medical Supplies Division (MSD) were also now out of stock. Critical situation Health sector trade unions have alleged that there is a shortage of nearly 200 essential medicines and five types of life saving drugs around the country and they predict that the shortages will get worse in coming weeks unless the Government allocates necessary funds for pharmaceutical imports. As the State and private sector hospitals are both facing shortages, experts of both sectors are urging the Government to prioritise the health sector when disbursing foreign funds as well to seek immediate humanitarian support from the world. “We are in a critical situation. The remaining stocks at private hospitals are enough for only around two weeks. Once the stocks are over, the hospitals cannot operate. Therefore, we are heading into a dangerous situation,” Association of Private Hospitals and Nursing Homes (APHNH) President Dr. Ananda Kuruppuarachchi told The Sunday Morning. He said they had already written to the relevant authorities but could not expect a solution from the Government sector as they were also facing severe shortages. According to him, they have sought the assistance from international donors as well. In a letter written to the Private Health Services Regulatory Council, the APHNH has highlighted that a total of 76 essentials medicines are in short supply in addition to ET tubes, suction tubes, NG tubes, urinary catheters, spinal needles, and suture material – all of which are also out of stock in the private sector. Dangerous shortages As highlighted by the All-Island Private Pharmacy Owners’ Association (AIPPOA), there is an extremely dangerous shortage of essential medicines which has now affected around 25% of the total medicines. “Many drugs are out of stock,” AIPPOA President Chandika Gankanda stressed, adding that the importers had also limited their imports due to the prevailing shortages. “We don’t get stocks as importers have cut down imports. The Government raised the prices when the dollar was at Rs. 255 but now it has increased to Rs. 320. Earlier the Finance Ministry assured a weekly increment based on dollar rate, but with the changes made there, the discussions were stalled. Even if prices are revised, the shortage will remain due to the foreign exchange shortages,” Gankanda stressed. However, when it comes to the State sector, as highlighted by Academy of Health Professionals (AHP) President Ravi Kumudesh, there is a serious shortage of about 40 essential medicines in the health service and he stressed that if this situation were to continue for another month, that number could reach around 150.  “Streptokinase, antirabies serum, tenecteplase and some anti-cancer drugs, antibiotics, analgesics, and even anaesthetics are hard to find. Also, the lack of regular medication for Non-Communicable Diseases (NCDs) can become a long-term problem,” he added. Meanwhile, as highlighted by the Society of Government Pharmacists (SGP), 525 kinds of medicines and 5,376 kinds of surgical supplies are now in short supply in the Colombo Medical Suppliers Division (MSD). According to SGP President Ajith P. Thilakaratne, the list includes six life-saving drugs, 239 essential medicines, 280 rare drugs, and 2,721 essential surgical drugs. According to the SGP, 38.7% of medicines and 62.9% of the surgical supplies have run out of stock. It said that 50% of medicines which should have been available in the MSD were also now out of stock. Pricing problems Meanwhile, Sri Lanka Chamber of Pharmaceutical Industry (SLCPI) President Sanjeewa Wijesekera told The Sunday Morning that the difficulty in opening LCs and the pricing issue had affected imports as many incurred losses due to not having price adjustments. “At present there is an out-of-stock situation mainly due to the ongoing forex crisis,” he added. As the price adjustments were given only last week, the SLCPI President stressed that there was marginal erosion incurred by the importers due to the rupee depreciation. However, as he predicted, even if the prices had been adjusted, the existing difficulties in opening of LCs would further affect imports.   The National Medicines Regulatory Authority (NMRA) has approved a maximum 20% price increase for non-gazette medicines beginning from 25 April. Securing funds The Sunday Morning reliably learns that Sri Lanka is in urgent need of securing nearly $ 60 million to import essential medicines for the next three months in addition to the $ 12 million required immediately by the State Pharmaceutical Corporation (SPC) and Osusala. As of now, the World Bank (WB) has agreed to provide a total of $ 10 million for the health sector and a total of $ 14 million is expected from the Asian Development Bank (ADB). Health Minister Prof. Channa Jayasumana has stated that several LCs have been opened for the importation of 186 drugs worth $ 19.2 million, 12 drugs and surgical instruments worth Euro 175,000, and 73 pharmaceutical surgical instruments and medical equipment worth Rs. 3.7 billion. Furthermore, 101 different medical drugs and surgical instruments donated by the Government of India arrived in Sri Lanka on Wednesday (27 April), brought by an Indian Navy ship. Further, the Government of India has also made a donation of drugs worth Rs. 340 million, which are due to arrive in the country within a week. According to Minister Jayasumana, Sri Lanka will also receive $ 1.37 million worth of medical aid from the WHO and Rs. 340 million from the Thai Government in the first week of May. The Singapore Red Cross has also confirmed that it will donate Rs. 340 million worth of drugs. Attempts by The Sunday Morning to contact Health Minister Prof. Channa Jayasumana proved futile.  Lab tests restricted Laboratory tests have been restricted due to the lack of reagents and chemicals and some investigations have already been stopped, Academy of Health Professionals (AHP) President Ravi Kumudesh told The Sunday Morning. “If left without a solution for a month or two, most investigations may come to a halt. Also, timely maintenance is recommended for equipment such as CT scanners, MRI scanners, linear accelerators, and some laboratory instruments as well as ventilators,” Kumudesh stressed.    


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