What would Prof. Senaka Bibile do if he was charged by the current leadership to rationalise pharmaceutical purchases in this country? The answer to that question is ‘we don’t know’ and there is no way of finding out because the good professor is no longer with us. But would he have held on to a document which was put into practice 35 years before – we know he didn’t do that in the ’70s because any document 35 years old during the ’70s would have had the smacks of the colonial model. No, Prof. Bibile was trying out a new formula which was gaining popularity all over the world at that time and working on a solution for the need of the hour. The rest we can learn from our history books as to how successful that system was!
Coming back to the future... we see a hidden agenda behind the need to change the current system. One of the policies vehemently advocated by one movement reportedly advocating patient’s rights – dominated by a few Doctors without patients is the reduction of the number of drug brands entering the country. While this NGO whose source of funding is not declared, seems to present some naive configuration to its reason, we all know that in an open economic situation reduction of choice will only create oligopolies if not monopolies.
As this NGO is canvassing for only two or three brands for one generic drug, this can easily create situations where prices will go up as there will be very little competition. Since the NGO is asking for a reduction in the list of drugs, we would like to ask an important question – who will be in charge of pruning the list and how will this not lead to corruption?
by Ananda Samarasinghe
(March 13, Colombo, Sri Lanka Guardian) As a preamble to presenting my point of view I would like first to place on record that the health sector in Sri Lanka is known to be one of the best in the world.
One might spot some hiccups in it here and there but by far and large it is a system that ensures the health care of the people of Sri Lanka, a system that has allowed the people to enjoy the best of both worlds i.e. state provided free medical care and good private sector medical care – in other words, freedom of choice.
But it is not heath care that is the issue here; we have noted the strange lack of balance in some columnists in canvassing the case for a change in the health sector. These writing seems to slant towards totally eradicating an unbeaten system that has existed for the last thirty years and to replace it with an antiquated scheme which has failed on the world stage – The Centrally controlled Economy.
The repetitious quoting of the Late Dr. S.A Wickremasinghe and Prof. Senaka Bibile report has increasingly become a cantankerous whaling which attempts to sounds more and more like the policy of certain other doctors, rather that the late Professor’s reasonable beliefs of that era.
All reports indicate that Prof. Senaka Bibile was a man for all seasons and his dynamic approach to a problem that existed during the Sirimavo Bandaranaike epoch was a commendable achievement.
We all know the ideological need during that time was to cut down on foreign exchange expenses and be less dependent on the outside world; self-sufficiency was the key word of the period. It was the time of closed economies where austerity was the philosophy even if that meant shortages, long queues, widespread hunger and lack of choice.
During this time (on October 17th 1970 to be precise) Prof. Bibile was charged by the then Prime Minister to prepare a blueprint to put this ideological belief into practice in the pharmaceutical sector. It is not only in the pharmaceutical sector that this happened but it happened across the board - in food, shelter, clothing, transport etc.
Prof. Bibile’s obvious route was to cut down on choice because choice was not an option in a socialist economy. He skilfully adapted a system that was tailor made for that era. In his report he said that the need for reduction was compelling in view of the difficult foreign exchange situation, as this was the only means of obtaining drugs in bulk supply with consequent reduction in prices.
Professor Bibile is best known for his advocacy of the government-controlled pharmaceutical purchasing plans often referred to as ‘rationalisation’ of pharmaceuticals.
The question now is, what would Prof. Senaka Bibile do if he was charged by the current leadership to rationalise pharmaceutical purchases in this country? The answer to that question is ‘we don’t know’ and there is no way of finding out because the good professor is no longer with us.
But would he have held on to a document which was put into practice 35 years before – we know he didn’t do that in the 70’s because any document 35 years old during the 70’s would have had the smacks of the colonial model. No, Prof. Bibile was trying out a new formula which was gaining popularity all over the world at that time and working on a solution for the need of the hour.
The rest we can learn from our history books as to how successful that system was!
Coming back to the future... we see a hidden agenda behind the need to change the current system. One of the policies vehemently advocated by a movement reportedly advocating patient’s rights– dominated by a few Doctors without patients is the reduction of the number of drug brands entering the country.
While this NGO whose source of funding is not declared, seems to present some naive configuration to its reason, we all know that in an open economic situation reduction of choice will only create oligopolies if not monopolies.
As this NGO is canvassing for only two or three brands for one generic drug, this can easily create situations where prices will go up as there will be very little competition. Since the NGO is asking for a reduction in the list of drugs, we would like to ask an important question – who will be in charge of pruning the list and how will this not lead to corruption?
Professor Bibile was a man of the hour – he stood on his feet and brought a solution to a ‘then’ problem.
The question now is who wants this antiquated ideology to be put into practice in a world of free trade and globalisation. Today’s rationalisation is looking ‘out’ not looking ‘in’. Should not the question to ask now be - is this the agenda of the Patients Rights Movement?
And if so, haven’t we learned our lessons from the past – that NGOs have been the bane of our country’s development, pulling us down to the path of obscurity rather than focussed prosperity?
(Ananda Samarasinghe is Vice President of the Sri Lanka Chamber of the Pharmaceutical Industry.)
- Sri Lanka Guardian
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