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Bridging the Gaps: The COVID-19 crisis and Sri Lanka’s healthcare response

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By Priyanka Jayawardena

Like many other countries, Sri Lanka faces numerous challenges in the battle against COVID-19. The pandemic has caused deep uncertainty and presented a colossal challenge for the country’s healthcare system. With the rapid increase in cases and the emergence of new variants, Sri Lanka began to face shortages of medical resources, including hospital beds and medical equipment.

The vaccination programme was beset with a host of problems early on due to the irregular and inconsistent supply of vaccines, disorganised deployment and deviation from the scientifically agreed prioritisation. There was also alleged misreporting of COVID-19 daily statistics in the Gampaha district and Eastern Province. The absence of real-time data acted as a hindrance to obtain a reliable risk assessment in the country. Against this backdrop, this blog examines the gaps in the ongoing pandemic control programme and outlines ways to bridge these gaps so that more lives could be saved from COVID-19.

COVID-19 Vaccination Programme

By mid-August 2021, more than 12 million Sri Lankans (55% of the population) had been vaccinated with at least the first dose. Other than the delayed supply of vaccines, there were issues related to getting approval for vaccine use and the vaccination prioritisation process. Moreover, many people were seen queuing up at vaccination centres aggravating health risks due to the lack of a properly planned system for vaccine deployment and the lack of an online appointment system. More recently, the government has taken several measures to improve the rollout, including expediting the procurement process and improving administration with the support of the defence services.

Gaps in Pandemic Control

Sri Lanka’s rate of COVID-19 screening has remained inadequate to prevent the spread of the virus. Systematic surveillance is crucial for the rapid identification and detection of suspected COVID-19 cases. With newer variants found to be more transmissible and deadlier, there is a need to identify mutants and track the nature of transmission. Currently, the University of Sri Jayewardenepura is the only institution equipped with laboratory facilities to conduct genomic sequencing to identify new variants.

Countries like Singapore, New Zealand and Australia systematically monitor the pandemic through extensive testing and contact tracing. These countries are conducting 10-100 times more tests than other countries with a similar number of new confirmed cases. Sri Lanka’s extent of testing relative to the scale of the outbreak (positive rate was around 10%), is on par with Thailand and Malaysia but lower than India, Vietnam and Cambodia where the positive rate is below 5%.

Further, a major challenge to the existing healthcare system is inadequate ICU beds, ventilators, oxygen supplies and other necessities required to care for patients with severe respiratory failure. The availability of ICU capacity plays a crucial role in critical cases, and constant and uninterrupted availability of oxygen supplied beds is needed to avert a disaster. Currently, less than 200 ICU beds are in isolation units for patients with severe COVID-19 symptoms, whereas just around 700 ICU beds are available in the hospital system of the entire country.

Equally, it is vital to have timely access to real-time data so that meaningful insights can be drawn but due to capacity constraints and administrative issues, PCR test results are reported to be delayed. In some districts, the delays are said to be longer than one week. Thus, delays in generating test results are a grave concern and represent a major obstacle in the COVID-19 control process. There is a growing need for immediate and accessible healthcare and digital healthcare resources to effectively respond to the challenges posed by COVID-19. However, Sri Lanka’s health information systems are weak and under-funded and the lack of an adequate central health database and IT infrastructure has hampered digital health services.

Towards a Stronger Healthcare Response

The healthcare system has to be streamlined to ensure a successful vaccination deployment and a smooth inoculation programme with online appointments including over the phone appointment facilities. Parallel to an efficient vaccination programme, an enhanced screening capacity is needed for the rapid identification of COVID-19 cases. Sri Lanka’s overall COVID-19 screening capacity remains low; therefore, expanding testing and increasing the health sector’s capacity to identify new mutants is vital to curb the pandemic. Random PCR testing too must be carried out in densely populated areas which are prone to be contagious, thereby taking additional precautionary measures.

There is a growing concern about the availability of medical supplies in emergency contexts. Sri Lanka has to effectively leverage its limited resources in response to the pandemic. The crisis response has seen local innovation in the manufacturing of ICU beds and lab consumables and there is further scope to encourage local enterprise and innovation for this purpose. For instance, a team of Sri Lankan scientists recently invented a new PCR test kit using NANO technology, which is said to drastically reduce the testing time from two hours to half an hour. There is now an opportunity to encourage local innovation and local production through such efforts, where they contribute to efficiency gains.

Furthermore, a robust laboratory strategy, which includes laboratory networking, communicating real-time information on COVID-19, quality assurance and adequate workforce capacity is important for rapid detection and case management. South Korea, for example, practised the disclosure of real-time information on COVID-19 by the government via dedicated websites, mass media, phone messages and mobile apps. Digitalisation of healthcare and effective use of technology for sharing real-time data, contact tracing and surveillance and coordinating the efficient use of clinical resources are vital for successful pandemic control. It is also necessary to improve systems to manage real-time data and decision-support systems. Improved functional integration and coordination in treatment centres and laboratory services bring in many benefits.

*This blog is based on the comprehensive chapter on “Coping with Pandemics: Sri Lanka’s Healthcare System” in IPS’ forthcoming ‘Sri Lanka: State of the Economy 2021’ report.

Link to original blog: https://www.ips.lk/talkingeconomics/2021/09/02/bridging-the-gaps-the-covid-19-crisis-and-sri-lankas-healthcare-response/

Priyanka Jayawardena is a Research Economist at the Institute of Policy Studies. Her research interests include education and skills development, labour economics, inequality analysis, health economics and child nutrition. She holds a BSc (Hon) in Statistics and an MA in Economics from the University of Colombo, Sri Lanka. (Talk to Priyanka – priyanka@ips.lk)



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Norochocholai coal-fired power complex seen as facing staggering financial losses

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While the Parliamentary debates were purely focused on missing the calorific value benchmark, the excessive Ash content (21% in the samples tested) is also a reason to reject the shipment, as maximum allowed ash percentage in the tender is 16%. This means even if the tests clear the coal on calorific values, the shipments still must be rejected based on ash content as per tender terms. This fly ash and low moisture will create a massive ecological disaster to the communities in Norachcholai - Withanage

Sri Lanka’s first and largest coal-fired power complex at Norochcholai is staring at mounting financial losses running into millions of rupees as low-quality coal imports, rejected shipments and unusable stockpiles disrupt operations and expose deep flaws in coal procurement, power sector and environmental experts warned yesterday.

Energy sector sources told The Island Financial Review the economic damage has already begun, with rejected coal stocks, delayed payments and declining plant efficiency forcing the system to absorb losses from under-performance, additional handling costs and the risk of turning to more expensive backup generation.

Insiders estimate that continued reliance on sub-standard coal could result in tens of millions of rupees in losses per day, once reduced output, higher fuel burn and maintenance costs are factored in.

At the centre of the controversy is a recent coal shipment procured by the Lanka Coal Company (LCC), which has come under intense scrutiny after laboratory tests reportedly showed ash content of around 21%, far exceeding the 16% maximum allowed under tender conditions.

While parliamentary debate has focused narrowly on whether the coal meets the required calorific value, experts stress that excessive ash alone is sufficient grounds for outright rejection, regardless of calorific performance.

The situation worsened after coal stocks at the Norochcholai Coal-Fired Power Complex were recently rejected, leaving shipments in limbo and payments withheld. Power sector officials say this has resulted in logistical losses, demurrage risks and operational uncertainty, while existing low-quality coal stockpiles continue to deteriorate in storage.

“Coal that does not meet specifications is not just unusable — it becomes a financial liability, a senior electrical engineer said.

High-ash coal reduces boiler efficiency, increases fly ash generation and accelerates wear on ash handling systems, electrostatic precipitators and boilers — translating into higher maintenance costs and forced outages. Industry analysts warn that these hidden costs ultimately find their way into CEB losses or consumer tariffs.

Environmental Scientist Hemantha Withanage warned that accepting or burning such coal would push Norochcholai into a new environmental crisis, with serious consequences for communities in Norochcholai, Puttalam and surrounding areas.

“This is not just about calorific value. High ash coal means significantly more fly ash, Withanage told The Island Financial Review. “With low moisture and excessive ash, particulate matter spreads easily, contaminating air, soil and water. This is a massive ecological threat that will directly affect public health.”

He stressed that fly ash contains toxic heavy metals and fine particulates linked to respiratory illness and long-term environmental degradation. “If tender conditions are ignored, the cost will be paid by communities, not the suppliers, Withanage said.

Critics say the crisis exposes serious weaknesses in coal procurement oversight, with questions now being raised about supplier selection, quality verification and accountability. They argue that repeatedly importing low-quality coal — only to reject it or burn it at reduced efficiency — amounts to systemic mismanagement of public funds.

By Ifham Nizam

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IRCSL launches ambitious mission to transform Sri Lanka’s insurance sector

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Dr. Ajith Raveendra De Mel

In a groundbreaking initiative, Insurance Regulatory Commission of Sri Lanka (IRCSL), announced an ambitious mission aimed at transforming the insurance industry into a cornerstone of national economic resilience and social stability.

To address this, the IRCSL will launch a nationwide education campaign titled “Insurance for All: For a Secure Future,” focusing on enhancing financial literacy across the country said Dr. Ajith Raveendra De Mel, the newly appointed Chairman IRCSL. Few sample events have already commenced last year in Matara, Jaffna and Kilinochchi that have set a strong precedent for future initiatives. “The positive response from participants highlighted the strong need for direct engagement and community-level awareness,” he said.

The IRCSL has also partnered with the Ministry of Education to integrate insurance literacy into the national curriculum, starting as early as Grade 5. This initiative aims to embed core concepts of risk management and financial protection, preparing students for future roles in the insurance industry. Complementing educational efforts, the IRCSL is also hosting an Inter-University Quiz Competition focused on insurance and financial literacy, aiming to engage university students and cultivate future thought leaders in the sector. Additionally, an e-Newsletter will keep stakeholders informed about industry updates and regulatory developments.

Dr. De Mel emphasized that this transformation it is not just about increasing insurance penetration, currently at a mere 1.1%, but about fostering a financially literate society where every citizen, family, and business is shielded from unforeseen risks. He said “Our mission is to cultivate a fully insured, financially literate, and future-ready society. The journey ahead involves profound regulatory, technological, and educational reform to create a modern, transparent, and robust regulatory environment that earns public trust while promoting innovation and sustainable growth in the industry.”

He pointed out the critical need for awareness, noting that many Sri Lankans perceive insurance as complex or exclusive to the wealthy. “We need to change how people think about insurance. Our goal is to make it simple, relatable, and accessible to everyone, particularly in rural and underserved communities,” he explained. The IRCSL will collaborate closely with the Insurance Association of Sri Lanka (IASL), the Sri Lanka Insurance Brokers Association (SLIBA), and the Sri Lanka Insurance Institute (SLII) to ensure that the message of financial preparedness reaches all corners of the nation. As Sri Lanka stands on the brink of an insurance transformation, Dr. De Mel’s vision promises a secure future driven by informed financial decisions and enhanced protection against life’s uncertainties.

The IRCSL is also focusing on digital transformation, enhancing operational excellence within the insurance sector. Key initiatives include establishing a Centralized Motor Insurance Database to improve transparency and efficiency in motor insurance, and advancing health insurance through digital integration, including standardized disease coding and electronic health records.

To ensure global competitiveness, the IRCSL is benchmarking against international best practices. A recent study tour to India has provided valuable insights into implementing risk-based supervision and capital frameworks, as well as developing accessible insurance products for underserved communities.

As the IRCSL approaches its 25th anniversary, it emphasizes the importance of staff development and alignment with other financial regulatory bodies to maintain high professional standards. The upcoming OECD/ADBI Roundtable on Insurance and Retirement Savings in Asia will further position Sri Lanka as a leader in insurance discussions, fostering regional collaboration and innovation.

by Claude Gunasekera

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Sri Lanka’s first public allergy awareness wristbands

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LAUGFS Life Sciences, in collaboration with the Medical Research Institute (MRI), Colombo, has launched Sri Lanka’s first-ever publicly driven allergy awareness wristbands, a groundbreaking initiative aimed at improving patient safety and preparedness in medical emergencies. The wristbands provide essential information about drug sensitivities, allowing healthcare professionals to respond quickly and effectively when time is critical.

The official handover ceremony featured distinguished medical experts, including Dr. Dhanushka Dassanayake, Consultant Immunologist and Head of the Department of Immunology – MRI, Dr. Rajiva De Silva, Senior Consultant Immunologist – MRI and Dr. Prabath Amerasinghe, Deputy Director – MRI, marking a historic milestone in patient care in the country.

Commenting on the initiative, Dr. Rajiv Perera, CEO of LAUGFS Life Sciences, said, we are proud to partner with the Medical Research Institute to launch Sri Lanka’s first-ever publicly driven allergy awareness wristbands. This initiative underscores our commitment to patient-centric healthcare by providing critical information that can save lives during emergencies. We believe that thoughtful collaborations like this can have a meaningful impact on patient safety, and we look forward to expanding the program to cover additional drugs and allergens, further advancing healthcare standards across the country.

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