Features
Covid-19 Vaccines:Some ethical dilemmas
Dr B .J. C. Perera MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
There is an unprecedented interest across the globe in the currently available vaccines against SARS-CoV-2 virus that causes COVID-19 disease. There are many factors to consider in this endeavour to vaccinate the general population. The primary considerations are the effectiveness and safety of the vaccines while the costs, the adequacy of the supplies of the vaccines, ethics of selection of priority groups for vaccination, logistics of transportation as well as fair and equitable distribution of vaccines to all corners of the world are also important. This article will discuss some of the pros and cons of a few that are relevant to Sri Lanka.
The effectiveness of the currently licensed vaccines is by now well established. They do very significantly protect us against more severe symptomatic disease and thereby reduce the needs for intensive treatment in hospitals and of course by virtue of that, reduce the associated mortality. This is of major importance as this little blot of a coronavirus has killed over 2.7 million people all over the world and in Sri Lanka it has taken the lives of around 550 people at the time of writing of this article. The initial premise on which the researchers worked on, as stipulated by even the World Health Organisation (WHO), is a committed effort towards reducing more severe disease and mortality. Generally, a vaccine is formulated to prevent anyone catching the disease. However, that was not the initial principle on which the research was targeted.
Yet for all this, now there seems to be some accumulating evidence that the vaccines do play a part in protecting at least some recipients against catching the disease and thereby reducing transmission from humans to humans. In some recipients of the vaccine who contracted the virus, significantly lower viral loads have also been seen. All of these do combine to provide a real bonus and would help a great deal in our fight to defeat the virus. However, it must be stressed that it does not provide universal one hundred percent protection against infection by the virus. Vaccinated individuals should not, I repeat., should not, abandon safe physical distancing, avoidance of gatherings, washing of hands and wearing of masks. If the vaccinated people happen to catch the virus, even if they are asymptomatic, they can still transmit it, at least to some people. So it is very important to follow all health guidelines.
The safety profile of the vaccine was quite stringently looked at during all the clinical trials in humans before these vaccines were licensed for general use. It must be remembered that all types of any vaccine against infective diseases have the risk of developing allergic or sensitivity reactions. Some of the recipients of the vaccine against COVID-19 are also liable to get chills or feeling cold, fever, muscle pains, some abdominal symptoms and fatigue. All of these are quite short-lived, just only for a couple of days. Some more serious side-effects have been noted in the human trials but these were extremely rare and not thought to be of grave significance. The latest problem that was publicised are disturbances in the clotting of blood in vaccine recipients in some Western countries. Clots were detected in deep veins and some detached clots had gone into the blood vessels of the lungs. A lot of fuss was made on this issue, particularly by the media, which even led to temporary suspension of at least one brand of the corona vaccines. However, deep venous thrombosis is a well-known problem in the West and a scrupulous assessment of a cause-and-effect nature, has not been able to establish the vaccine to be directly responsible for these problems. In fact, after firm assurance of the safety of the vaccine being provided by the European Medicines Agency (EMA), many of those countries have restarted their vaccination programme with the incriminated vaccine. It is important also to highlight that even after giving around 800,000 or so vaccinations in Sri Lanka, this problem has not been seen here to a really significant extent, up to now. From an ethical perspective, there is everything to be gained by administering the currently used Oxford-AstraZenica vaccine in Sri Lanka.
The real ethical dilemma in our country is how to organise the administration of the limited supplies of the vaccines to cover the most vulnerable groups of our citizens. The administration of the vaccine to front -line health workers and the forces personnel in the front-line went off quite well, except for a couple of hitches initially in the provision of the vaccine for health personnel in the private sector. After that, for a couple of days, an ill-advised ad hoc decision to vaccinate those between 30 and 59 years caused a profound degree of mayhem and chaos at vaccination centres. At the present time there seems to be some order where the over 60-year-olds are given the vaccine. It took a considerable number of adverse scathing reports in the media and intense pressure brought on by many people, for sanity to prevail. Ethically, it is imperative that the carefully formulated ‘Priority List’ of groups of people for administration of the vaccine is strictly adhered to. Queue-jumpers, thugs and those with connections should be very firmly dealt with.
There are some other ethical aspects to the administration of the vaccine. There are some concerns regarding the second dose of the vaccine. In a previous article (The Island – 17th March 2021), I have explained the rationale for changing the timing of the second dose to three months after the first dose from the earlier recommended time period of one month from the first dose. So far around 800,000 or more first doses have been administered. It is imperative that we give the second dose to this cohort in three months or so from the first dose. The government must, I repeat MUST, ensure that sufficient stocks of the vaccine are kept for this group of people.
There have been some arguments put forward in certain quarters to say that we should use all available stocks to vaccinate as many people as possible with the first dose to provide even short-term immunity to as many people as possible. They make it out to be a human rights issue. This author believes that it is a more compelling question of human rights for ALL those who have already had the first dose to be given the second dose at the appropriate time, to provide them with the best possible and sustained protection. This contention would apply to even those between 30 and 59 years, who were given the first dose of the vaccine during those initial disordered days.
As far as ethics go, in view of the global shortage of vaccines, it is essential that the powers-that-be take steps to even get as many brands of the vaccines with PROVEN EFFICACY AND SAFETY RECORDS into the country. It really does not matter where these vaccines originate from. The only criteria that are of paramount importance are whether the vaccine is effective and whether it is safe.
As at present it is best to give both doses of the same vaccine to each recipient. However, when more scientific information is available, we may be able to mix vaccines if there is evidence that it would work equally well or even better when vaccines are mixed. All over the world, there are several scientific studies in progress to ascertain the usefulness of such a pathway. However, that decision should be a well-informed one, based on robust scientific evidence. It could only be made by the expert scientific medical community. It should not be made on economic, logistical or political grounds by non-medical people and most certainly not, by lay politicians, on their own accord.
The take home message for our people at the present time is that the authorities are trying their very best to provide the vaccines against this coronavirus that is running amok. The prioritised groups who are due to receive the vaccine should be reassured of the effectiveness and safety of this vaccination. Misinformation, especially through the social media, concocting of various stories of doubtful repute and spreading of false rumours, should not be allowed to scuttle the current vaccination procedures. A system of well-organised system of administration of the vaccines will go a long way towards ensuring success in this war against a tiny enemy that has the potential to bring all of us to our knees and make us sink to the lowest depths of despair.
Features
The challenge of being positive about SAARC
It was a few years back that a former President of Sri Lanka took it on himself to pronounce SAARC ‘dead’. Since then there have been other sections of Sri Lankan opinion that have joined the critics of SAARC and taken the solemn stance that SAARC has indeed died what may be called a natural death.
Their fatalism is understandable. SAARC has failed to meet at heads of government or state level for the past several years to take the SAARC process notably forward. Regional cooperation has more or less been only an appealing idea. No substantive concrete projects have taken off to make the idea a hard reality. ‘Inner paralysis’ seems to be SAARC’s lot. Hence the fatalism in these circles.
However, being one of the worst cash-strapped regions of the world and a teemingly populated one with people virtually left to their devices, what choices do the ‘SAARC Eight’ have other than to try their best to band together and continue with their cooperation efforts, however small they may be?
There is no escaping the mounting debt trap for many of these countries and bankrupt Sri Lanka is a glaring example, but ‘throwing in the towel’ and abandoning themselves entirely to the diktats of the strongest economies and their agencies will prove a ‘living death’ for many countries in the SAARC fold.
The gains may be meagre but giving-up on SAARC cooperation in full would prove self-defeating for the organization and South Asia. Right now, the collective intention ought to be to salvage what the region could from the tenuous cooperative efforts. Moreover, such initiatives could go some distance to generate a degree of goodwill among the Eight and help in sustaining a dialogue process.
Given this backdrop it proved ‘a stich in time’ for the Regional Centre for Strategic Studies (RCSS), Colombo, to recently host the SAARC Secretary General Ambassador Md. Golam Sarwar to a round table discussion on the unifying potential of SAARC and its future possibilities, besides other related issue areas.
Held on June 24th and moderated by RCSS Executive Director and former ambassador Ravinatha Aryasinha, the forum brought together a vibrant, wide ranging audience comprising academicians, diplomats, senior public servants, civil society activists and many others. Following the presentation by Ambassador Golam Sarwar titled, ‘Reigniting SAARC: Achievements, Challenges and the Way Ahead’, a lively Q&A followed.
The above forum could be described as an act of lighting the proverbial ‘candle’ rather than ‘cursing the darkness.’ It surely is a ‘darkness’ that could be seen as daunting considering that the region’s pivotal powers, India and Pakistan, are failing to act in a spirit of accord but are engaged in bitter finger-pointing on a number of questions of vital importance to SAARC.
On the other hand, what is the rest of the region doing to bring the above sides together? It is disappointing that to date the rest of SAARC has failed to launch a major diplomatic drive to bring peace between the feuding regional heavyweights. It needs to act without delay and establish its earnestness and this effort would need to prove SAARC’s staying power in the unfolding months and even years.
In assessing SAARC’s seeming failure local opinion in particular has failed to factor in what could be described as weak leadership. Since Sheikh Mujibur Rahman of Bangladesh, the founding father of SAARC, the region has failed to produce a visionary leader who could advance the SAARC cause with charisma and drive.
Among other reasons, weak leadership accounts considerably for the faltering and stuttering status, as it were, of SAARC. Badly needed are leaders who could go the extra mile, think less of narrow national interests and work diligently towards the collective well being of the region but SAARC’s millions of ordinary people have been made to wait in vain for leaders of such stature. Instead, they have been burdened with politicians who seem to be relishing the apparently moribund state of SAARC.
Looking back, it could be said that it was the dynamic leadership factor that led to the launching of the Non-Aligned Movement and for its sustenance for a few decades. True, it could be seen in some quarters that NAM is no more, but as in the case of SAARC, the former too has been unfortunate to be burdened over the years with politicians who lack the vision and drive to unflaggingly advance the fortunes of the South. NAM and SAARC lack the dynamism and vision of leaders of the stature of Jawaharlal Nehru, for example, to give them the required guidance and intellectual depth.
The reasons are complex for there not being among us currently political leaders with the vision and the steadfast commitment to advance the legitimate interests of the South. However, it could be stated with conviction that the majority of Southern leaders have too easily caved in to the demands of the global North and its financial agencies.
These leaders have failed to see, for instance, that the largely market economy oriented Northern governments would not view with favour a centrist economic model that attaches priority to the interests of the dis-empowered publics of the South. This realization ought to have dawned on the current government in Sri Lanka, for instance, some while ago but it has no choice but to abide by IMF dictates since economic survival at present is unthinkable without the latter’s succour.
Accordingly for SAARC this should be the time for some soul-searching. Priority needs to be attached to ending the feuding between India and Pakistan since at present the material fortunes of the region hinge largely on these regional giants giving peaceful relations among them a try. This is no easy challenge to meet but some daring, visionary diplomacy needs to take hold among the rest of SAARC.
There is some sense in SAARC bringing the peoples of the region together through programs that address their best collective interests. A meeting of minds among SAARC nations could enable SAARC and its agencies to build a region-wide people’s movement for progressive political and economic change that could in turn lead to the region’s political leaders sensitizing themselves more to the neglected needs of their publics.
However, the time is ‘now’ for the initiation of these progressive changes and the voice of SAARC well wishers would need to drown out those of their critics.
Features
OPA seminar examines Sri Lanka’s economic recovery, resilience and growth pathways
A seminar, “Sri Lanka’s Economic Crossroads: Navigating Recovery, Resilience and Growth” was recently held by the Organisation of Professional Associations of Sri Lanka (OPA) at the OPA Auditorium, bringing together economists, OPA members, and professionals from diverse fields for an insightful discussion on Sri Lanka’s economic recovery and future growth prospects.
The event was held under the patronage of Jayantha Gallehewa, President of the OPA, and was jointly organised by the National Issues Committee (NIC) and the Seminars, Workshops and Programmes Committee of the OPA. The event reaffirmed the organisation’s commitment to advancing professional excellence, fostering insightful intellectual engagement, facilitating interdisciplinary knowledge exchange and creating a constructive platform for informed dialogue on issues of national importance.
The panel of speakers comprised Dr. Harsha Aturupane, Lead Economist and Programme Leader for Human Development at the World Bank for Sri Lanka and the Maldives; Dr. Achinthya Koswatta, Senior Lecturer in Economics at the Open University of Sri Lanka, and Anushan Kapilan, Lead Economist at Verité Research.
In his welcome address, the President of the OPA emphasised that Sri Lanka was at a critical juncture in its economic recovery journey where sustained reforms, effective implementation, and collective national commitment are essential to achieving long-term stability, resilience and inclusive growth. He noted that the country had experienced one of the most severe economic crises in its history with the economy contracting by 7.8 percent in 2022 and a further 11.5 percent in 2023, resulting in significant economic and social challenges.
Delivering his introductory remarks Bhanu Wijeyaratne, Vice President of the OPA and Chairman of the National Issues Committee, underscored the need to move beyond short-term economic stabilisation towards a comprehensive agenda of structural transformation. He observed that the economic crisis had revealed deep-rooted weaknesses within the economy, including persistent fiscal pressures, rising public debt, foreign exchange limitations, and insufficient diversification of the export base. He stressed that addressing these challenges through strategic reforms, institutional strengthening and long-term economic planning would be essential to establishing a more resilient and competitive economy.
While acknowledging recent positive developments, including improved inflation management, tourism recovery and signs of economic stabilisation, Wijeyaratne stressed the need to advance reforms aimed at strengthening fiscal discipline, enhancing productivity, improving competitiveness, developing human capital and reinforcing governance and institutional effectiveness.
He further highlighted the important role of professionals, businesses, academia and other stakeholders in contributing to evidence-based dialogue and supporting Sri Lanka’s journey towards a resilient, inclusive and sustainable economic future.
Delivering the keynote presentation, Dr. Harsha Aturupane provided a comprehensive assessment of Sri Lanka’s economic prospects within the broader context of global economic transformation. He argued that Sri Lanka functioned as a small open economy whose performance is significantly influenced by developments in the global marketplace. External factors could not be controlled, and the country must strengthen its domestic capacity and resilience to respond effectively to international economic shifts, he noted.
Tracing the evolution of global economic systems, Dr. Aturupane highlighted the transition from ideological divisions between state-controlled and market-oriented economies towards increasingly pragmatic approaches focused on growth, competitiveness and development. He noted that Sri Lanka’s own economic journey reflects a similar evolution, with contemporary policy debates now centred on practical solutions for sustainable economic progress.
The presentation also examined the transformative impact of globalisation. Dr. Aturupane observed that global economic integration had enabled several East Asian economies, including South Korea, Singapore, Taiwan and Hong Kong, to achieve remarkable economic advancement through export-led growth strategies. Sri Lanka similarly benefited from this process through the expansion of its apparel industry and increased integration into global value chains.
Turning to Sri Lanka’s recovery programme, Dr. Aturupane emphasised that the ongoing stabilisation process should be viewed as a national programme supported by the International Monetary Fund rather than solely as an IMF initiative. He observed that strong worker remittances, improved tourism earnings, enhanced government revenue mobilisation and prudent import management have contributed significantly to economic stabilisation.
Despite this progress, he cautioned that rebuilding foreign exchange reserves and meeting future debt obligations remain major challenges. He underscored the need to strengthen export performance, attract investment and generate sustainable foreign exchange earnings to ensure long-term economic resilience.
The discussion also focused on monetary stability, inflation management and exchange-rate policy. Dr. Aturupane stressed that maintaining price stability was fundamental to sustainable growth and household welfare, while sound monetary policy remains essential for preserving economic confidence.
Looking beyond stabilisation, he argued that Sri Lanka must transition towards a broader economic transformation agenda. Sustainable growth, he noted, will depend on expanding productive capacity through investment, technological advancement, innovation, skills development and structural reforms.
Among the key constraints identified was the high cost of energy, which continues to affect competitiveness and investment attractiveness. Dr. Aturupane emphasised the importance of improving efficiency and affordability within the energy sector to enhance Sri Lanka’s business environment.
He further highlighted the social dimensions of the crisis, noting the rise in poverty and economic vulnerability among households. Strengthening social protection systems and ensuring inclusive growth, he argued, must remain central components of the national development agenda.
Another critical challenge identified was Sri Lanka’s demographic transition. With an ageing population, outward migration and evolving labour market dynamics, the country is increasingly confronting labour shortages in several sectors. Dr. Aturupane suggested that greater automation, increased labour-force participation and strategic workforce planning would be necessary to address these emerging realities.
Concluding his presentation, he emphasised the need to improve governance, strengthen institutions, enhance competitiveness and create an enabling environment for private sector investment. Sri Lanka’s future success, he noted, will depend on its ability to move decisively beyond crisis management towards a development model founded on resilience, innovation, productivity and inclusive growth.
Dr. Achinthya Koswatta reiterated the importance of policy consistency and predictability in fostering investment and industrial development. She observed that frequent policy changes create uncertainty and discourage long-term investment decisions, whereas stable and coherent policy frameworks build confidence and support sustainable economic transformation.
Meanwhile, Anushan Kapilan highlighted the substantial progress achieved in restoring macroeconomic stability following the recent crisis. He noted significant improvements in fiscal performance, including increased government revenue, reduced reliance on debt financing and a historically low fiscal deficit.
He further observed that public debt levels are declining faster than anticipated, economic growth has exceeded expectations and inflation has been brought under control more rapidly than forecast. Nevertheless, he cautioned that the recovery remains uneven, particularly within the industrial sector and that many households have yet to experience a meaningful improvement in living standards.
The seminar was expertly coordinated by Eng. Chamil Edirimuni, Vice President of the OPA and Chairman of the Seminars, Workshops and Programmes Committee, while the technical moderation and interactive discussion session were facilitated by Bhanu Wijeyaratne, Vice President of the OPA and Chairman of the National Issues Committee.
The event was attended by Tisara De Silva, President-Elect of the OPA, Eng. Ravi Rupasinghe, General Secretary, Past Presidents, members of the Executive Council, representatives of the General Forum and professionals representing a wide range of disciplines.
The seminar concluded with a vibrant exchange of ideas and perspectives, reaffirming the importance of evidence-based policy dialogue, institutional collaboration and collective national commitment in advancing Sri Lanka’s economic recovery, resilience and sustainable growth.
Features
Her roots run deep in Sri Lanka
Yes, for UK-based presenter and artiste Samantha Kay, home is where the heart – and the roots – are. And her roots run deep in Sri Lanka.
In an exclusive interview with The Island, Samantha says “I’m proud to be Sri Lankan. My mum is from Kandy and my dad is from Colombo, so Sri Lanka has always held a very special place in my heart.
“Whenever I visit Sri Lanka, I love spending time on the beautiful south coast, especially Hikkaduwa and Mirissa. It’s somewhere I always feel connected to my roots and completely at peace.”
Now living in Bournemouth, on the south coast of England, where, she says, she is lucky to be close to some of the UK’s most beautiful beaches, including the iconic Sandbanks, Samantha has built a career that refuses to fit into one box.
She is a radio presenter, podcast host, singer-songwriter, personal trainer and life coach.
“I genuinely love the variety because every role allows me to connect with people and, hopefully, make a positive difference in someone’s day.”
Of course, music has taken her far.
One of her proudest achievements, she says, was releasing a song with 90s music icon Angie Brown, which reached No. 9 in the UK Club Charts.
She also reached the final stages of The X Factor and performed at Wembley Stadium in front of thousands.
Beyond music, Samantha competed in bikini bodybuilding across the UK, winning several titles. “It taught me discipline, resilience and self-belief,” she recalls.
Today, her focus is on radio, podcasting and coaching women. Her podcast encourages people to live life on their own terms rather than feeling pressured to follow society’s expectations.
Says Samantha: “Whether someone is single, changing careers, travelling solo or simply trying to find their purpose, I want them to know that it’s never too late to create a life that feels authentic. If you’ve ever felt like you don’t fit into the box, maybe you were never meant to.”
Samantha Kay also spent a year in Dubai, performing at five-star hotels, including FIVE, and coaching at the iconic outdoor gym on Palm Jumeirah.
“I taught strength and conditioning classes, and hosted wellness retreats, combining my passion for music, health and inspiring others.”
However, with family matters calling her back to the UK, she made the choice to return. “Family comes first,” she says.
Looking ahead, Samantha plans to grow her radio and podcast work, release more music, and expand her wellness retreats.
“My biggest passion is helping people, especially women, build confidence and believe in themselves,” she says.
“Wherever my career takes me, I hope to continue inspiring others to live with courage, kindness and authenticity, while never forgetting my Sri Lankan roots.”
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