Features
How Sri Lanka abandoned its own healthcare revolution
In the 1970s, Professor Senaka Bibile pioneered a revolutionary pharmaceutical policy that promised to convert healthcare for the developing world. His National Medicinal Drugs Policy created a rationalized system using 630 generic medications, eliminating brand names, banning manufacturer promotions, and consolidating imports through the State Pharmaceutical Corporation. The policy aimed to guarantee quality drugs at affordable prices while ensuring doctors prescribed only necessary medications.
The World Health Assembly in Geneva recognized Prof. Bibile’s achievements in May 1982, with delegates from 47 countries participating in negotiations on pharmaceutical rationalization. A WHO official acknowledged that the guiding philosophy of WHO’s Action Programme on Essential Drugs was “based on that recommended by the late Professor Bibile of Sri Lanka.” By 2013, as many as 37 developing nations had successfully implemented similar policies. Yet Sri Lanka—the birthplace of this innovation—has systematically failed to adopt its own professor’s vision.
The revolution that never was
When President J.R. Jayewardene introduced open economic policies in 1978, he abandoned Bibile’s programme entirely. What followed was decades of broken promises, mysterious file disappearances, and legislation that betrayed the original principles. The story of this abandonment reveals the extraordinary power of multinational pharmaceutical corporations to subvert national policy and condemn millions to financial hardship.
Professor Bibile, working with Communist Party Leader Dr. S.A. Wickremasinghe, developed the “essential medicines” concept that should have protected patients. Instead, successive governments carried only fragments of his vision. Today, the SPC procures medicines for government services at excellent prices, enabling free healthcare provision. However, the pharmaceutical mafia heartlessly promotes expensive branded products to specialists who prescribe by brand name, distressing patients economically.
A trail of broken promises
In 2005, the UPFA government promised to implement the National Medical Drugs Policy (NMDP). The Cabinet approved it in principle in 2007, establishing a National Standing Committee that comprised the People’s Movement for Rights of Patients. Health Minister Maithripala Sirisena declared his Ministry a “bottomless pit of corruption” in 2011 and pledged to slash drug prices by two-thirds before leaving office. Instead, drafts shuttled between government offices for years, files strangely disappeared, and the process delayed indefinitely.
Sirisena himself exposed during his presidential campaign that someone offered him a bribe adequate to “nurture seven generations” while serving as Health Minister. He revealed that the original National Drugs Policy was “stolen while it was in the womb” and had to be organized a second time. An allegation of high level corruption was made regarding the mysterious disappearance of a file in this regard. Minister Rajitha later stated the amount offered to him was Rs. 300 million. But there was silence on the offender’s identity.
By 2013, Sirisena presented a draft bill that totally deviated from Bibile’s proposals. The People’s Movement for the Rights of Patients condemned it as a document prepared by the pharmaceutical gang itself. Professor Carlo Fonseka, former Chairman of National Authority on Tobacco and Alcohol and President of the Sri Lanka Medical Council, ridiculed it as totally unsuitable, a mockery lacking the essential medicines model, quality control theory, or regulatory mechanism.
Minister Rajitha’s 2016 announcement to reduce costs of 47 medicines proved merely a political stunt, benefiting only prosperous consumers purchasing expensive pharmaceuticals. Drug cartels later increased rates of lower-priced medicines to align with elevated regulatory ceilings, affecting most citizens, a typical case of daylight robbery.
The pharmaceutical stranglehold
The pharmaceutical industry’s distinctive marketing feature is that the ultimate customer isn’t the patient who pays, but the doctor who prescribes. Immoral practitioners receive lucrative incentives: five-star family holidays, sponsored medical education for children, monthly payments running into hundreds of thousands, all in exchange for prescription practices dictated by manufacturers. Poor patients pay inflated prices for substandard, superfluous products while exposing themselves to harmful biochemical side-effects.
Wall Street statistics divulge that eleven US pharmaceutical giants made $65 billion in 2010, more than the other 489 Fortune 500 companies combined. Second only to arms trading in profitability, Big Pharma uses its wealth to counterbalance every opposing institution, spreading tentacles through education, manufacturing, research, importing, testing, registration, quality control, distribution, and prescription systems.
Former British Medical Journal editor Richard Smith published an article titled “Is the Pharmaceutical Industry like the Mafia?” documenting the methodical corruption of science by drug companies to exaggerate benefits and downplay harms. The industry influences doctors, academics, journals, patient organizations, regulators, and politicians using mob-like tactics. Forbes Magazine questioned industry trustworthiness in “Is Big Pharma Addicted to Fraud?” noting that legal prescription drug abuse makes the American medical system a foremost cause of death.
The NMRA’s Battle Against Corruption
When President Sirisena established the National Medicines Regulatory Authority (NMRA) in July 2015, appointing Professors Lal Jayakody and Krisantha Weerasuriya as Chairman and CEO respectively, the new authority immediately incited systematic corruption. Officials discovered that drug shortages in state hospitals were “well calculated,” remedied through a corrupt practice called “No Objection Letters.”
The SPC would bypass registered suppliers during shortages, importing unknown-quality medicines at inflated prices through the previous Cosmetic Devices and Drugs Authority (NMRA). In one case, the SPC requested importing the anxiolytic sedative Lorazepam through an unregistered supplier for Rs. 36 million. When NMRA insisted on proper tenders from the four registered suppliers, the lowest bid was only Rs. 250,000—just 0.7% of the original quotation.
Similarly, the SPC sought importing Gentamycin antibiotic eye drops from Merit Organic India, bypassing twelve registered suppliers. The product wasn’t even in the company’s manufacturing profile. When the NMRA called a media conference to explain its work and expose corruption, Health Ministry Secretary Anura Jayawickrama summoned Chairman Professor Jayakody and ordered its cancellation, citing administrative regulations. This blatant suppression occurred during World Media Freedom Week, contradicting government commitments to transparency. Within months, both Jayakody and Weerasuriya faced removal charges alleging inefficiency—a clear message to anyone threatening pharmaceutical interests.
The mystery of Bibile’s death
Professor Bibile died on September 29, 1977, in Guyana under circumstances that remain deeply suspicious. During a WHO consultancy, a “Professor of Medicine” from a West Indies University hosted Bibile and his wife for dinner with drinks. Bibile, who suffered from tachycardia, developed a severe cardiac attack afterward. His usual remedy failed, governmental delays prevented hospital admission, and he died at the entrance.
Regional medical specialists concluded that just two drops of digitalis in alcohol would fatally intensify his heart condition, a claim vehemently rejected by Bibile’s close associates but consistent with the Mafia-style “we are watching you” threats he had received. Whether murdered or not, Sri Lankan health ministers and authorities have repeatedly “murdered” his legacy.
The Path Forward
In Minister Nalinda Jayatissa lies our only hope of shattering decades of systemic corruption. The moment for bold, uncompromising action is now, while reform remains politically viable. Countries like Australia force pharmaceutical companies to price branded drugs marginally above generics through health insurance negotiation. South Africa has succeeded with effective pricing formulas. Swift measures could radically cut healthcare dollar outflows while shielding our people from excessive medication.
Two fundamental necessities remain unmet: authorizing that doctors prescribe only by generic names (the 2015 legislation was undermined by allowing brand names alongside), and compiling a list of essential drugs imported exclusively by the SPC. Until valid answers emerge, the media must educate the public about Big Pharma’s clandestine operations, the harmful properties of unnecessary drugs, billions lost in foreign exchange, and unprecedented gains achievable through Bibile’s reforms.
Civil society must demand better medicine prices. Had Bibile’s policies been fully implemented, these crises would never have occurred. The battle continues between uninformed consumers and marketing deception, between vested interests and public welfare. The question remains: do Sri Lanka’s current politicians possess the necessary transparency and determination to finally honor the vision of their greatest medical innovator? Or will the pharmaceutical faction continue to profit while the poor suffer?
by KKS PERERA ✍️
Four decades of systematic sabotage have denied Sri Lankans access to affordable,
quality medicines.
Features
Dilemmas of ‘hurting economies’ – the case of Sri Lanka
Maldives President Dr. Mohamed Muizzu was in Sri Lanka recently on what was apparently a goodwill visit and this event, no doubt, bodes very well for Maldives-Sri Lanka relations. Besides, the visit would go some distance in strengthening Sri Lanka’s claims to Non-Alignment.
However, the commentator on regional politics could be accused of simplistic thinking if he/she glosses over or ignores the regional politics nuances or undertones of the Maldivian President’s visit. In Sri Lanka we currently have a government which is eager to solidify its bridges, so to speak, with China and which, given the chance, would be courting increasingly close relations with Russia. In other words, the NPP government is likely to see itself as a ‘natural ally’ of the East and would prefer to distance itself to the extent possible from the West, if that is a realistic proposition.
Given the foregoing backdrop, it would be in some of the NPP regime’s best interests to be on cordial terms with the Maldives which is a close ally of China in the South Asian region. However, the NPP government, given the utter financial helplessness of Sri Lanka, cannot afford to distance itself politically and diplomatically from India and the West. Sheer economic necessity compels Sri Lanka to adopt this foreign policy stance. In other words, the latter has no choice but to be ‘Non-Aligned.’
This columnist was led to the above observations on listening to a lucid and comprehensive presentation titled, ‘A Global Economy in the Shadow of the Iran War and implications for Sri Lanka’s debt recovery’, by Dr. Ganeshan Wignaraja, Visiting Senior Fellow, ODI Global London, at the Regional Centre for Strategic Studies (RCSS), Colombo on May 4th. The forum, RCSS Strategic Dialogue – 4, was moderated and presided over by RCSS Executive Director Ambassador (retd) Ravinatha Aryasinha.
The forum brought together a wide cross section of society, including diplomatic personnel, academicians, public and private sector personalities and the media. After the presentation a very lively and informative Q&A followed.
Ambassador Aryasinha at the outset set an appropriate backdrop to the presentation and discussion by stressing ‘the increasing interconnectedness of geopolitical and economic developments, noting how disruptions in the Middle East could have significant ramifications for global markets, trade flows, energy prices and broader economic stability, including Sri Lanka.’
Indeed, there are occurring currently very disruptive economic and material consequences for the world from ‘the Iran War’, and with US-Iran hostilities spiraling in West Asia it may not be wrong to surmise that the worst could be yet to come, unless a peace process materializes in earnest.
Meanwhile, ‘hurting countries’ such as Sri Lanka would need to summon their best economic management capabilities to remain materially and economically afloat. ‘Economic transformation’ is what is urgently needed and not mere management and some of the insights thrown up by Dr. Ganeshan Wignaraja should have the local polity thinking.
There was the following observation, for instance: ‘Sri Lanka has achieved remarkable cyclical stabilization but faces critical challenges in transitioning to transformative growth, with 2027-2028 debt repayments looming and only $5.4 billion usable reserves.’
Needless to say, the path ahead to ‘transformative growth’ for Sri Lanka is strewn with multiple challenges and meeting them effectively is of the first importance. Sri Lanka must soldier on towards even a semblance of development in the short and medium terms and such initiatives cannot be separated from its foreign policy choices since the country’s economic partners and their growth prowess have a close bearing on the country’s material fortunes.
As mentioned, Sri Lanka will be compelled to be ‘a friend of all countries and an enemy of none’ going forward but it cannot afford to be seen as cultivating China as a close growth partner at the expense of India and other major economies of the region.
This is primarily because while India is remaining a major economic power, the current West Asian crisis notwithstanding, China’s economy is being seen as ‘slowing’. Dr. Wignaraja singled out the following in the main as the factors causing this slow-down: a bursting property bubble, increasing state regulation, and weakening investor confidence. Besides, the speaker sees production cycles moving away from China and India replacing China and Hong Kong as ‘manufacturing hubs’.
Accordingly, the NPP regime in Sri Lanka would need to craft its regional policy in particular with the utmost far-sightedness. It will need to have close economic links with all the growth centres that matter.
On the question of authentic economic transformation, the following observations of Dr. Wignaraja on Sri Lanka’s economy are of the first importance as well: ‘Foreign reserves are now at $ 5.4 billion, the cost of living is high, an estimated 20 per cent of the population lives below the poverty line of $ 3.65 per day, the recent cyber security breach at the Treasury would affect some 10 payments.’ These factors were termed ‘critical vulnerabilities’.
It is difficult to conceive of an economic transformation worthy of the phrase minus a steady economic empowerment of the populace. The above data point to the considerable magnitude of the local poverty problem. Right now, the disruptive effects of the West Asian crisis render swift poverty alleviation a most difficult proposition.
One possible way out of the present economic debacle is the forging of a national consensus by the present government on all outstanding problems that have been bedeviling the country’s advancement. That is, there needs to be a meeting of minds across current political divides. Considering the present inflammatory political polarities in Sri Lanka this would prove an insurmountable challenge.
Unfortunately, conscience-filled and civic minded sections in Sri Lanka have chosen to be laid back rather than seize the initiative, come centre stage and impress on politicians the need for enlightened governance and progressive change. There needs to be a historic coming together of the right thinking to ensure that the best interests of the people and of the people only are served by governments. In the absence of such a process, might would be projected as right and brute force would come to increasingly rule politics and society.
Features
Australia funds project to restore climate-resilient vegetable livelihoods in cyclone-affected highlands
The Ministry of Agriculture, Livestock, Lands and Irrigation, the Government of Australia, and the Food and Agriculture Organization of the United Nations (FAO) have launched of a AUD 2 million (USD 1.4 million) recovery initiative to restore and transform vegetable production systems in the cyclone-affected districts of Nuwara Eliya and Badulla.
The FAO said yesterday (5) that the agreement was formalized through the signing of the grant agreement by Matthew Duckworth, Australian High Commissioner to Sri Lanka, and Vimlendra Sharan, FAO Representative for Sri Lanka and the Maldives, alongside the signing of the project document by D. P. Wickramasinghe, Secretary of Agriculture.
Cyclone Ditwah, which struck Sri Lanka in November 2025, caused widespread devastation across the country, severely disrupting agricultural production systems and livelihoods. The highland districts of Nuwara Eliya and Badulla, key suppliers of vegetables such as beans, carrots, leeks, cabbage, tomato and potato, were among the hardest hit, with thousands of smallholder farmers losing crops, seed stocks, and productive assets.
This 12-month initiative aims torestore and strengthen climate-resilient vegetable production systems, with a strong focus on empowering women farmers and supporting persons with disabilities. The project will directly benefit more than 2,400 smallholder farmers, through improved seed and seedling production systems, small machinery, training, and market linkages while indirectly supporting thousands more.
“This initiative is an important step not only in restoring what was lost, but in building a more resilient and self-reliant agricultural sector,” said Minister Lal Kantha. “By strengthening local seed systems and supporting smallholder farmers, particularly women and vulnerable groups, we are investing in the long-term sustainability of Sri Lanka’s food systems.”
“Australia stands alongside Sri Lanka in its ongoing recovery from Cyclone Ditwah,” said High Commissioner Duckworth. “Australia is a steadfast partner in the agriculture sector with its importance for food security, rural development and climate resilience. By focusing on climate smart practices, farmer-led solutions and inclusive economic opportunities, this project will deliver meaningful and lasting benefits to affected communities.
The project will prioritize the restoration of farmer-led seed systems for beans and potatoes, support the re-establishment of both open-field and protected cultivation systems and women led seedling supply nurseries while empowering all farmers with Climate-Smart Good Agricultural Practices (CSGAP) with small scale machinery and input support.
A key feature of the initiative is the establishment of six accessible and inclusive nurseries in Nuwara Eliya and Badulla. These nurseries will serve as sustainable agri-based enterprises, producing high-quality vegetable seedlings while creating new income opportunities and strengthening local input supply chains.
By combining recovery support with long-term resilience measures, the project will help stabilize vegetable production, improve household food security and nutrition, and reduce reliance on imported seeds.
Features
War on Iran may hasten unraveling of New World Order
It took several decades for the US to realise it was losing the war in Vietnam. It took a bit shorter time in Afghanistan. And what is happening in the countries the US and Israel intervened and broke up? The US has been asked to leave Iraq. Syria is talking to Russia about establishing military bases, President al-Sharaa met with Vladimir Putin in Moscow to discuss the project, which is vital for Russian power projection in the Middle East. Libya has been divided into two competing administrative units with the Eastern section actively engaged with Russia in defence matters. The Sudanese government has finalised a 25-year deal to allow a Russian naval facility in the Red Sea in exchange for weapons, including anti-aircraft systems. On the Eastern side of the Red Sea, Yemen remains divided, with the main power center, the Houthis maintaining a staunchly anti-US, anti-Israel stance, while the internationally recognised government remains in exile.
When the Iranian Foreign Minister recently undertook a tour of Pakistan, Oman and Russia, the US wanted to meet him and got ready to send its negotiators Vice President J. D. Vance and his team to Pakistan, but Iranian FM snubbed them and left Pakistan, saying Iran did not want to talk to the US while a blockade of their ports were in place. The Iranian FM met President Putin, who congratulated Iran for courageously defending their country and then phoned US President Trump and told him further attacks on Iran would not be acceptable. During this conversation on April 27, 2026, Putin reportedly warned Trump that further U.S. or Israeli attacks on Iran would have dangerous consequences, according to Al Jazeera). Such a sequence of events would not have been possible in the unipolar world we had in the past.
Furthermore, the damage that Iran has inflicted on the US and Israel in this war would have been unimaginable in the late 20th Century and early 21st Century. Sixteen US military bases spread across Saudi Arabia, Qatar, UAE, Bahrain, Kuwait, Iraq, Jordan and Oman have been either destroyed or severely damaged. Advanced surveillance aircraft and radar systems worth more than $ 2.8 bn were destroyed. This had a far-reaching effect on the war as the US could not use these bases in the war against Iran and also in the defence of its allies in the Gulf.
The attacks on Israel have been equally damaging. In Central Israel and Tel Aviv area multiple attacks targeted military and intelligence assets, resulting in massive damage. Iranian missiles hit the Haifa oil refinery, causing a shutdown, and hit residential buildings, leading to injuries and structural damage. Residential and commercial areas were damaged in Bat Yam and Petah Tikva with significant casualties and destruction. Attacks in Dimona and Arad targeted the Negev Nuclear Research Center, with casualties reported in both towns. The Soroka Medical Center in Beersheba was hit in a strike. The strategic port and naval base in Eilat were targeted. In Rishon LeZion suburban residential areas suffered extensive damage.
Usually, Israel makes short work of its many enemies in the region, for example it took just six days to defeat the combined military of Egypt, Jordan and Syria in 1967 and grab their land as well. Hamas, Fatah and Palestinians would suffer ignominious defeats if they dare challenge Israel. However, the recent war against Hamas, following a daring wide scale invasion into Israel by Hamas in October 2023, went on for more than two years with no conclusive victory for Israel.
These significant massive military setbacks suffered by the combined forces of the US and Israel have been made possible by the unprecedented advancement in military technology achieved mainly by China and to a degree by Russia as well. Iran has been able to develop ballistic missile systems that could penetrate the “iron dome” that Israel boasted, with technological assistance from China and North Korea. Iran’s drones are very cheap yet very effective, requiring interceptors worth millions of dollars to counter them, thus making it much more costly for the US to fight this war than it is for Iran.
Further, Hezbollah in Lebanon, Houthies in Yemen and Hamas in Palestine are well equipped with advanced missiles and drones. Hezbollah has been able to destroy about hundred Israel tanks and stop their advance. According to Larry Johnson, former CIA intelligence analyst, Israel soldiers are much war weary and mentally affected and are being withdrawn. Netanyahu’s 40 year dream of a “Greater Israel” is telling on the poor soldiers.
If a person like Barack Obama had been the US President instead of the hyper egoistic, blustering, intellectually barren Trump, things may have been different. An attempt would have been made to reconcile with the fact that the world is changing, instead of trying to stop it and make “America Great Again”. Perhaps, it could be said that Trump is facilitating the emergence of the new world order by enabling the US citizens to see the reality, the futility of war and the fact that Israel is a liability because the US is fighting its war. Further, the war has enabled Iran to assert its place in the region and negotiate from a position of strength.
Perhaps, Israeli people may realise that the Palestine problem cannot be solved by militarily occupying their land, and that in a changing world a “Greater Israel” is a “pie in the sky”. They may have to agree to a two-state solution. US support may not always be forthcoming, certainly not at the level that Trump could extend, as this war is very unpopular and expensive. The other very significant fact is that Israeli settlers in the occupied lands feel insecure and one in three wants to leave and the numbers may grow when Palestinians and their sympathisers grow in strength in the new world order.
Moreover, the war on Iran has afforded China the opportunity to demonstrate with authority the fact that it stands for universal peace and does not tolerate illegal wars. Its message to the US conveyed its world view and its desire for peace in no uncertain terms. Trump cannot afford to disregard the Chinese position on the war on the eve of his visit to that country which may decide on future trade between the two countries as the US depends on China for several essential materials like rare earth minerals. Furthermore, China has shown that peace could be achieved by developing the economies of the underdeveloped countries irrespective of their alliances. It helps Iran as well as Saudi Arabia and try to build bridges between these foes. It welcomes Trump in the coming weeks and hopes to strengthen ties between the two countries despite the weaknesses of the latter.
Another important factor is the gradual decline of the critical value of the petro-dollar. Following the end of the gold standard in 1971, the US struck deals with Saudi Arabia and other OPEC nations (around 1974) to price oil exclusively in USD in exchange for military protection and arms sales. Dollars earned by selling oil came to be known as petro-dollar. Oil producers, holding large dollar surpluses, reinvest these funds in the US Treasury securities, real estate, and financial assets ensuring the recycling of petro-dollars. The system ensures a consistent global demand for US dollars, which helps fund the US budget deficit and maintains the currency’s dominance.
However, the petro-dollar system is on the decline and there are two main reasons for this, firstly the gradual rise of the new world order with organisations like BRICS, making a concerted effort to extricate from the dollar dominance by developing alternate currencies and methods to bypass the dollar. Secondly, the need felt by most countries to develop alternative energy sources to replace enormously harmful fossil fuel would eventually result in a decline in the demand for it and consequently the effectiveness of the petro-dollar. China is leading the world in both these endeavours; depolarisation process and renewable energy production. The war on Iran seems to have hastened the process of depolarisation as Iran insists that it will sell its oil for yuan only.
These revolutionary changes in the aftermath of the Iran war have their undeniable implications for the Global South, where more than 60% of the poor live.
by N. A. de S. Amaratunga
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