It will be cheaper and easier to implement

By Saman Indrajith

LSSP leader Prof. Tissa Vitarana, the country’s most senior virologist, participating in the third reading stage of the budget debate under the expenditure headings of the Ministry of Health, said that it was not necessary to wait for a successful vaccine to be made and used to control the Covid-19 virus. It would also be very expensive. A public health approach based on intensive health education, and the active participation of the community would be cheaper, easier to implement and more effective even to get rid of the virus altogether from the country.

“We must first understand that this is a new virus to the world. There are many other types of viruses in the world which can cause alarm and even lead to epidemics, but there is a social immunity that has arisen against them with time and they tend to be milder. But for Covid-19 there is no such immunity. There is insufficient understanding of its behavior. It is still being studied and new knowledge of the virus is being discovered every day.” Prof. Vitarana said.

“It is in such a context that our Government faced the challenge and I must praise the way in which the Government handled that challenge. In the first wave, our experts identified separate clusters that had their origins from foreign sources. Action had been taken to identify the threat and to mitigate the damage in a scientific manner, so that Sri Lanka came to be among one of the few top countries in the world which handled the virus threat without letting it evolve into a pandemic”, said the renowned Virologist who was the former Head of the Medical Research Institute’s Virology department, and also worked as a consultant virologist at the Edinburgh City Hospital.

“But the virus gradually evolved itself. A PCR test is being used to make the diagnosis. The PCR test to identify the infection has a 70% level of accuracy. But PCR tests done against other viruses have a level of accuracy of more than 90%. This means that further research needs to be done to improve the capabilities of the Covid-19 PCR tests. About 30% of positives are being missed. That is the reality with regard to PCR tests. Further about 80% of those infected by the virus show no illness but can infect other people. Therefore, these are not easy conditions to control the spread of infection”, he said.

The World Health Organization has expressed its willingness to give vaccines to 20% of our population free of charge. The WHO can access the institutional capacity to ensure the safety and potency of those vaccines. These vaccines should be used to save the lives of elders and those who have other chronic medical conditions, for example heart patients. However, the main purpose of giving vaccines to a population is to make a country immune to the disease. To effectively stop transmission of the virus, at least 80% of the population needs to be immunized. This is a new vaccine and it is not known how long the immunization would last. And research is still been done on how frequently the vaccine should be given to obtain optimum protection. Under these circumstances the development of a program to vaccinate the entire population is unreliable and would be very costly. So the duty of the Government is to increase public awareness of the importance of following the three main health rules – the wearing of masks when other people are present, maintaining a distance of at least one meter, but better two meters, between oneself and other people, and frequent hand washing using soap, specially after touching any surface which has been touched by other people, Prof. Vitarana, who completed his PhD in virology from the University of London in 1971, further said.

He noted that there is a severe shortage of medicines in the Government hospitals and the cost is very high in the open market.

“I would like to suggest to the Minister that the way out would be to implement the Senaka Bibile Medicinal drug policy. Tenders were called worldwide to meet the requirement not only of the public health care system but also the private sector. Thus, the tenders called supplied the total national requirement. The tenders were called by the State Pharmaceutical Corporation using generic names of the medicine so that they could be bought at the cheapest prices provided their quality was ensured by getting certificates of good manufacturing practice by the supplying pharmaceutical companies”, he said.

This enabled all the Government hospitals to provide all the required medicines for practically every illness free of charge. The medicines were made available to the private sector too at the lowest possible prices. That was the result of the implementation of the Senake Bibile policy”, Prof. Vitarana added.