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REFLECTIONS ON THE COVID PANDEMIC

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BY SARATH AMUNUGAMA

Despite the carping criticism ,particularly from the social media, SriLanka is one of the few countries which has survived the Corona epidemic relatively unscathed. According to the latest figures available while writing this article 85,695 persons have tested positive for the virus and over 80,000 have now finished their quarantine period. A total of 502 deaths have been recorded. While the numbers given daily of those infected is relatively unimportant, since it is only a reflection of the numbers tested which is a comparatively small sample of the total population or ‘’universe’’- to use statistical phraseology.

The more people are tested the more likely that the numbers would increase till the effects of isolation and vaccinations kick in. The number of deaths is relatively small when compared to the death toll in developed countries. Research has shown that Asians living in tropical zones are less likely to succumb to the virus. On the other hand with the onset of winter there was a steady increase of reported cases in countries with a cold climate.

The initial ‘’roll out‘’ of the vaccine has been quite successful with nearly 730,000 people especially in the ‘’At risk’’categories receiving the injection. Unlike in many other countries the numbers resisting getting the vaccine injection seems to be small which is a good sign. In many other countries in our region that is a major problem. If we can rapidly vaccinate a large segment of the population the pace of testing need not be a priority. It would be more reasonable to deploy our limited medical services to administer the vaccine. The rumour that there will be insufficient vaccines to go round seems to be disproved by the regular shipments that are arriving.

 

PUBLIC HEALTH SERVICE

Sri Lanka is fortunate to have a good public medical service as the WHO has noted on several occasions. Since the introduction of the adult universal franchise our political leaders of different persuasions have all agreed on the need for an efficient public health service. The trauma of the Malaria epidemic of the 1930s led to the State Council supporting an extensive rural health programme which is associated with the name of George E de Silva, MSC for Kandy. He was the Minister of Health in the State Council and supported by Dr S A Wickremasinghe then of the LSSP and later of the Communist Party, became the ‘’Father of the Rural Health Scheme’’ which transformed the health standards of the disadvantaged village population.

It also laid the foundations of the demographic surge of the 40s and 50s, the results of which are seen in the overwhelming population configurations and economic planning dilemmas of our present times. Under this initiative Rural Hospitals were built all over the country. Midwives were appointed countrywide and pre-natal and post natal care was undertaken by the state. As a consequence there was a sharp drop in infant and maternal mortality and a rise in the years of life expectancy. A world renowned economist summarized this situation when he said ‘’Sri Lanka is third world country with a first world health service’.

Social scientists are aware of a debate that took place many years ago in the ‘’Demography‘’ journal regarding the reasons for the population surge in Sri Lanka. Some argued that this was due to the discovery of DDT and the elimination of Malaria,particularly in the Dry Zone with the introduction of colonization schemes. Others led by Ananda Meegama replied convincingly that this development was not mono-causal but depended on several innovations and policy packages associated with the Rural Health Schemes which were put in place by the State Council and continued by Parliament after Independence.

This debate drew attention of scholars to the welfare measures undertaken in our country. The Nobel prize winning Economist Amartya Sen wrote that SrI Lanka and Kerala had adopted a style of growth which could provide a model for the Third World. I must say however that whenever I met Dr Amartya Sen at meetings and discussed our situation he would say that his sanguine prognostications about Sri Lanka had been derailed by the failure to address the ethnic issue. His bets on SriLanka were off because we could not solve our ethnic problem.

I have always felt that George E de Silva has had a raw deal in our history writing. If CWW Kannangara has been lauded as the father of Free Education ,De Silva should receive a similar accolade as the Father of Free Health .

As shown above we have a health service we can be proud of. Even from the aspect of inoculations our health services have administered the polio vaccine and the triple vaccine countrywide and have been lauded by the WHO. Today no SriLankan child dies of these infections. The best example of our able medical service is Dr Sudarshini Fernandopulle, State Minister of Health who was my State Minister when I was Minister of Science and Technology. As a specialist physician she boldly and courageously held her ground when other bigwigs of the Ministry were throwing holy water into rivers and swallowing magical potions in front of Television cameras. Never in the history of the Government health sector has there been an exhibition of such stupid behavior by political authorities. Another Minister is reported to have generously provided government funds for a nutmeg crushing machine to make more of the anti-covid brew. A few intelligent journalists blew this snake oil salesman’s credentials sky high when they reported that the gullible swallowers, including famously the lady Minister of Health, had contracted Corona and were hospitalized under intensive care.

In a noteworthy coincidence two of the ‘’peni’’ drinkers were struck by the virus within a few days. Mr Speaker who hosted the swallowing session in Parliament in the glare of publicity was shown a few days later meekly getting the anti -corona jab. But what took the cake was his statement published in the newspapers that he agreed to be vaccinated because he wanted to set an example. As a former MP who was continuously in the House for 26 years I was dismayed to find the Speaker’s office used to promote dubious products merely because an MP wished to accommodate one of his constituents.

Of late Speakers have tended to act as political leaders in waiting who have no hesitation in using their high office for personal benefit. That is another recent development contributing to public disenchantment with Parliament. [As a social scientist I was intrigued by the discovery via Baas Unnehe the snake oil salesman, that Kali – a fond abbreviation for Badrakali, the demoness- was a Tamil language speaker. When this ‘Peniya’’ lost his cool with the throng of supplicants surrounding him at home, he ,on behalf of Kali ,Shouted ‘’Poda Poda Poda ‘’at a woman who also responded in gibberish .A Tamil friend told me that ‘’poda’’ is ungrammatical Tamil when addressing a female.]

While there may have been a few mishaps which have been reported in the media, the vaccination programme has been carried out smoothly thanks to the public officials and the army. Many of my friends, admittedly over 60, were anxious that they would not be able to access the vaccine but in a couple of days were able to get it without much difficulty. Whatever may have been the instructions in most centres there was a queue for over sixties and the grama sevakas could recognize the people from their divisions. All in all the initial ‘’Roll Out’’seems to be successful without the usual absentees that have been reported in other countries.

Presumably it will now be extended to other parts of the country so that we can reach a proportion of coverages so that the ‘’herd tendency’’would make it possible for us to open the economy and the social life of the country. Medical Scientists have said that to reach such immunity about 70 percent of the population have to be vaccinated. I read with interest that Basil Rajapaksa had said that we should aim at such an immunization. As a small country we should find this possible and would help in positioning us as a lead country for investment and tourism. In this Isreal provides us with a good model.

Being a small country with good links to their compatriots in the scientific and business fields in the West, Israel has set a blistering pace in vaccinating its population. Sadly their racial policies have left out the Palestinians from the vaccination programme. This discrimination is so reminiscent of what Hitler did to their forefathers in the thirties and early forties. What we can learn from their vaccination programme however is the clear prioritization of access to the vaccine. They identified the over 60s as their target group based on demographic data and covered this category promptly. According to the Economist, hospitalization of the over 60 cohort dropped substantially after 70% of the number in that cohort was vaccinated by the Isreali government.

One of the grumbles about our vaccination programme, as seen in the letters to Editors, is shifting attention away from the over 60 cohort which is abnormally large in our particular demographic profile. By uncritically following the WHO guideline in this matter we seem to have ignored the ground realities of our demography. This was shown in the unanticipated demand from this category which had to be accommodated by hastily adding a separate queue for the over sixties in the vaccination centres.

Let me now turn to some basic issues which came to the fore due to the Covid pandemic. The first is the need to recognize the role of modern science. All too frequently our media has highlighted anti-scientific ‘’ mumbo Jumbo’’ to direct the conversation away from the need to establish a science based society in our country. Many people supported President Gotabaya Rajapaksa because he was a tech savvy modernizer. Unlike our other leaders he was not seen weighed against gold, half naked in a ‘’Thulbaram’’. [It is an irony that many of these Godmen or Pusaris died recently after contracting Corona.] Indeed unlike our politicians GR knew that wars cannot be won by making Pujas. You need manpower, planning and training, use of proper modern weapons, latest communications technology and research and logistical superiority to overwhelm an opponent who had access to top weapons experts worldwide.

I was a minister when the LTTE with superior weapons such as MBRLs were on the verge of driving our armed forces out of Jaffna peninsula. One of the reforms introduced by the GR-Fonseka team was to immediately get the latest weaponry. Unfortunately the leaders of the UNP, led by Ranil, could not understand any of this and were setting up the media to question the financing of those planes and weapons.

The discovery of the Covid vaccine is nothing short of a modern scientific miracle, says the Economist of February 2021. ’’To call vaccination a miracle is no exaggeration. A little more than a year after the virus was first recognized medics have already administered 148 million doses. Although the vaccines fail to prevent all mild and asymptomatic cases of Covid 19, they mostly seem to spare patients from death and the severest infections that require hospitalization, which is what really matters’’.

Another problem which is facing the country is the inefficient provincial health system. Many of our Chief Ministers were small time politicians who had very little idea of management. I am now revealing a secret that JRJ never wanted to appoint politicians as chief Ministers. His idea was to appoint senior public servants with a proven track record of management to run the newly established provincial councils.I remember that politicians like Dissanayake of Gampola lobbied against this saying that officials had no political savvy. Instead he proposed himself for the post of Chief Minister of Central Province and JRJ was made to change his mind by confidantes like Gamini and Ronnie de Mel.

Any investigation will show that the rural hicks who became Chief Ministers plundered the revenue of the provincial councils for salaries and perks for their colleagues. Money set apart for education and health were squandered to give jobs for the boys in order to get political mileage for their attempt to enter Parliament. This irresponsibility has led to a crisis in provincial education and health. Except perhaps in the North, the public in all other provinces want this subject reverted to the Central Government as the local education and health systems have broken down.

The health services in the provinces can effectively function at present because fortunately the Councils are dissolved. It is up to the Government to make a realistic assessment of the provincial council system which has been an utter failure in the Sinhala provinces. I would suggest the setting up of an international group of experts to evaluate the provincial council system which has been in operation for over 30 years. As I shall show later a streamlined health system will become a necessity in the ‘’Post-Covid World’’. A better framework for health and education, especially in rural areas must be evolved. An inquiry must be launched as to how the funds allocated to PCs have been misappropriated and wasted in political ‘’gift giving’’.

Scientists and economists are now talking of the ‘’New Coronormal’’. The epidemic has created a new normal with which we have to live. Says the Economist ‘’To the extent that medicine alone cannot prevent lethal outbreaks of Covid 19, the burden will also fall on behavior, just as it has in most of the pandemic. Habits like mask wearing may become part of everyday life. Vaccine passports and restrictions in crowded spaces could become mandatory. Vulnerable people will have to maintain great vigilance. Those who refuse vaccination can expect health education but limited protection. But even if Covid- 19 has not been completely put to rest, the situation is immeasurably better than what might have been. The credit for that goes to medical science.’’

Finally we cannot avoid the mega question of our attitude as a country and administration to the process of modernity. Though cranks and eccentric academics may muddy the waters we cannot avoid the thrust of modernization. All countries in this interrelated world follow a path to modernity which is time tested and, above all, practical. The covid virus has clearly shown the pathetic inability of non–science to address practical issues. While individuals may be delusional and call on gods like Natha to answer their prayers, real life is different and cannot succeed by rhetoric and speech-making. We need to get our priorities right and seek rational solutions. It is clear that countries that have successfully negotiated the modernization process can give a better life for the people Covid is a wake up call. I invite all concerned politicians, administrators, business people and academics to begin a discussion on the rational path to modernization which alone can lift us out of the morass in which we find ourselves now.



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Features

Who Owns the Clock? The Quiet Politics of Time in Sri Lanka

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(This is the 100th column of the Out of the Box series, which began on 6 September, 2023, at the invitation of this newspaper – Ed.)

A new year is an appropriate moment to pause, not for celebration, but to interrogate what our politics, policies, and public institutions have chosen to remember, forget, and repeat. We celebrate the dawn of another brand-new year. But whose calendar defines this moment?

We hang calendars on our walls and carry them in our phones, trusting them to keep our lives in order, meetings, exams, weddings, tax deadlines, pilgrimages. Yet calendars are anything but neutral. They are among humanity’s oldest instruments of power: tools that turn celestial rhythms into social rules and convert culture into governance. In Sri Lanka, where multiple traditions of time coexist, the calendar is not just a convenience, it is a contested terrain of identity, authority, and fairness.

Time is never just time

Every calendar expresses a political philosophy. Solar systems prioritise agricultural predictability and administrative stability; lunar systems preserve religious ritual even when seasons drift; lunisolar systems stitch both together, with intercalary months added to keep festivals in season while respecting the moon’s phases. Ancient India and China perfected this balancing act, proving that precision and meaning can coexist. Sri Lanka’s own rhythms, Vesak and Poson, Avurudu in April, Ramadan, Deepavali, sit inside this wider tradition.

What looks “technical” is actually social. A calendar decides when courts sit, when budgets reset, when harvests are planned, when children sit exams, when debts are due, and when communities celebrate. It says who gets to define “normal time,” and whose rhythms must adapt.

The colonial clock still ticks

Like many postcolonial societies, Sri Lanka inherited the Gregorian calendar as the default language of administration. January 1 is our “New Year” for financial statements, annual reports, contracts, fiscal plans, school terms, and parliamentary sittings, an imported date shaped by European liturgical cycles and temperate seasons rather than our monsoons or zodiac transitions. The lived heartbeat of the island, however, is Avurudu: tied to the sun’s movement into Mesha Rāshi, agricultural renewal, and shared rituals of restraint and generosity. The result is a quiet tension: the calendar of governance versus the calendar of lived culture.

This is not mere inconvenience; it is a subtle form of epistemic dominance. The administrative clock frames Gregorian time as “real,” while Sinhala, Tamil, and Islamic calendars are relegated to “cultural” exceptions. That framing shapes everything, from office leave norms to the pace at which development programmes expect communities to “comply”.

When calendars enforce authority

History reminds us that calendar reforms are rarely innocent. Julius Caesar’s reshaping of Rome’s calendar consolidated imperial power. Pope Gregory XIII’s reform aligned Christian ritual with solar accuracy while entrenching ecclesiastical authority. When Britain finally adopted the Gregorian system in 1752, the change erased 11 days and was imposed across its empire; colonial assemblies had little or no say. In that moment, time itself became a technology for governing distant subjects.

Sri Lanka knows this logic. The administrative layers built under colonial rule taught us to treat Gregorian dates as “official” and indigenous rhythms as “traditional.” Our contemporary fiscal deadlines, debt restructurings, even election cycles, now march to that imported drumbeat, often without asking how this timing sits with the island’s ecological and cultural cycles.

Development, deadlines and temporal violence

Modern governance is obsessed with deadlines: quarters, annual budgets, five-year plans, review missions. The assumption is that time is linear, uniform, and compressible. But a farmer in Anuradhapura and a rideshare driver in Colombo do not live in the same temporal reality. Monsoons, harvests, pilgrimage seasons, fasting cycles, school term transitions, these shape when people can comply with policy, pay taxes, attend trainings, or repay loans. When programmes ignore these rhythms, failure is framed as “noncompliance,” when in fact the calendar itself has misread society. This mismatch is a form of temporal violence: harm produced not by bad intentions, but by insensitive timing.

Consider microcredit repayment windows that peak during lean agricultural months, or school examinations scheduled without regard to Avurudu obligations. Disaster relief often runs on the donor’s quarterly clock rather than the community’s recovery pace. In each case, governance time disciplines lived time, and the least powerful bend the most.

Religious time vs administrative time

Sri Lanka’s plural religious landscape intensifies the calendar question. Buddhism, Hinduism, Islam, and Christianity relate to time differently: lunar cycles, solar markers, sacred anniversaries. The state acknowledges these mainly as public holidays, rather than integrating their deeper temporal logic into planning. Vesak is a day off, not a rhythm of reflection and restraint; Ramadan is accommodated as schedule disruption, not as a month that reorganises energy, sleep, and work patterns; Avurudu is celebrated culturally but remains administratively marginal. The hidden assumption is that “real work” happens on the Gregorian clock; culture is decorative. That assumption deserves challenge.

The wisdom in complexity

Precolonial South and East Asian calendars were not confused compromises. They were sophisticated integrations of astronomy, agriculture, and ritual life, adding intercalary months precisely to keep festivals aligned with the seasons, and using lunar mansions (nakshatra) to mark auspicious thresholds. This plural logic admits that societies live on multiple cycles at once. Administrative convenience won with the Gregorian system, but at a cost: months that no longer relate to the moon (even though “month” comes from “moon”), and a yearstart with no intrinsic astronomical significance for our context.

Towards temporal pluralism

The solution is not to abandon the Gregorian calendar. Global coordination, trade, aviation, science, requires shared reference points. But ‘shared’ does not mean uncritical. Sri Lanka can lead by modelling temporal pluralism: a policy posture that recognises different ways of organising time as legitimate, and integrates them thoughtfully into governance.

Why timing is justice

In an age of economic adjustment and climate volatility, time becomes a question of justice: Whose rhythms does the state respect? Whose deadlines dominate? Whose festivals shape planning, and whose are treated as interruptions? The more governance assumes a single, imported tempo, the wider the gap between the citizens and the state. Conversely, when policy listens to local calendars, legitimacy grows, as does efficacy. People comply more when the schedule makes sense in their lives.

Reclaiming time without romanticism

This is not nostalgia. It is a pragmatic recognition that societies live on multiple cycles: ecological, economic, ritual, familial. Good policy stitches these cycles into a workable fabric. Poor policy flattens them into a grid and then blames citizens for falling through the squares.

Sri Lanka’s temporal landscape, Avurudu’s thresholds, lunar fasts, monsoon pulses, exam seasons, budget cycles, is rich, not chaotic. The task before us is translation: making administrative time converse respectfully with cultural time. We don’t need to slow down; we need to sync differently.

The last word

When British subjects woke to find 11 days erased in 1752, they learned that time could be rearranged by distant power. Our lesson, centuries later, is the opposite: time can be rearranged by near power, by a state that chooses to listen.

Calendars shape memory, expectation, discipline, and hope. If Sri Lanka can reimagine the governance of time, without abandoning global coordination, we might recover something profound: a calendar that measures not just hours but meaning. That would be a reform worthy of our island’s wisdom.

(The writer, a senior Chartered Accountant and professional banker, is Professor at SLIIT, Malabe. The views and opinions expressed in this article are personal.)

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Medicinal drugs for Sri Lanka:The science of safety beyond rhetoric

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The recent wave of pharmaceutical tragedies in Sri Lanka, as well as some others that have occurred regularly in the past, has exposed a terrifying reality: our medicine cabinets have become a frontline of risk and potential danger. In recent months, the silent sanctuary of Sri Lanka’s healthcare system has been shattered by a series of tragic, preventable deaths. The common denominator in these tragedies has been a failure in the most basic promise of medicine: that it will heal, not harm. This issue is entirely contrary to the immortal writings of the Father of Medicine, Hippocrates of the island of Kos, who wrote, “Primum non nocere,” which translates classically from Latin as “First do no harm.” The question of the safety of medicinal drugs is, at present, a real dilemma for those of us who, by virtue of our vocation, need to use them to help our patients.

For a nation that imports the vast majority of its medicinal drugs, largely from regional hubs like India, Pakistan, and Bangladesh, the promise of healing is only as strong as the laboratory that verifies these very same medicinal drugs. To prevent further problems, and even loss of lives, we must demand a world-class laboratory infrastructure that operates on science, not just sentiment. We desperately need a total overhaul of our pharmaceutical quality assurance architecture.

The detailed anatomy of a national drug testing facility is not merely a government office. It is a high-precision fortress. To meet international standards like ISO/IEC 17025 and World Health Organisation (WHO) Good Practices for Pharmaceutical Quality Control Laboratories, such a high-quality laboratory must be zoned into specialised units, each designed to catch a different type of failure.

*  The Physicochemical Unit: This is where the chemical identity of a drug is confirmed. Using High-Performance Liquid Chromatography (HPLC) and Gas Chromatography-Mass Spectrometry (GC-MS), scientists determine if a “500mg” tablet actually contains 500mg of the active ingredient or if it is filled with useless chalk.

*  The Microbiology Suite: This is the most critical area for preventing “injection deaths.” It requires an ISO Class 5 Cleanroom: sterile environments where air is filtered to remove every microscopic particle. Here, technicians perform Sterility Testing to ensure no bacteria or fungi are present in medicines that have to be injected.

*  The Instrumentation Wing: Modern testing requires Atomic Absorption Spectrometers to detect heavy metal contaminants (like lead or arsenic) and Stability Chambers to see how drugs react to Sri Lanka’s high humidity.

*  The injectable drug contamination is a serious challenge. The most recent fatalities in our hospitals were linked to Intravenous (IV) preparations. When a drug is injected directly into the bloodstream, there is no margin for error. A proper national laboratory must conduct two non-negotiable tests:

*  Bacterial Endotoxin Testing (BET): Even if a drug is “sterile” (all bacteria are dead), the dead bacteria leave behind toxic cell wall products called endotoxins. If injected, these residual compounds cause “Pyrogenic Reactions” with violent fevers, organ failure, and death. A functional lab must use the Limulus Amoebocyte Lysate (LAL) test to detect these toxins at the parts-per-billion level.

*  Particulate Matter Analysis: Using laser obscuration, labs must verify that no microscopic shards of glass or plastic are floating in the vials. These can cause fatal blood clots or embolisms in the lungs.

It is absolutely vital to assess whether the medicine is available in the preparation in the prescribed amounts and whether it is active and is likely to work. This is Bioavailability. Sri Lanka’s heavy reliance on “generic” imports raises a critical question: Is the cheaper version from abroad as effective as the original, more expensive branded formulation? This is determined by Bioavailability (BA) and Bioequivalence (BE) studies.

A drug might have the right chemical formula, but if it does not dissolve properly in the stomach or reach the blood at the right speed, it is therapeutically useless. Bioavailability measures the rate and extent to which the active ingredient is absorbed into the bloodstream. If a cheaper generic drug is not “bioequivalent” to the original brand-named version, the patient is essentially taking a useless placebo. For patients with heart disease or epilepsy, even a 10% difference in bioavailability can lead to treatment failure. A proper national system must include a facility to conduct these studies, ensuring that every generic drug imported is a true “therapeutic equivalent” to the brand-named original.

As far as testing goes, the current testing philosophy is best described as Reactive, rather than Proactive. The current Sri Lankan system is “reactive”: we test a drug only after a patient has already suffered. This is a proven recipe for disaster. To protect the public, we must shift to a Proactive Surveillance Model of testing ALL drugs at many stages of their dispensing.

*  Pre-Marketing Approval: No drug should reach a hospital shelf without “Batch Release” testing. Currently, we often accept the manufacturer’s own certificate of analysis, which is essentially like allowing students to grade their own examination answers.

*  Random Post-Marketing Surveillance (PMS): Regulatory inspectors must have the power to walk into any rural pharmacy or state hospital, pick a box of medicine at random, and send it to the lab. This could even catch “substandard” drugs that may have degraded during shipping or storage in our tropical heat. PMS is the Final Safety Net. Even the best laboratories cannot catch every defect. Post-Marketing Surveillance is the ongoing monitoring of a drug’s safety after it has been released to the public. It clearly is the Gold Standard.

*  Pharmacovigilance: A robust digital system where every “Adverse Drug Reaction” (ADR) is logged in a national database.

*  Signal Detection: An example of this is if three hospitals in different provinces report a slight rash from the same batch of an antibiotic, the system should automatically “flag” that batch for immediate recall before a more severe, unfortunate event takes place.

*  Testing for Contaminants: Beyond the active ingredients, we must test for excipient purity. In some global cases, cheaper “glycerin” used in syrups was contaminated with diethylene glycol, a deadly poison. A modern lab must have the technology to screen for these hidden killers.

When one considers the Human Element, Competence and Integrity, the very best equipment in the world is useless without the human capital to run it. A national lab would need the following:

*  Highly Trained Pharmacologists and Microbiologists and all grades of staff who are compensated well enough to be immune to the “lobbying” of powerful external agencies.

*  Digital Transparency: A database accessible to the public, where any citizen can enter a batch number from their medicine box and see the lab results.

Once a proper system is put in place, we need to assess as to how our facilities measure up against the WHO’s “Model Quality Assurance System.” That will ensure maintenance of internationally recognised standards. The confirmed unfavourable results of any testing procedure, if any, should lead to a very prompt “Blacklist” Initiative, which can be used to legally bar failing manufacturers from future tenders. Such an endeavour would help to keep all drug manufacturers and importers on their toes at all times.

This author believes that this article is based on the premise that the cost of silence by the medical profession would be catastrophic. Quality assurance of medicinal compounds is not an “extra” cost. It is a fundamental right of every Sri Lankan citizen, which is not at all subject to any kind of negotiation. Until our testing facilities match the sophistication of the manufacturers we buy from, we are not just importing medicine; we are importing potential risk.

The promises made by the powers-that-be to “update” the testing laboratories will remain as a rather familiar, unreliable, political theatre until we see a committed budget for mass spectrometry, cleanroom certifications, highly trained and committed staff and a fleet of independent inspectors. Quality control of therapeutic medicines is not a luxury; it is the price to be paid for a portal of entry into a civilised and intensively safe healthcare system. Every time we delay the construction of a comprehensive, proactive testing infrastructure, we are playing a game of Russian Roulette with the lives of our people.

The science is available, and the necessary technology exists. What is missing is the political will to put patient safety as the premier deciding criterion. The time for hollow rhetoric has passed, and the time for a scientifically fortified, transparent, and proactive regulatory mechanism is right now. The good health of all Sri Lankans, as well as even their lives, depend on it.

Dr B. J. C. Perera  

MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paediatrics), MRCP(UK), FRCP(Edin), FRCP(Lond), 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.

Joint Editor, Sri Lanka Journal of Child Health

Section Editor, Ceylon Medical Journal

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Rebuilding Sri Lanka Through Inclusive Governance

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Management Committee of the 'Rebuilding Sri Lanka' Fund Appointed with Representatives from the Public and Private Sectors - PMD

In the immediate aftermath of Cyclone Ditwah, the government has moved swiftly to establish a Presidential Task Force for Rebuilding Sri Lanka with a core committee to assess requirements, set priorities, allocate resources and raise and disburse funds. Public reaction, however, has focused on the committee’s problematic composition. All eleven committee members are men, and all non-government seats are held by business personalities with no known expertise in complex national development projects, disaster management and addressing the needs of vulnerable populations. They belong to the top echelon of Sri Lanka’s private sector which has been making extraordinary profits. The government has been urged by civil society groups to reconsider the role and purpose of this task force and reconstitute it to be more representative of the country and its multiple  needs.

 The group of high-powered businessmen initially appointed might greatly help mobilise funds from corporates and international donors, but this group may be ill equipped to determine priorities and oversee disbursement and spending. It would be necessary to separate fundraising, fund oversight and spending prioritisation, given the different capabilities and considerations required for each. International experience in post disaster recovery shows that inclusive and representative structures are more likely to produce outcomes that are equitable, efficient and publicly accepted. Civil society, for instance, brings knowledge rooted in communities, experience in working with vulnerable groups and a capacity to question assumptions that may otherwise go unchallenged.

 A positive and important development is that the government has been responsive to these criticisms and has invited at least one civil society representative to join the Rebuilding Sri Lanka committee. This decision deserves to be taken seriously and responded to positively by civil society which needs to call for more representation rather than a single representative.  Such a demand would reflect an understanding that rebuilding after a national disaster cannot be undertaken by the state and the business community alone. The inclusion of civil society will strengthen transparency and public confidence, particularly at a moment when trust in institutions remains fragile. While one appointment does not in itself ensure inclusive governance, it opens the door to a more participatory approach that needs to be expanded and institutionalised.

Costly Exclusions

 Going  down the road of history, the absence of inclusion in government policymaking has cost the country dearly. The exclusion of others, not of one’s own community or political party, started at the very dawn of Independence in 1948. The Father of the Nation, D S Senanayake, led his government to exclude the Malaiyaha Tamil community by depriving them of their citizenship rights. Eight years later, in 1956, the Oxford educated S W R D Bandaranaike effectively excluded the Tamil speaking people from the government by making Sinhala the sole official language. These early decisions normalised exclusion as a tool of governance rather than accommodation and paved the way for seven decades of political conflict and three decades of internal war.

Exclusion has also taken place virulently on a political party basis. Both of Sri Lanka’s post Independence constitutions were decided on by the government alone. The opposition political parties voted against the new constitutions of 1972 and 1977 because they had been excluded from participating in their design. The proposals they had made were not accepted. The basic law of the country was never forged by consensus. This legacy continues to shape adversarial politics and institutional fragility. The exclusion of other communities and political parties from decision making has led to frequent reversals of government policy. Whether in education or economic regulation or foreign policy, what one government has done the successor government has undone.

 Sri Lanka’s poor performance in securing the foreign investment necessary for rapid economic growth can be attributed to this factor in the main. Policy instability is not simply an economic problem but a political one rooted in narrow ownership of power. In 2022, when the people went on to the streets to protest against the government and caused it to fall, they demanded system change in which their primary focus was corruption, which had reached very high levels both literally and figuratively. The focus on corruption, as being done by the government at present, has two beneficial impacts for the government. The first is that it ensures that a minimum of resources will be wasted so that the maximum may be used for the people’s welfare.

Second Benefit

 The second benefit is that by focusing on the crime of corruption, the government can disable many leaders in the opposition. The more opposition leaders who are behind bars on charges of corruption, the less competition the government faces. Yet these gains do not substitute for the deeper requirement of inclusive governance. The present government seems to have identified corruption as the problem it will emphasise. However, reducing or eliminating corruption by itself is not going to lead to rapid economic development. Corruption is not the sole reason for the absence of economic growth. The most important factor in rapid economic growth is to have government policies that are not reversed every time a new government comes to power.

 For Sri Lanka to make the transition to self-sustaining and rapid economic development, it is necessary that the economic policies followed today are not reversed tomorrow. The best way to ensure continuity of policy is to be inclusive in governance. Instead of excluding those in the opposition, the mainstream opposition in particular needs to be included. In terms of system change, the government has scored high with regard to corruption. There is a general feeling that corruption in the country is much reduced compared to the past. However, with regard to inclusion the government needs to demonstrate more commitment. This was evident in the initial choice of cabinet ministers, who were nearly all men from the majority ethnic community. Important committees it formed, including the Presidential Task Force for a Clean Sri Lanka and the Rebuilding Sri Lanka Task Force, also failed at first to reflect the diversity of the country.

 In a multi ethnic and multi religious society like Sri Lanka, inclusivity is not merely symbolic. It is essential for addressing diverse perspectives and fostering mutual understanding. It is important to have members of the Tamil, Muslim and other minority communities, and women who are 52 percent of the population, appointed to important decision making bodies, especially those tasked with national recovery. Without such representation, the risk is that the very communities most affected by the crisis will remain unheard, and old grievances will be reproduced in new forms. The invitation extended to civil society to participate in the Rebuilding Sri Lanka Task Force is an important beginning. Whether it becomes a turning point will depend on whether the government chooses to make inclusion a principle of governance rather than treat it as a show of concession made under pressure.

by Jehan Perera

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