Shortage of medicines: Senaka Bibile Policy is the solution

The Senaka Bibile Medicinal Drug Policy is the answer to the present severe shortage of medicines in the government hospitals. As a result, most patients have to purchase their medicines from private pharmacies. The price of these medicines has soared to such an extent that the poor are unable to afford them. This is particularly the case for those with chronic conditions such as diabetes where they need to take medicines daily. This leads to a flaring up of these severe illnesses resulting in premature death. Sri Lanka is going back towards the situation that existed before the 1970s, when Senaka introduced his policy. Then the Drug Companies controlled the global and local markets and the Health Department had to abide by their terms. The majority of the patients suffered as a result.

 How did Senaka change that situation through his Policy? He found that various the Drug Companies were purchasing from the few producers of the Generic drugs at a low price and making a huge profit by giving them a brand name and capturing the market. Let me give you an example. The widely used generic product Paracetamol is sold under various Brand names by the different Drug Companies at a huge profit. Senaka set up the State Pharmaceutical Corporation (SPC) with the support of the Finance Minister, Dr N.M Perera, and Minister T. B. Subasinghe. The SPC used the List of Essential Drugs, about 233 (at that time) which had been prepared by Senaka, out of about 1,000 or more available in the market. They obtained the Government health sector requirement from the Medical Supplies Department (MSD). In addition, Senaka made an estimate of the requirement of the Private Health Sector and this was added to the State Sector requirement. Then the SPC called world-wide tenders for the total requirement of essential generic drugs, like paracetamol, for the coming year for Sri Lanka as a whole. Because this was a large amount Senaka was able to get at a very low -price good quality generic medicines for all the people in Sri Lanka. The State Health Sector requirement was given to the MSD. For the Private Sector Senaka set up the Osu Sala at Lipton Circus, Colombo. To reach the people in the rest of the country he chose reliable private pharmacies to whom the Osu Sala out sourced the SPC medicines as its agent. This acted as a pressure on the other private pharmacies to bring down the price of Drug Company products like Panadol, Panadeine etc.

Senaka was keen on developing countries like Sri Lanka not having to depend on imports from abroad and mooted the idea of manufacturing the medicines. For this he set up a State Pharmaceuticals Manufacturing Corporation (SPMC). This was able to produce about 43 drugs due to the efforts of Dr. Gladys Jayawardena, who as DDGLS in the Health Ministry stepped in to carry his work forward. Senaka was also very keen as Professor of Pharmacology to ensure that medical students would practice good medicine when they passed out as doctors. So, he set up a Formulary Committee that produced an excellent Hospitals Formulary as a proper guide in clinical pharmacology. Senaka was an excellent teacher and he never brought any notes into the class room but he was ensuring that the students got his message, by repetition or expanding his message. Senaka shifted to Peradeniya University when it was establishing the Medical Faculty and became the first Professor of Pharmacology. He was an educationist and introduced many new teaching methods.

 Senaka was born in remote Bibile. His father was a Rate Mahattaya. He obtained a scholarship to enable him to study at Trinity College, Kandy. Once he became a doctor the first thing, he did was to repay his scholarship so that a poor student could get the chance that he obtained. It was at Trinity that he got interested in social service and upliftment of the poor. He was attracted to the Lanka Sama Samaja Party (LSSP) and its struggle against British Imperialist rule. He joined the LSSP while at University and made an excellent study of Marxism/Leninism. As a medical student I formed a Socialist Society and used to take a group of interested students to his house in Rajagiriya on bicycles. He gave us some good talks on socialism and encouraged us to be critical before accepting his ideas. In the LSSP he took to active politics and became the Treasurer of the Youth Congress. When racial attacks against the LSSP were at its worst during the anti-Tamil Language riots he volunteered to contest a bye-election for the Kuppiawatte Ward in the Colombo Municipal Council. When we went canvassing for him, we were abused as supporters of Tamil also being made an official language with Sinhala. But he did not give in and stood up for the correct policy of the LSSP, knowing that he would lose. My admiration for Senaka soared. But the acceptance by WHO of his Medicinal Drug Policy and sending him to various poor countries to start the process gave him greatest satisfaction. I remember the time when he was to make what turned out to be his final visit abroad to the Caribbean countries and South America. My wife Kamini and I went to his house for dinner with him and his wife Leela. He gave his jovial laugh and said, “Tissa sees how the drug company lobby is trying to frighten me to give up my mission. I have got several calls warning me not to go tomorrow as there is a plot to kill me.” I told him that he should remember that they will not be happy to lose their profits and he should be careful. He left the next day on his mission. It was in Guiana that they killed him by giving him a chemical at a dinner which led to a very rapid heartbeat. With his previous history of ischemic heart disease this could have a fatal outcome. There was some delay in getting him to hospital, and even there he was kept on the trolley for a long time without being seen by a doctor, despite all Leela’s appeals. Kamini and I went to Katunayake to receive Leela with Senaka’s ashes. One of the saddest days in my life. Senaka was only 54 years old when he was killed. He had a lot more energy in him to serve the people and fight for a socialist future for mankind. On this 13th of February we thank him for what he did for the poor people of the world. It will never be forgotten.

 Tissa Vitarana

General Secretary of the LSSP