Features
2024 SL presidential election: A significant shift towards liberal leftist politics
By Amarasiri de Silva
The 2024 Sri Lankan presidential election is considered a watershed moment for several key reasons. One of the most significant aspects is the peaceful transfer of power from a neoliberal administration to the left-oriented National People’s Power (NPP), led by Anura Kumara Dissanayake. The NPP, supported by the Janatha Vimukthi Peramuna (JVP), marked a significant shift in the country’s political landscape. Historically, the JVP was involved in two armed uprisings in 1971 and 1989 in attempts to seize control through revolutionary means, both of which failed and were violently suppressed by the government.
The election results in 2024 reflect the public’s disillusionment with traditional political parties, particularly in light of the economic crises that have plagued Sri Lanka since 2022. Ranil Wickremesinghe, the neoliberal incumbent, played a pivotal role in stabilising the economy after widespread protests ousted the Rajapaksa government. However, despite his efforts to gain public trust, the voters, particularly the younger generation, demanded change and were drawn to the progressive and socialist policies of the NPP.
The peaceful electoral victory of the NPP, with such a revolutionary past, marks a new chapter in Sri Lankan politics. This election reflects a shift from armed struggle to democratic participation, cementing the NPP’s position as a legitimate political force. Moreover, this outcome challenges the entrenched political elite and signals a potential restructuring of Sri Lanka’s political and economic system. Originating from a farming community in Anuradhapura, Dissanayake embodies the character of an ordinary citizen, contrasting with the traditional rulers of the country who come from the Radala high caste or high-class families. This marks a significant shift in Sri Lanka’s political landscape.
The 2024 Sri Lankan presidential election result, which saw the victory of the leftist NPP, backed by the JVP, is not just a change of government but a direct challenge to the long-standing political elite that has dominated the country for decades. This entrenched political class, primarily represented by parties like the UNP and the SLFP, or the SLPP or Pohottuwa, has been heavily associated with neoliberal policies, dynastic politics, and a failure to address deep socio-economic inequalities. The victory of the NPP, a party with socialist leanings, marks a significant departure from this status quo.
The shift signals a potential restructuring of both the political and economic systems in Sri Lanka. Politically, the NPP’s rise reflects a growing rejection of elite control and the consolidation of power among a few families, like the Rajapaksas, Bandaranaikes, and Wickremesinghe’s political lineage. For years, these elites shaped the country’s policies, focusing on liberal economic reforms, often criticized for favouring the wealthy and exacerbating income disparities. The NPP’s success, bolstered by the JVP’s revolutionary past, suggests a new direction, focusing on redistributing political power and fostering a more egalitarian economic structure. Although the percentage increase of the NPP in the presidential election is attributed to the division between the UNP and the SJB, it is deeply rooted in the people’s desire for a fundamental system change. This is clearly reflected in the significant increase in the NPP’s voter base. This dramatic rise underscores the growing public demand for change and the NPP’s ability to capture the sentiments of a population eager for a new political direction. The electorate’s growing disillusionment with traditional political parties and failure to address socio-economic inequalities and governance issues has driven voters to seek an alternative in the NPP, reflecting a broader demand for transformative change in the country’s political and economic landscape.
Ranil Wickremesinghe, representing the UNP, and Sajith Premadasa, leading the SJB, have each garnered substantial support. However, their division has fragmented the votes that would otherwise likely consolidate under one party. This indicates that if the UNP and SJB had remained unified or had formed a coalition, they would have likely outperformed the NPP, reducing the latter’s influence and growth in parliamentary electoral results.
The fragmentation in the centre-right and centre-left political spaces, dominated by the UNP and SJB, has thus contributed to a scenario where a previously smaller political force like the NPP can make significant gains, as the Opposition’s division has weakened their ability to retain a majority vote share. Therefore, the NPP’s rise does not solely reflect an increase in its inherent support but rather the strategic consequences of a divided Opposition.
Economically, the NPP victory signals a potential shift toward policies prioritising social welfare, public ownership, and economic equity. The neoliberal approach championed by past governments, which included deregulation, privatisation, and aligning with global financial institutions like the IMF, faced strong opposition from the NPP and JVP. The NPP has advocated for state intervention in key sectors, wealth redistribution, and addressing the economic needs of the working class, a stark contrast to the elite-driven policies that favoured corporate interests and foreign investments.
This outcome also challenges the traditional role of Sri Lanka in the global economy. As a small developing nation, Sri Lanka has long depended on foreign aid, loans, and investment from international actors, especially during its economic crisis. The NPP’s victory may signal a recalibration of these relationships, as the party has criticized the terms of engagement with global financial institutions, calling for more autonomy and a greater focus on domestic development. In summary, the 2024 election represents more than just a change in leadership; it signals a broader transformation in Sri Lanka’s political and economic system, aiming to dismantle elite control and refocus governance on social justice and economic equity.
Despite the strong backing of the NPP from the oppressed and working-class voters in the 2024 Sri Lankan Presidential Election, a noticeable gap emerged in support from ethnic minorities, particularly in the North and upcountry regions. These regions are home to significant and Muslim and Tamil populations, who have historically been marginalized and continue to face social, political, and economic discrimination.
While the NPP’s platform of social justice, equity, and anti-elite rhetoric resonated with many of the country’s Sinhalese working class, the party’s message did not seem to fully address the complex grievances and historical trauma faced by these ethnic minorities. The Tamil population in the Northern Province, for instance, has long held concerns over unresolved issues from the civil war, such as the demand for justice, truth-seeking for alleged war crimes, and a genuine political solution that would grant them greater autonomy. The electoral results from the Batticaloa district reveal that the Tamil population in the region has yet to demonstrate significant allegiance to the NPP in recent elections. Batticaloa, located in the Eastern Province of Sri Lanka, is predominantly inhabited by Tamils and Muslims. Tamil nationalist sentiments and concerns over ethnic rights, governance, and autonomy have historically shaped the political landscape in this region.
The NPP, primarily identified with the Sinhala-majority JVP, has traditionally struggled to gain traction in the Tamil electorate. This is mainly due to the party’s historical associations and lack of focus on the specific grievances of the Tamil community, such as demands for regional autonomy, post-war reconciliation, and devolution of power. The NPP’s broader, more nationalist platform has not resonated as strongly with the Tamil voters, who tend to align with parties that explicitly advocate for Tamil rights and representation, such as the Tamil National Alliance (TNA) and other regional parties.
This trend was visible in the 2020 parliamentary elections and other recent elections. The NPP failed to make significant inroads in Batticaloa, with most Tamil voters favouring more localised, ethnic-based parties that they perceive as better representing their political aspirations. This lack of support for the NPP in Batticaloa can also be attributed to the deep-rooted ethnic tensions in Sri Lanka’s political sphere. Many Tamil voters may view the NPP as part of the broader Sinhala-majority political establishment, which has historically been in opposition to Tamil demands for autonomy and justice for wartime grievances. Thus, the Batticaloa results underscore the NPP’s challenges in gaining support among Tamil populations, who remain more aligned with parties that advocate for their specific ethnic and regional concerns. This reflects a broader pattern in Sri Lankan politics, where ethnic identities and regional issues often dictate voting patterns.
The NPP’s position on these matters, while generally supportive of reconciliation, may have been perceived as insufficiently robust or sensitive to the specific needs of the Tamil community. Similarly, in the upcountry regions, which Tamil-speaking plantation workers of Indian origin largely inhabit, there remains a deep history of socio-economic deprivation. While the NPP’s economic agenda could benefit these groups, there may have been doubts about whether the party could deliver on its promises, given its primary appeal to a predominantly Sinhalese electorate. Ethnic minorities in these areas may also have been wary of aligning with a party rooted in Sinhalese-majoritarian political culture despite the NPP’s efforts to position itself as a multi-ethnic, inclusive political force.
The gap in minority support likely reflects a broader historical pattern in Sri Lankan politics, where minority communities have been cautious about backing new political movements, especially those with a strong base among the Sinhalese majority. Instead, many of these voters may have supported more established minority-friendly parties or candidates, such as the TNA in the North or the UNP, which was traditionally seen as more accommodating to minority concerns. This divergence underscores the deep ethnic and regional cleavages that continue to shape Sri Lankan electoral politics, even in the context of a broader desire for change.
The 2024 presidential election results highlight significant challenges for the new NPP government, led by Anura Kumara Dissanayake. Despite their platform advocating for a unified and ethnically cohesive government, the election results show that the message has not fully resonated with the country’s ethnic minorities, particularly the Tamils in the North and the upcountry Tamil communities, as well as the Muslim population. This poses a significant challenge for the NPP, which must now find ways to reconcile these disparities while fostering ethnic harmony in both economic and political spheres.
The JVP, which forms the core of the NPP, has historically struggled to build a strong base among ethnic minorities. The JVP’s revolutionary roots and prior engagement in Sinhalese-majoritarian politics during the 1971 and 1989 uprisings may have contributed to a lingering perception among minorities that the party is more focused on Sinhalese interests. Although the NPP campaigned on a platform of equality and inclusivity, it seems that these promises did not sufficiently convince the Tamil and Muslim communities, who have long demanded autonomy, recognition of their identity, and solutions to lingering post-war grievances. For the Tamil population in the Northern Province, for instance, issues such as war crimes accountability, land rights, and devolution of power remain unresolved, and the NPP’s messaging on these fronts may have lacked the specificity or reassurance they were seeking.
In the upcountry regions, where Tamil-speaking plantation workers of Indian origin face entrenched socio-economic hardships, the NPP’s broader economic reforms, while potentially beneficial, did not seem to connect with the unique struggles of these communities. Similarly, Sri Lanka’s Muslim population has faced increasing marginalization and targeted violence in recent years, and the NPP’s ability to address these concerns may be viewed with skepticism, given the JVP’s lack of a strong track record in minority issues.
The new NPP government now faces a critical challenge: how to build trust with ethnic minorities and integrate them into its broader vision of economic and political development. Achieving ethnic harmony in a deeply divided country will require more than rhetoric; it will necessitate concrete policy measures that address these communities’ historical injustices and grievances. The NPP will need to engage in meaningful dialogue with minority leaders, create mechanisms for greater political autonomy in the North and East, and ensure that economic development reaches all parts of the country, especially those that have historically been left behind. These efforts are essential not only for the success of the NPP government but also for the long-term stability and unity of Sri Lanka.
The NPP enjoyed overwhelming support from Sinhalese-majority districts in southern Sri Lanka, particularly from areas like Hambantota, Matara, and Galle. These regions are traditionally strongholds of the working and middle classes, including lower-middle-class workers, small-scale farmers, and rural laborers, including fisher folk. Many in these communities have faced longstanding economic hardships exacerbated by social disparities, stagnating wages, and a lack of equitable development. The NPP’s promise of economic reform, social justice, and redistributive policies appealed to these voters, who saw the NPP as a chance for significant change after decades of economic neglect by successive governments.
However, this support also presents a challenge for the NPP government. These regions have high expectations for concrete improvements in living standards, income growth, and social equity. The disparity between wealthier urban centers and rural southern districts has deepened over the years, and many rural voters feel marginalized by neoliberal policies that have primarily benefited Colombo and other urban hubs. Issues like insufficient access to quality education, healthcare, infrastructure development, and fair wages are critical concerns for these communities.
To redress these grievances, the NPP government must focus on policies that address rural economic development, ensure better income distribution, and enhance social welfare systems. Programmes to improve agricultural productivity, provide subsidies for small businesses, and increase state investment in public services, like healthcare and education, will be key to bridging the socioeconomic gap. Additionally, addressing structural inequalities and creating more inclusive economic growth models will be necessary to ensure that the benefits of development are shared across the country, particularly in these southern districts that supported the NPP so strongly. In short, the NPP’s support base in the south reflects deep dissatisfaction with the status quo, and delivering on their expectations will require focused, equitable development strategies to tackle the economic and social challenges that have hindered growth in these communities.
Finally, in addition to the policies they propose for the country’s development, the NPP should consider adopting practical policies proposed by their Opposition, particularly the SJB.
An essential suggestion from the SJB involves introducing a system of digital economy, including providing a digital wallet for each individual. This system would allow citizens to manage their daily transactions and major purchases in a streamlined, secure digital format. Implementing such a policy could have far-reaching benefits for the new NPP government. Firstly, a digital economy with an integrated wallet system could increase government revenue by formalizing many aspects of the informal economy. It would enable a more efficient tax collection system, helping to reduce the gap between government expenditure and income. Moving towards a direct income tax system where financial transactions are monitored and taxed appropriately, this policy could generate significant revenue quickly. This would provide the necessary funds to meet the current fiscal challenges as the state grapples with a high expenditure-income gap that demands urgent solutions.
Moreover, the digital wallet could ease day-to-day financial transactions for citizens, fostering greater economic inclusivity, particularly among marginalized or underbanked communities. Creating more transparency and encouraging savings through digital means lay the foundation for a more modernized financial infrastructure.
As the NPP forms its new government, many are eager to see whether it will adopt such forward-thinking policies. Another key concern is how the NPP, with only three members in Parliament, will approach governance. There is speculation that the NPP might quickly dissolve Parliament and call for general elections. In such a scenario, the party could potentially gain enough seats to form a majority government. However, navigating the parliamentary process and creating a robust governance structure will be critical to maintaining the public’s trust and ensuring that policies like the digital economy are implemented effectively. I personally congratulate Anura Kumara Dissanayake, the new President of the Democratic Socialist Republic of Sri Lanka.
Features
Who Owns the Clock? The Quiet Politics of Time in Sri Lanka
(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.)
Features
Medicinal drugs for Sri Lanka:The science of safety beyond rhetoric
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
Features
Rebuilding Sri Lanka Through Inclusive Governance
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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