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Expect newer variants with rapid spread of COVID-19 in many parts of South Asia, medical experts say



Army personnel visiting a Colombo suburb to vaccinate those unable to visit vaccination centres (pic by Nishan S Priyantha)

The uncontrolled spread of COVID-19 in many parts of South Asia implies that newer variants will continue to emerge, a research paper titled ‘Stronger together: a new pandemic agenda for South Asia’ by top South Asian medical experts state.

Among the medical experts is Prof. Neelika Malavige of the Department of Immunology and Molecular Medicine, University of Sri Jayewardenepura.

The paper said that it is estimated that by 1 September 2021, approximately 1.4 million in South Asians will die due to COVID-19 alone. They also said the total number of excess deaths will be much higher—including non-COVID causes, as health systems are on the brink of collapse. With 33.4% of South Asians being extremely poor and the large-scale loss of livelihood being reported, the region faces a potentially catastrophic future for the ongoing decade.

“However, countries in South Asia continue to remain divisive. This differs from other geographic ‘blocs’ that frequently cooperate on mutual interest issues. Tensions in South Asia are shaped by complex domestic, bilateral, intra-regional and international geopolitical factors, despite the region’s obvious geographic, economic and cultural interdependence,” they claim.

A key lesson from the current pandemic is that countries need to share lessons and actively coordinate, complement, and supplement each other’s public health responses, especially between neighbours. The experts then presented a pragmatic ‘Stronger Together’ agenda on critical areas of concern for political, social, medical, and public health leaders in South Asia to consider and build on.

Given below the suggested action plan

“Cross-national surveillance for the
SARS-CoV-2 variants

“The uncontrolled spread of COVID-19 in many parts of South Asia implies that newer variants will continue to emerge. Some variants will inherently display increased transmissibility, infectivity and vaccine/antigenic escape capability, making it difficult for us to track and intelligently act on them. Rapidly scaling up capacity for genomics and rolling out countrywide surveillance systems require increased time and resources. Regional collaborative efforts within existing facilities and building a regional network similar to the Indian SARS-CoV-2 Genome Sequencing Consortia are feasible. The network can also build capacity within each country in the long run making countries self-sufficient to collect data and strengthen regional surveillance. Linking genomic data with clinical and public health data as well as enabling environmental surveillance will provide a more comprehensive picture of circulating SARS-CoV-2 variants. This is an investment, not only for the ongoing pandemic but also for other endemic pathogens and emerging infectious diseases.

“Interconnected and resilient health systems

“Health system capacity and human resources for health remain a major regional challenge. Healthcare worker density in the region is well below the suggested threshold of 44.5 healthcare workers per 10 000 population to achieve universal health coverage. National averages hide the disparities that exist across various geographic, demographic and socioeconomic population groups. The possibility of interconnected and collaborative health systems holds enormous potential, specifically for border areas. Setting up mechanisms for cross-border patient management (relaxed barriers or visa requirements on sharing medical documentation) and regional medical missions is essential from a humanitarian standpoint. Facilitating cross-border teleconsultation by designing more flexible mutually agreed upon regulations will also further boost capacity. At the minimum, peer support groups and tele-mentoring should be put into place. For this, mutual recognition of medical licenses and healthcare qualifications is essential. While close collaborations will be needed for the pandemic response, forming functional mechanisms of public health networking between countries under a long-term regional strategy will be required for developing a shared resilience and preparedness plan.

“Addressing COVID-19 supplies shortage

“There is a dependency on aid from the diaspora and from bilateral, multinational and humanitarian aid agencies to secure COVID-19 supplies during the current surge. This is neither sustainable, nor secure, nor without consequences. South Asian countries need to jointly invest in the augmentation of dedicated production capacities of essential medicines and other supplies. Much has been said about India’s tremendous capacity as the ‘pharmacy of the world’, not recognising manufacturing capacity in Bangladesh, Sri Lanka, Pakistan, Nepal and other countries in the region. Nationalistic policies and hoarding of active pharmaceutical ingredients by high-income countries (HICs) impede access and scale-up. However, such power imbalances can be mitigated to an extent if South Asia acts as a ‘bloc’. Production augmentation alone would not be sufficient—there is a need to agree on shared technology ownership/transfer and an equity-based regional distribution model based on priority groups defined based on assessment of risks and vulnerability.

“COVID-19 vaccines specifically remain a crucial challenge for South Asia. In the short term, South Asian countries must act as a bloc to request excess vaccines from HICs, using a collective needs assessment and a diplomatic approach. In the long term, there is a need to re-invent global health mechanisms such as COVID-19 Vaccines Global Access (COVAX). Equity—the defining purpose of COVAX—has been subverted by HICs who had brought vaccines directly from manufacturers and built stockpiles. The South Asian bloc, together with others, needs to shift COVAX from a neo-colonial purchase-donate model to a model with regional manufacturing hubs. Access to vaccines or essential medicines, a vital component of the right to health, should not be dependent on charitable inclinations, economic or political interests of HICs, or private corporations—a regional effort is required to change the status quo.

“Cooperation between scientific, professional organisations and associations

“Clinical providers (e.g., doctors, nurses), scientists and public health professionals in South Asia must recognise that there is much context-specific knowledge to be learnt from one another and that collaboration is valuable. Shared challenges include low value, irrational clinical care, unregulated home-grown medical solutions and medical misinformation. Many South Asian countries do not develop their own clinical practice guidelines or the ones that are developed are not of high-quality. There is an urgent need for medical associations to collaboratively develop contextually relevant clinical practice guidelines at par with global standards. Advocacy for more significant investments in health and health workers is needed. The social conscience needs to realise that pathogens do not understand nationalism, populism or respect borders. There is also an urgent need to fight against irrationality and anti-science in the region. Drawing on the diverse experiences of countries regarding public health responses, vaccine roll-out, diagnosis and treatment capacity would be highly advantageous in designing effective pandemic responses both immediately and for the long term.

“The way forward

“Focusing on a ‘Stronger Together’ future is a necessary step for tackling health security challenges beyond COVID-19, such as the climate crisis. The longer COVID-19 stays uncontrolled, even in a single country in South Asia, all other countries will be in immediate danger from novel variants and other social, economic and political consequences. Beyond the immediate benefits of addressing the pandemic, a collective regional approach, with global knowledge-exchange collaborations, will be vital for re-imagining the global health structure with equity at its centre.”

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President instructs officials to vaccinate kids with Pfizer



Health Ministry still deliberating pros and cons

President Gotabaya Rajapaksa had instructed health officers to inoculate children between the age 15 to 19 with Pfizer vaccine, Army Commander General Shavendra Silva said yesterday.

General Silva added that the President had also instructed officials to inoculate children with special needs above the age of 12, with the Pfizer vaccines. He there are around 50,000 children with special needs.

General Silva said Sri Lanka would receive adequate Pfizer vaccine doses in the coming weeks. During the Presidential Task Force meeting, on Covid-19, it was decided to allow the Department of Motor Traffic, and the Land Registry to operate during the lockdown, which was extended until 01 October. However, a few hours before this statement was made, Deputy Director General of Health Services, Dr. Hemantha Herath told the media that no decision had been taken on vaccinating children.

He, however, said that discussions were ongoing about vaccinating children.

“There are a number of discussions on this because this is a serious matter. We have also decided that when we vaccinate the priority will be given to children with comorbidities. Then the rest will be vaccinated based on age groups. But we have not decided on anything else,” he said.

The dates, the brand and other details would be announced once the Health Ministry was done with consultations with experts. Once the decisions were taken the Ministry would prepare guidelines which would then be made available to the public, he said.

“So, I urge the parents not to worry or panic. They can vaccinate their children once we issue guidelines. We will ensure that this will be done safely and with virtually no side-effects or shortages,” Dr. Herath said.

The Deputy Director General of Health Services also urged people not to be misled by claims that those who had been double jabbed and being treated at home were dying in increasing numbers. Some people with serious underlying issues could die even if they were double jabbed, he said.

“However, as we vaccinate an increasing number of Sri Lankans, the deaths and those who need ICU treatment will decline rapidly. Don’t be fooled by various unscientific claims. We are a nation that has universal vaccine rates and we should maintain that tradition with COVID,” he said.

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Sumanthiran demands immediate due process against Lohan



Immediate legal action including arrest and prosecution must be taken against Lohan Ratwatte and others who were involved in the incidents at Welikada and Anuradhapura Prisons, TNA Parliamentarian M.A. Sumanthiran said on Thursday. He said Ratwatte’s mere resignation from one portfolio would not do.

“The Presidential Secretariat has issued a statement that Lohan Ratwatte has taken responsibility for the incidents that transpired at Welikada and Anuradhapura Prisons. Although Ratwatte is said to have resigned from his post as Minister for Prison Management and Prisoners’ Rehabilitation, he continues to be a minister in charge of other subjects. This is not something we can accept,” he said.

The TNA MP said that the State Minister should be removed from all his positions immediately and the pistol he carried with him should be taken away from him.

“Otherwise, it’s a grave threat to the public at large,” Sumanthiran said. There had been other incidents where Ratwatte brandished his weapon in public spaces, he added.

The TNA MP said that an independent investigation should be held with regard to those incidents and Ratwatte and others involved in entering the Welikada and Anuradhapura Prisons should be arrested and charged.

“The police have still not taken any action in this regard. The question that must be posed is how he was able to carry his personal firearm inside the prison premises. Prison officials must answer these questions,” he said.

MP Sumanthiran said that given that the prisoners were wards of the state, their security was in the hands of the state.

“Therefore, this is a very serious incident. Action must be taken accordingly,” he said.

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Taking contradictory stand on 2015 Geneva Resolution



‘Govt. seeking credit for accountability mechanisms set up by previous administration

UNHRC 48th sessions:

By Shamindra Ferdinando

Attorney-at-law Sudarshana Gunawardena has alleged that the government’s stand on accountability issues at the Geneva-based United Nations Human Rights Council is contradictory to its much publicised opposition to the Geneva Resolution 30/1 co-sponsored by the previous administration.

Sri Lanka co-sponsored 30/1, on Oct 1, 2015. The then Foreign Minister the late Mangala Samaraweera is on record as having said that the UNP-led government had President Maithripala Sirisena’s consent to go ahead with the co-sponsorship.

Former Prime Minister Ranil Wickremesinghe’s media spokesperson Gunawardena yesterday (17) pointed out that the government, at the ongoing 48th sessions of the UNHRC, has reiterated its commitment to key accountability mechanisms set up in terms of the Geneva Resolution.

Civil society activist Gunawardena, who also functioned as the Director General, Information Department during the previous administration said that the assurance given by Foreign Minister Prof. G.L. Peiris last Tuesday (14) should be examined against the backdrop of Sri Lanka’s withdrawal from 30/1 resolution.

Prof. Peiris’ predecessor, Dinesh Gunawardena announced Sri Lanka’s withdrawal at the Feb-March 2020 sessions.

The Sri Lanka Podujana Peramuna (SLPP) owed an explanation, Gunawardena stressed, urging the government to take the public into confidence. “Stop playing politics at the expense of our international relations,” Gunawardena said, underscoring the need for what he called a national consensus on the post-war reconciliation process.

Responding to another query, Gunawardena said that FM Prof. Peiris in his address to the Geneva sessions discussed the progress in what he described as a domestic process in respect of accountability issues. Reference was made to the Office on Missing Persons (OMP), the Office for Reparations (OR) and the Office for National Unity and Reconciliation (ONUR). However, the FM conveniently failed to acknowledge that the OMP, OR and ONUR had been established in keeping with the 2015 Geneva Resolution that covered broader understanding of transitional justice.

The SLPP, while taking credit for the ongoing transitional justice process, continued to publicly reject 30/1, the very basis of the solution, Gunawardena said. “In other words, the SLPP’s actions are very different from their pledges before the electorate in the run-up to presidential and parliamentary polls in 2019 and 2020, respectively.

Referring to the assurance given by Prof. Peiris at the UNHRC that Sri Lanka Human Rights Council was carrying on its mandate, Gunawardena challenged the government to prove its sincerity by allowing no holds barred investigation into SLPP lawmaker Lohan Ratwatte’s raids on Welikada and Anuradhapura prisons on Sept 6 and 12, respectively.

The announcement made by the HRCSL regarding its decision to initiate an inquiry of its own in the absence of police investigation received public attention and appreciation, Gunawardena said.

Commenting on the declaration that Sri Lanka was engaged in an integrated process to bring the Prevention of Terrorism Act (PTA) in line with international norms and best practices, lawyer Gunawardena urged the government to study the work done by the previous government in that regard. Referring to statements made by then Prime Minister Ranil Wickremesinghe in that regard, Gunawardena said that the then Joint

Opposition quite maliciously rejected the move. “They should be ashamed of theirconduct,” relevant ministers and the Attorney General Department couldn’t be unaware of the agreement on new anti-terrorism law.

Gunawardena said that the SLPP administration shouldn’t hesitate to appreciate the previous government’s achievements. “We are quite pleased that mechanisms accepted by the previous government continue to be in operation even though the progress seems slow. However, the SLPP cannot deprive the UNP-led administration of the credit it deserved,” lawyer Gunawardena said.

Gunawardena urged the government to examine the report of the Committee appointed by then Premier Wickremesinghe to develop what he called the policy and legal framework of the proposed Counter Terrorism Act of Sri Lanka. He said that a politically motivated campaign derailed that effort whereas the Opposition propagated the lie the yahapalana government intended to deprive Sri Lanka of anti-terrorism law.

Asked to comment on the revelation of the SLPP government having talks with a group of civil society activists to explore ways and means to strengthening the reconciliation process, Gunawardena said that a 13-page Foreign Ministry note dated Aug. 31, 2021 addressed to Colombo-based diplomatic missions acknowledged the pivotal role played by the civil society. Having always accused the civil society of being part of a Western strategy, the same lot exposed their duplicity by meeting a group of civil society activists.

Gunawardena was referring to President Gotabaya Rajapaksa and Ministers, Basil Rakapaksa, Prof. Peiris, Dinesh Gunawardena, Ali Sabry, PC, and Namal Rajapaksa having separate meetings with SLCC (Sri Lanka Collective for Consensus) in the run-up to the Geneva confab. SLCC comprises 16 individuals.

Gunawardena noted the Human Rights Commissioner Michelle Bachelet, too, in her hard-hitting Sept 13 statement on Sri Lanka referred to President Rajapaksa’s meeting with the SLCC.

Gunawardena said that in addition to the SLCC, another group styled itself as the Civil Society Platform (CSP) in a statement issued on Sept. 13 made its position clear on a range of accountability issues as well as stepped up pressure on the civil society. CSP consists of 30 organizations and 36 individuals.

Responding to declarations by FM Prof Peiris and Foreign Secretary Admiral Jayanath Colombage that external investigations wouldn’t be acceptable, lawyer Gunawardena said that instead of rejecting the investigation the government should furbish whatever information in its hands or had access to the new investigative mechanism. The government couldn’t ignore the fact that the UNHRC authorized the fresh investigative mechanism at the 46th session with an overwhelming majority with 22 countries voting for the resolution, 11 against and 14 missing the vote.

Gunawardena urged the government to take a realistic view as Sri Lanka didn’t have time and space to engage in silly maneuvers. The bottom line was that the March 2020 announcement that Sri Lanka withdrew from 30/1 was nothing but a farce, Gunawardena said.

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