Connect with us

Features

Ivermectin – A possible win-win situation

Published

on

BY Dr. Sumedha S. Amarasekara

Ivermectin is a drug that has been increasingly occupying medical attention, following its possible role in the treatment and prevention of SARS-CoV-2 (Covid-19). A news item in the The Sunday Times of 05.09.2021 says, ‘Ivermectin divides doctors while NMRA gives waiver to import drug to stop black market sales’.

Ivermectin:

Ivermectin was discovered in 1975 and had come into medical use by 1981. It is an antiparasitic drug that has antiviral and anti-inflammatory properties. It is a well-known drug, approved as an antiparasitic agent by both the FDA (U.S. Food and Drug Administration) and the WHO (World Health Organization). It is on the list of the WHO’s Essential medicines. It is considered to be extremely safe in the recommended dose (0.2 to 0.4 mg/kg). Over the last 20 to 30 years the medical/scientific community has begun to investigate /appreciate its antiviral and anti-inflammatory properties (Kircik LH, Del Rosso JQ, Layton AM, Schauber J. Over 25 Years of Clinical Experience with Ivermectin: An Overview of Safety for an Increasing Number of Indications. J Drugs Dermatol. 2016 Mar;15(3):325-32. PMID: 26954318)

Ivermectin is also an extremely cheap drug. A 12mg tablet –the normal recommended dose for a 60 kg adult- is around US $ 0.03 -3 cents. The manufacturing cost is estimated at US $ 168 for 1 kilogram. Therefore, as one can work out, to manufacture 12 mg will cost: 168 divided by 1,000,000 and multiplied by 12 = US $ 0.002. Hence the bulk of the cost of the drug is in fact in converting the drug into tablets, packaging and distribution!

Evidence of the use of Ivermectin :

There is an increasing number of news items and journal publications showing the efficacy of Ivermectin’s role in reducing the mortality of Covid-19 and reducing the spread (prophylaxis) of Covid-19 among the population. A case-control study done at the All India Institute of Medical Sciences concluded that two-doses of Ivermectin prophylaxis at a dose of 300μg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 (Covid-19) infection among health care workers for the following month (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886121/). A meta-analysis published in June this year shows a probable reduction of mortality (i.e. deaths) by 62%, when Ivermectin was used as a therapeutic agent and a possible reduction of spread by 86% when Ivermectin was used as a prophylactic agent(American Journal of Therapeutics 28, e434–e460 (2021).

In fact the control of Coivd-19 in the Northern states of India and across a number of other countries has been attributed to the use of Ivermectin. An increasing number of countries has stated that they are adding Ivermectin on to their arsenal in combating Covid-19 (https://www.youtube.com/c/WhiteboardDoctor/playlists- Ivermectin and Covid-19).

However, the NIH (National Institute of Health) maintains that there isn’t sufficient data to recommend Ivermectin for or against, in the treatment of Covid-19, which is the same stance that has been taken up by the National Medicines Regulatory Authority (NMRA) of this country as well. The WHO’s stand is still that, Ivermectin should not be used outside a clinical trial.

Conducting clinical trials:

To understand this apparent discrepancy between the results of the clinical trials and the stance of the NIH, WHO, etc., requires an insight into the interpretation of clinical trials. In today’s world conducting and interpreting clinical trials is almost a separate discipline on its own and is well beyond the scope of this article (and mine as well!).

However, an understanding of clinical trials and their interpretation is necessary to understand the clinical trials themselves and the decision-making process of these authorities. There is a variety of trials that could be done. The basis of all these trials is that one group of patients is given Ivermectin and the other group is not given Ivermectin. Following the trial, by comparing the mortality rates and spread of Covid-19 (the results) between the two groups, scientists would be able to say what effect Ivermectin has on the mortality and spread of Coivid-19. For the results to be valid, apart from the Ivermectin, everything else between these two groups needs to be the ‘same’, such as the male to female ratio of patients, other illnesses they have, other medication they take, smoking habits, alcohol consumption, etc. As one can see it is not easy to get two comparable groups. Thereafter, if one is treating for Covid -19, both groups need to have the same degree of sickness i.e. the average number of mild to moderate to severe cases should match up. If one is checking for prevention (prophylaxis) then their exposure to ‘known Covid-19 cases’ and ‘potential cases’ needs to match up as well. For example starting from, do they wear one or two masks, what type of masks, do they wear a face shield, do they maintain social distancing; all the time or some of the times, have they been exposed to any known Covid-19 patients, have they attended any weddings, funerals, parties, ‘get togethers’, do they live in apartments or individual houses, do they travel to work using public transport, do they shop on line or in person, etc… etc… As one can see this is even more complex than trying to match groups for treatment. This is what leads to the term Controlled. Thereafter, scientists need to make sure that every patient has an equal chance of either receiving the Ivermectin or not. In other words, there is no bias in who receives and who does not receive the drug. Because inadvertently one might be influenced by whom one gives the drug to i.e. the drug may be given to someone considered sick who needs the drug and not given to one with a milder disease. This process of randomly allocating the treatment leads to the term Randomised. From a patient’s point of view, they may feel psychologically let down by not having received the drug or psychologically boosted by receiving the drug. This can affect their response to the treatment. The doctors monitoring the patient can be influenced as well, if they know whether a patient is taking the drug or not. To eliminate this phenomenon everybody receives ‘the drug’- either the drug or the placebo –originating from the Latin phrase ‘I shall please’. Therefore only those who actually run the trial know, who gets what. So the person/s who gives the ‘drug’ and monitors the patients do not know what they are giving and neither do the patients know what they are receiving which is called a double blind. If all these elements are combined then we arrive at a randomised, double blind, controlled study which is considered as the golden standard.

Interpretation of clinical trials:

So the trial is done and the results are out. Now a complex issue remains as to how certain the scientists are that these results are due to Ivermectin and not due to a natural variation of events. To illustrate this we can look at a hypothetical situation of 10,000 Covid -19 patients that have an overall mortality of 2% i.e. 200 deaths. If we were to divide these patients into lots of 1000, it is extremely unlikely that these deaths would be distributed equally for every lot of 1000 patients. Some lots would have had more deaths, other lots would have had less, averaging out at 20 per group of 1000 i.e. 2%. Now let us assume that the two groups of patients selected of a 1000 each for the study, were to have 10 deaths in one group and 30 deaths in the other –averaging out at 2%. The critical issue to grasp is that, which group is which is not known. Assume Ivermectin was given to the group that was to have 30 deaths and as a result of Ivermectin the death rate was halved and ended up being 15 –a 50% reduction- this is 50% (5) more than that of the control group, so it could be erroneously concluded that Ivermectin does not work, when it actually does work. On the other hand Ivermectin may not actually work, but in this instance it was given to the group that was to have 10 deaths, so erroneously the conclusion is that Ivermectin does work, when in fact it doesn’t. If things were not as complex as it were, it is worthwhile to remember that this natural variation exists for all of the characteristics mentioned above between the two groups as well. This needs to be taken in to account.

So when scientists interpret data, these variations are taken into consideration and there are three main aspects that they consider. The first is the power of the study. That basically means, are there sufficient numbers of patients in the study for the scientists to be able to pick up a true difference that goes beyond the natural variation. The hypothetical study shown above, has very little power; as one could see that the results could not be interpreted due to the natural variation. Next is significance. That is a measure of allowing for chance to be involved in the result. For most studies the significance level, known commonly as a P value is set below 0.05 (P< 0.05). In this context it would mean that, there is less than a 5% chance that the decrease in mortality is, not due to Ivermectin i.e. the chance of Ivermectin causing the decrease in mortality is more than 95%. Thirdly, there is the concept of ‘a confidence interval’. Broadly speaking the narrower the confidence interval the more valid the results are.

Clinical interpretation and Ivermectin:

It is a deficiency of some of the above factors in the clinical trials so far conducted and their subsequent interpretation that have resulted in this stance of the various authorities. Therefore the vital aspect to understand in going forward is that the issue is not primarily to do with the results from all these trials (and other evidence) that have been conducted across the world; that have shown that Ivermectin does work. But, it is to do with the validity of these results. Therefore the view put forward by those who are guarded in their recommendation in the use of Ivermectin, is that the validity (certainty) of these trials is not strong enough for the use of Ivermectin to be recommended. Which of course is not the same as saying that Ivermectin does not work.

This view needs to be counterbalanced by the following facts. Firstly, there have been no significant adverse effects reported in any of the trials conducted using Ivermectin. Secondly, there is only an extremely limited number of drugs that have been recommended in the treatment of Covid-19 and none of these is ‘curative’ in the strictest sense of the word. Thirdly, though vaccination makes a significant difference to the outcome if one were to get Covid-19, it has not been as successful in preventing its spread.

Available options:

The WHO apart from the vaccines, has only recommended a few drugs to be used in the treatment of Covid-19. Remdesivir is one such drug. This is however, only to be used in the treatment of Covid-19 patients, essentially in a hospital environment. A vial of this drug costs over US $ 500. Not exactly a practical solution for us! Besides there are no clinical trials scheduled by the major pharmaceutical companies comparing Remdesivir (US $ 500) with Ivermectin (US $0.03) to be seen in the near horizon. Countries that have already used Ivermectin and are satisfied with its outcomes are not going to be conducting trials to assess a drug that they already find works.

One option is to evaluate all the existing evidence and start using Ivermectin. Prof. Saroj Jayasinghe (Faculty of Medicine, University of Colombo) a highly respected clinician has already written to the Ministry of Health recommending that Ivermectin should be used in the treatment of Covid-19.

However, to take a national stance on a drug not approved by the WHO could be considered ‘irresponsible’ and may jeopardise our future with regard to health and safety issues on an international forum.

Therefore, another option would be to follow the guidelines of the WHO and conduct a clinical trial. The issue that would now cross one’s mind is given in this discussion; conducting a trial that would give valid results would be an extremely complex and arduous undertaking. How does one organise these matching groups etc..?

The solution:

An islandwide clinical trial with the use of Ivermectin.

With regard to an islandwide clinical trial, the numbers will be huge running into millions. This leads to an enormous power and thereby an incredible validity of the study. It also ironically means that the amount of extra data that one needs to record, to make sure that one has matching groups, etc., becomes minimal as well. As a point of illustration, if we were to have a randomised clinical trial–blind or not-across the 14,022 Grama Niladhari Wasams involving around 22 million adults and children, where half are given Ivermectin; the outcome would be dependent on the use of Ivermectin, as the chance of another confounding factor or natural variation affecting one group-of roughly 11 million- and not the other would be almost nonexistent!

Let us not forget that we are probably one of the few countries in the world where countrywide elections are held and the results are given within a day or so.

The WHO will/should give its blessing and if need be, provide help with the necessary expertise (and resources?) to conduct this trial.

This is essentially a win, win

and win situation

An acceptable clinical trial is required to provide the definitive answers-what the WHO, the NIH and our NMRA need. The medical sector would be happy to get the findings they require with a ‘controlled opening of the country’. The country needs to be opened in some manner to assess the prophylactic role of Ivermectin and the ‘government’ would find it feasible and more than willing to do so for economic reasons. The people would be happy to get ‘a drug that would/could work’ and more importantly an easily affordable one in their hour of need.

The advantage of an island wide clinical trial:

There are a number of important points that are extremely favourable in terms of conducting an islandwide clinical trial with Ivermectin.

1. Ivermectin is an extremely safe drug at the prescribed doses. It can be given to children as well, leading to a comprehensive island\wide clinical trial. This is particularly important as we still do not have a proper handle on vaccination when it comes to children.

Given that Ivermectin is already used as an antiparasitic agent and given to children, it can be used separately in an islandwide clinical trial to re-open the schools.

2. Ivermectin is an extremely cheap drug. This is most relevant to us in our current economic predicament. The cost of treating an adult with Covid-19 and /or using Ivermectin as a prophylactic drug (the loading dose and the required tablets for three months) on average will be less than Rs. 500 per person. As the dose is based on body weight, the cost will be less for children.

3. When used as a prophylactic drug, it has an extremely simple dosing schedule – a loading dose administered a couple of days apart then a maintenance dose once a week or at a prescribed interval.

4. The existing trials show a considerable impact from this drug. Based on the existing trials, if Ivermectin were to work, we should be expecting at least a 50% reduction of mortality and at least the same reduction in the spread of the disease, or there about. Therefore the effects of using this drug would be extremely easy to monitor.

5. A very important point, the prevention (i.e. prophylactic) aspect of Ivermectin, starts once the drug has got absorbed into the system – pretty much immediately. When one considers the vaccine, the first dose needs to be given, then a period of at least four weeks has to pass for the body to generate a sufficient immune response for the second dose to be given. Thereafter, a further two to three weeks need to elapse before one is considered to be immune i. e. close upon almost two months. With Ivermectin, if one takes the tablet at night, by morning one is ‘good to go’.

6. Finally, another significant and interesting aspect is that we would be able to evaluate the relative efficacy and interactions between Ivermectin and our vaccines. How does Ivermectin impact on those who have completed both vaccine doses or only had one or have not been vaccinated at all? Looking to the future, how does Ivermectin-given that it has therapeutic as well as prophylactic properties- compare with Vaccination?

The country still faces a dilemma of opening the country vs having an uncontrolled spread of Covid-19. The reality is that we will need to ‘reopen the country’. This is the best time while the country is in a lock down to organise an islandwide clinical trial. Plan what type of trial/trials we want to execute, formulate the primary and secondary questions that need to be answered, identify the significant sub groups, determine what monitoring processes are required, etc. Make necessary plans to reopen the country systematically with an islandwide clinical trial in place.

Hopefully, we shall see the light at the end of the tunnel.



Features

Sri Lanka’s Foreign Policy amid Geopolitical Transformations: 1990-2024 – Part I

Published

on

President Reagan and Mikhail Gorbachev after signing the Intermediate Range Nuclear Forces Treaty in 1987, signalling the end of the Cold War

Sri Lanka’s survival and independence have historically depended on accurately identifying foreign policy priorities, selecting viable strategies as a small island state, and advancing them with prudence. This requires an objective assessment of the shifting geopolitical landscape through a distinctly Sri Lankan strategic lens. Consequently, foreign policy has been central to Sri Lanka’s statecraft, warranted by its pivotal location in the Indian Ocean—adjacent to South Asia yet separated by a narrow stretch of water.

Amid pivotal geopolitical transformations in motion across South Asia, in the Indian Ocean, and beyond, the formulation and implementation of Sri Lanka’s foreign policy has never been more critical to its national security. Despite the pressing need for a cohesive policy framework, Sri Lanka’s foreign policy, over the past few decades, has struggled to effectively respond to the challenges posed by shifting geopolitical dynamics. This article examines the evolution of Sri Lanka’s foreign policy and its inconsistencies amid shifting geopolitical dynamics since the end of the Cold War.

First

, the article examines geopolitical shifts in three key spaces—South Asia, the Indian Ocean, and the global arena—since the end of the Cold War, from Sri Lanka’s strategic perspective. Building on this, second, it analyses Sri Lanka’s foreign policy responses, emphasising its role as a key instrument of statecraft. Third, it explores the link between Sri Lanka’s foreign policy dilemmas during this period and the ongoing crisis of the post-colonial state. Finally, the article concludes that while geopolitical constraints persist, Sri Lanka’s ability to adopt a more proactive foreign policy depends on internal political and economic reforms that strengthen democracy and inclusivity.

Shifting South Asian Strategic Dynamics

Geopolitical concerns in South Asia—Sri Lanka’s immediate sphere—take precedence, as the country is inherently tied to the Indo-centric South Asian socio-cultural milieu. Sri Lanka’s foreign policy has long faced challenges in navigating its relationship with India, conditioned by a perceived disparity in power capabilities between the two countries. This dynamic has made the ‘India factor’ a persistent consideration in Sri Lanka’s strategic thinking. As Ivor Jennings observed in 1951, ‘India thus appears as a friendly but potentially dangerous neighbour, to whom one must be polite but a little distant’ (Jennings, 1951, 113).The importance of managing the ‘India Factor’ in Sri Lankan foreign policy has grown further with India’s advancements in military strength, economic development, and the knowledge industry, positioning it as a rising global great power on Sri Lanka’s doorstep.

India’s Strategic Rise

Over the past three decades, South Asia’s geopolitical landscape has undergone a profound transformation, driven by India’s strategic rise as a global great power. Barry Buzan (2002:2) foresees this shift within the South Asian regional system as a transition from asymmetric bipolarity to India-centric unipolarity. India’s continuous military advancements have elevated it to the fourth position in the Global Firepower (GFP) index, highlighting its formidable conventional war-making capabilities across land, sea, and air (Global Firepower, 2024). It currently lays claims to being the world’s third-largest military, the fourth-largest Air Force, and the fifth-largest Navy.

India consistently ranks among the fastest-growing major economies, often surpassing the global average. According to Forbes India, India is projected to be the world’s fifth-largest economy in 2025, with a real GDP growth rate of 6.5% (Forbes, January 10, 2025). India’s strategic ascendance is increasingly driven by its advancements in the knowledge industry. The country is actively embracing the Fourth Industrial Revolution (4IR) and emerging as the Digital Public Infrastructure (DPI) hub of South Asia. However, India’s rise has a paradoxical impact on its neighbours. On one hand, it offers them an opportunity to integrate into a rapidly expanding economic engine. On the other, it heightens concerns over India’s dominance, leaving them feeling increasingly overshadowed by the regional giant.

Despite significant geo-strategic transformations, the longstanding antagonism and strategic rivalry between India and Pakistan have persisted into the new millennium, continuing to shape South Asia’s security landscape. Born in 1947 amid mutual hostility, the two countries remained locked in a multi-dimensional conflict encompassing territorial disputes, power equilibrium, threat perceptions, accusations of interference in each other’s domestic affairs, and divergent foreign policy approaches. The acquisition of nuclear weapons by both countries in 1998 added a new dimension to their rivalry.

The SAARC process has been a notable casualty of the enduring Indo-Pakistani rivalry. Since India’s boycott of the Islamabad Summit in response to the 2016 Uri attack in Kashmir, the SAARC process has remained in limbo. Countries like Sri Lanka, which seek to maintain equally amicable relations with both India and Pakistan, often find themselves in awkward positions due to the ongoing rivalry between them. One of the key challenges for Sri Lanka’s foreign policy is maintaining strong relations with Pakistan while ensuring its ties with India remain unaffected. India now actively promotes regional cooperation bodies in South Asia, excluding Pakistan, favouring broader frameworks such as BIMSTEC. While Sri Lanka can benefit greatly from engaging with these regional initiatives, it must carefully navigate its involvement to avoid inadvertently aligning with India’s efforts to contain Pakistan. Maintaining this balance will require sharp diplomatic acumen.

India’s expansive naval strategy, especially its development of onshore naval infrastructure, has positioned Sri Lanka within its maritime sphere of influence. As part of the Maritime Infrastructure Perspective Plan (MIPP) launched in 2015 to enhance operational readiness and surveillance capabilities, India is developing an alternative nuclear submarine base for the Eastern Command under Project Varsha (Deccan Chronicle, 22.11.2016). This base is located in Rambilli village, 50 km southwest of Visakhapatnam and 1,200 km from Colombo (Chang, 2024). Additionally, INS Dega, the naval air base at Visakhapatnam, is being expanded to accommodate Vikrant’s MiG-29K and Tejas fighter aircraft.

Another key strategic development in India’s ascent that warrants serious attention in Sri Lanka’s foreign policy formulation is India’s progress in missile delivery systems (ICBMs and SLBMs) and nuclear-powered submarines. In 1998, India made it clear that its future nuclear deterrence would be based on a nuclear triad consisting of land-based Intercontinental Ballistic Missiles (ICBMs), submarine-launched ballistic missiles (SLBMs), and strategic bombers (Rehman, 2015). Since then, India has steadily advanced in this direction. The expansion of India’s missile delivery systems, including ICBMs and SLBMs, serves as a reminder that Sri Lanka exists under the strategic shadow of a major global power.

The development of India’s nuclear-powered ballistic missile submarines (SSBNs) accelerated after 2016. The first in this class, INS Arihant (S2), was commissioned in August 2016, followed by the launch of INS Arighat in November 2021. Designed for strategic deterrence, INS Arighat is equipped to carry the Sagarika K-4 submarine-launched ballistic missiles (SLBMs), with a range of 3,500 kilometers, as well as the K-5, a long-range SLBM capable of reaching 5,000 kilometers. The submarine is based at INS Varsha (Deb, 2021).

India has significantly advanced its missile delivery systems, improving both their range and precision. In 2021, it successfully tested the Agni-5, a nuclear-capable intercontinental ballistic missile with a range of 5,000 kilometers. On March 11, 2024, India joined the ranks of global powers possessing Multiple Independently Targetable Re-entry Vehicle (MIRV) technology (The Hindu, January 4, 2022). These advancements elevate the Bay of Bengal as a pivotal arena in the naval competition between India and China, carrying profound political and strategic implications for Sri Lanka, which seeks to maintain equally friendly relations with both countries.

Further, India’s remarkable strides in space research have cemented its status as a global power. A defining moment in this journey was the historic lunar landing on 23 August 2023, when Chandrayaan-3 successfully deployed two robotic marvels: the Vikram lander and its companion rover, Pragyan. They made a graceful touchdown in the Moon’s southern polar region, making India the fourth nation to achieve a successful lunar landing. This milestone has further reinforced India’s position as an emerging great power, enhancing its credentials to assert itself more confidently in South Asian, Indian Ocean, and global power dynamics.

India envisions a stable and secure South Asia as essential to its emergence as a great power in the Indian Ocean and global strategic arenas. However, it does not consider Pakistan to be a part of this stability that it seeks. Accordingly, when India launched the ‘Neighbourhood First Policy’ in 2008 to strengthen regional ties, Pakistan was excluded. India’s ‘Neighbourhood First Policy’ gained renewed momentum after 2015 under Prime Minister Narendra Modi. His approach to South Asia is embedded in a broader narrative emphasising the deep-rooted cultural, economic, and social exchanges between India and other South Asian countries over centuries. India’s promotion of heritage tourism, particularly the ‘Ramayana Trail’ in Sri Lanka, should be viewed through this strategic lens as part of its broader strategic narrative.

Evolving Indian Ocean Geo-political Dynamics

The Indian Ocean constitutes the next geopolitical frame for Sri Lanka’s foreign policy. The Indian Ocean is a huge bay bordered by the Afro-Asian landmass and Australia on three sides and the South Asian peninsula extends into the Indian Ocean basin centrally. Situated at the southern tip of South Asia, Sri Lanka extends strategically into the heart of the Indian Ocean, shaping its geopolitical significance and strategic imperatives for maintaining sovereignty. Historically, Sri Lanka has often been caught in the power struggles of extra-regional actors in the Indian Ocean, repeatedly at the expense of its independence.

Sri Lanka’s leadership at the time of independence was acutely aware of the strategic significance of the Indian Ocean for the nation’s survival. The first Prime Minister D.S. Senanayake, who was also the Minister of Defence and External Affair, stated in Parliament that: “We are in a dangerous position, because we are on one of the strategic highways of the world. The country that captures Ceylon would dominate the Indian Ocean. Nor is it only a question of protecting ourselves against invasion and air attack. If we have no imports for three months, we would starve, and we have therefore to protect our sea and air communications” (Hansard’s Parliamentary Debates, House of Representative. Vol. I, 1 December 1947, c. 444)

As naval competition between superpowers during the Cold War extended to the Indian Ocean, following the British naval withdrawal in the late 1960s, Sri Lanka, under Prime Minister Sirimavo Bandaranaike, played a key diplomatic role in keeping the region free from extra-regional naval rivalry by mobilising the countries that were members of the Non-Aligned Movement (NAM). In 1971, Sri Lanka sponsored a proposal at the UN General Assembly to establish the Indian Ocean as a Peace Zone (IOPZ). While the initiative initially gained traction, it stalled at the committee stage and ultimately lost momentum.

The maritime security architecture of the Indian Ocean entered a new phase after the end of the Cold War. The United States became the single superpower in the Indian Ocean with an ocean-wide naval presence bolstered by the fully fledged Diego Garcia base. Correspondingly, the regional strategic linkages that evolved in the context of the Cold War were eventually dismantled, giving way to new strategic relationships. Additionally, three key developments with profound implications for Sri Lanka should be noted: India’s projection of political and naval power into the deeper Indian Ocean, China’s rapid economic and military rise in the region, and the entry of other extra-regional powers into Indian Ocean politics. Although Sri Lanka adopted a broader strategic perspective and a more proactive foreign policy in the 1970s, its approach to geopolitical developments in the Indian Ocean in the post-Cold War era became increasingly shaped by domestic challenges—particularly countering the LTTE threat and addressing post-war exigencies.

India’s Expanding Naval Diplomatic Role in the Indian Ocean

Parallel to its strategic rise, India has intensified its engagement in the broader strategic landscape of the Indian Ocean with renewed vigor. This expansion extends beyond its traditional focus on the South Asian strategic theatre, reflecting a more assertive and multidimensional approach to regional security, economic connectivity, and maritime diplomacy. India’s active participation in multilateral security frameworks, infrastructure investments in critical maritime hubs and strategic alignments with major global powers signify its role in the changing naval security architecture of the Indian Ocean. India’s shifting strategic posture in the Indian Ocean is reflected in the 2015 strategy document Ensuring Secure Seas: Indian Maritime Security Strategy. It broadens the definition of India’s maritime neighbors beyond those sharing maritime boundaries to include all nations within the Indian Ocean region (Ensuring Secure Seas, p. 23).

In 2015, Indian Prime Minister Narendra Modi launched his signature Indian Ocean diplomacy initiative, Security and Growth for All in the Region (SAGAR) to foster trust and transparency, uphold international maritime norms, respect mutual interests, resolve disputes peacefully, and enhance maritime cooperation. Strategic engagement with the littoral states in the Indian Ocean region, especially Sri Lanka, the Maldives, Seychelles, and Mauritius and Madagascar has emerged as a key component of India’s Indian Ocean naval diplomacy.

The Seychelles archipelago, located approximately 600 miles east of the Diego Garcia base, holds particular significance in India’s maritime strategy. During Prime Minister Narendra Modi’s official visit to Seychelles in March 2015, India and Seychelles signed four agreements. A key strategic outcome of the visit was Seychelles’ agreement to lease Assumption Island, one of its 115 islands, to India—a move that reinforced Seychelles’ alignment with India’s broader naval diplomacy in the Indian Ocean

Similarly, Mauritius holds a central position in India’s naval diplomacy in the Indian Ocean. During Prime Minister Modi’s visit to Mauritius in March 2015, India signed a Memorandum of Understanding with Mauritius to establish a new base on North Agalega Island, a 12-kilometer-long and 1.5-kilometer-wide Island. The base is crucial for air and surface maritime patrols in the southwest Indian Ocean. It will also serve as an intelligence outpost. In September 2016, defense and security cooperation between India and Mauritius deepened alongside the signing of the ‘Comprehensive Economic Cooperation Partnership Agreement’ (CECPA).

India’s expanding strategic interests across the Indian Ocean are reflected in its growing economic, educational, and defense collaborations with Madagascar. In 2007, India established its first overseas listening post in northern Madagascar to monitor shipping activities and intercept marine communications in the Indian Ocean. This initiative provided India with a naval foothold near South Africa and key sea-lanes in the southwestern Indian Ocean. The significance of India’s defense ties with Madagascar is further highlighted by Madagascar’s participation in China’s Belt and Road Initiative (BRI). As a crucial hub along the Maritime Silk Road connecting Africa, Madagascar’s strategic importance is underscored in the broader geopolitical landscape.

Another element of India’s expanding naval diplomacy in the Indian Ocean is its participation in both unilateral and multilateral anti-piracy operations. India’s commitment to regional security was reinforced in 2008 when it established a ‘Strategic Partnership’ with Oman, securing berthing and replenishment facilities for its navy, along with a strategically significant listening post in the Western Indian Ocean. India’s naval presence in the Arabian Gulf gains additional significance amid reports of a new Chinese naval base in Djibouti and recent submarine deployments. Successful anti-piracy missions in the western Indian Ocean underscore India’s growing influence in the region’s evolving naval security architecture.

India increasingly views its vast Diaspora as a soft power tool to bolster its status as an Indian Ocean power. In June 2014, it launched the Mausam project to reinforce its cultural ties across the region, showcasing its heritage, traditions, and contributions to global arts, literature, cinema, yoga, and cuisine. This initiative complements India’s expanding naval diplomacy and strategic presence in the Indian Ocean. Over the years, it has established listening facilities, airfields, and port infrastructure in key locations such as northern Madagascar, Agaléga Island (Mauritius), and Assumption Island (Seychelles). This has led India Today to ask: “Could this mark the emergence of an Indian ‘String of Flowers’ to counter China’s ‘String of Pearls’?” (The be continued)

by Gamini Keerawella

Continue Reading

Features

Greener Pastures, Mental Health and Deception in Marriage:

Published

on

Exploring Sunethra Rajakarunanayake’s Visachakayo

Sunethra Rajakarunanayake’s Sinhala novel Visachakayo (published in 2023) is a thriller in its own sense due to its daring exploration of social themes that modern Sinhala writers fail to touch. To me, the novel is a mosaic that explores pressing issues that middle-class Sri Lankans go through in the 21st Century. The narrative is seen from the perspective of Akshara, a Tamil girl whom the reader first meets in an infamous ‘Visa Queue’ to get her passport to go to England.

Akshara lives with her grandmother ‘Ammamma’ and her aunt ‘Periyamma’ (the younger sister of her mother). Both Ammamma and Periyamma look after her in the absence of her mother, Chinthamani who passed away a long time ago. Akshara’s father lives in Jaffna, with the kids of the second marriage. Later, we are told that Akshara’s father had to marry the second wife due to the loss of his wife’s first husband, who was an LTTE cadre. The second marriage of men seems to be a common theme in the novel due to their commitments to the family as an act of duty and honour.

The most iconic character in the novel is Preethiraj, ‘the man with a big heart’ who functions as a father figure to the other characters in the novel. It is through Preethiraj’s memory that the reader becomes aware of sociological themes in the novel: displacement and immigration, the institution of marriage and mental health issues. Preethiraj (fondly known as Preethi) is the son of Pushpawathi, the second wife of Akshara’s grandfather. Preethi goes to Royal College, but he has to relocate to Jaffna in 1958. Preethi endures social injustice in both public and private spheres. His studious sister, a medical student, labels him as a ‘lunatic’, while his mother condemns him as the ‘odd one’.

The novel intersects between the three themes: immigration and displacement, mental health issues and the institution of marriage. Almost all the characters have to go through displacement, suffer from intricacies of love laws and marriage rules like in The God of Small Things by Arundathi Roy. The writer offers a nuanced analysis of these three themes. For example, take mental health issues. The novel portrays a spectrum of mental health issues, such as schizophrenia, psychosis, Othello Syndrome, depression, autism and even malingering. At times, the representation of such ailments is extremely sarcastic:

“Hm… Canadian citizenship is an easy solution to secure those opportunities. However, unless I am asked to intervene, I will not meddle with their affairs. The son of one of my friends was introduced to a pretty girl. They liked her, not because of her money, but because of her looks and her ability to play the piano. But later, they discovered she has schizophrenia. Now their son follows whatever she says to save the marriage. My friend says she has lost her son” (p.20).

“Those opportunities” refer to material wealth including money and property in Colombo. Here, Rajakarunanayake does not fail to capture the extreme materialism and consumerism. However, in general, her representation of human follies is extremely humane.

   The title ‘Visachakayo’ is another interesting coinage that reflects the plight of Sri Lankans who migrate to the ‘global north’ in search of greener pastures. Akshara’s friend, Subhani, who has migrated to England, explains that the term ‘Visachaya’ captures the in-between status of immigrants who are waiting for PR in a foreign country. Subhani mockingly says that they are equal to beggars who beg for visas. Subhani’s coinage and other accounts of Sri Lankan immigrants in England, the novel shows how difficult it is for an immigrant from the ‘global south’ to fight for a living in a country like England where immigrants come to resolve their financial struggles back home.

The novel is an eye-opener in many ways. First, it is an attempt to bridge the gap caused by the Sinhala-Tamil ethnic strife. It is also a cultural mosaic that captures both the joys and sorrows of Sinhala, Tamil and Burgher families in Sri Lanka. The novel also delves into mental health issues, categorically tied to marriage, a daring task even for a seasoned writer. However, Rajakarunanayake’s writing style compels the reader to adopt a more humane and empathetic approach towards individuals grappling with mental health challenges at various stages of their lives. The linguistic technique of using ‘ne’ tag at the end of sentences creates a conversational tone, making the narrative as if it is a conversation between a therapist and a patient. Her writing style also resembles that of Sri Lankan and Indian diasporic writers, a style that is used when writing about the motherland in exile, of which food becomes a critical trope in the narrative that unites the characters who live in exile.

Rajakarunanayake has done a commendable job in the representation of social issues, making this novel a must-read for anyone who is interested in researching social dynamics of contemporary Sri Lanka. It soon needs to be translated into English which will offer a unique experience to Sri Lankan English and international readers. A good book is something that affects the reader. Visachakayo has this quality, and it makes the reader revisit the past, reflect on the present and anticipate the future with hope for humanity just as Preethi does regardless of hardships he endured in the theatre of life.

By C. M. Arsakulasuriya

Continue Reading

Features

A strategy for Mahaweli authority to meet future challenges amidst moves to close it down

Published

on

The potential available in lands under Mahaweli Project, which cover about one third of farming areas of the Dry Zone, could easily help the country become self-sufficient in healthy foods, provided it is managed properly. However, at present, the main focus of the Mahaweli Authority of Sri Lanka (MASL) is mainly on Operation & Maintenance of Canal network feeding the farms. Main purpose of the Mahaweli Restructuring & Rehabilitation Project (MRRP) funded by the World Bank in 2000 was to diversify that objective to cover enhancement of agriculture aspects also. System H Irrigation Systems covering about 20,000 Hectares commanded under Kalawewa Tank located in the Anuradhapura District was used as a pilot area to initiate this effort. However, only the Canal Rehabilitation component of the MRRP was attended because of the government policy at that time. Restructuring component is still awaiting to be completed. Only, a strategy called Water Quota was introduced under the MRRP to initiate the restructuring component. However, the management restructuring required addressing the agriculture component expected under MRRP is still not attended.

Propose Strategy

Total length of the canal network which needs seasonal maintenance is about 1,000 Km in a typical large-scale irrigation project such as Kalawewa. Main role of the Resident Project Managers (RPM) appointed to manage such projects should be to enhance the food production jointly with the Farmer Organizations. Therefore, the abbreviation used for RPM should be redefined as Resident Production Manager. The role of a Production Manager is not limited to maintenance of canal networks as adapted presently. In the current production phase, Irrigation projects should be perceived as a Food Producing “Factory” – where water is the main raw material. Farmers as the owners of the factory, play the role of the labour force of the factory. The Production Manager’s focus should be to maximize food production, deviating from Rice Only Mode, to cater the market needs earning profits for the farmers who are the owners of the “factory”. Canal systems within the project area which need regular maintenance are just “Belts” conveying raw materials (water) in a Typical Factory.

Required Management Shift

In order to implement the above management concept, there is a need for a paradigm shift in managing large scale irrigation projects. In the new approach, the main purpose of managing irrigation systems is to deliver water to the farm gate at the right time in the right quantity. It is a big challenge to operate a canal network about 1000 KM long feeding about 20,000 Hectare in a typical Irrigation System such as Kalawewa.

It is also very pathetic to observe that main clients of irrigation projects (farmers providing labor force) are now dying of various diseases caused by indiscriminate use of agrochemicals. Therefore, there is a need to minimize the damages caused to the ecosystems where these food production factories are located. Therefore, the management objectives should also be focused on producing multiple types of organically grown crops, profitably without polluting the soil and groundwater aquifers causing diseases like Kidney Failures.

Proposed Management Structure

Existing management staff should either be trained or new recruitments having Production Engineering background, should be made. Water should be perceived as the most limited input, which needs to be managed profitably jointly with the farming community. Each Production Manager could be allocated a Fixed Volume of water annually, and their performance could be measured in terms of $s earned for the country per Unit Volume of water, while economically upgrading a healthy lifestyle of the farmers by using climate smart agriculture.

In addition to the government salary, the production management staff should also be compensated in the form of incentives, calculated in proportion to income generated by them from their management areas. It should be a Win-Win situation for both farmers as well as officers responsible for managing the food production factory. Operation of the Main Canal to cater flexible needs of each factory is the main responsibility of the Resident Production Manager. In other countries, the term used to measure their performance is $ earned per gallon of water to the country, without damaging the ecosystem.

Recent Efforts

Mahaweli Authority introduced some of the concepts explained in this note during 2000 to 2006, under MRRP. It was done by operating the Distributary canals feeding each block as elongated Village Tanks. It was known as the Bulk Water Allocation (BWA) strategy. Recently an attempt was made to digitize the same concept, by independently arranging funds from ICTA / World Bank. In that project, called Eazy Water, a SMS communication system was introduced, so that they can order water from the Main Reservoir by sending a SMS, when they need rather; than depend on time tables decided by authorities as normally practiced.

Though the BWA was practiced successfully until 2015, the new generation of managers did not continue it beyond 2015.

Conclusion

The recent Cabinet decision to close down the MASL should prompt the MASL officers to reactivate the BWA approach again. Farmer Organisations at the distributary canal level responsible for managing canal networks covering about 400 Hectares can be registered as farmer cooperatives. For example, there are about 50 farmer cooperatives in a typical irrigation project such as Kalawewa. This transformation should be a gradual process which would take at least two years. I am sure the World Bank would definitely fund this project during the transition period because it is a continuation of the MRRP to address the restructuring component which was not attended by them in 2000 because of government policy at that time. System H could be used as a pilot demonstration area. Guidelines introduced under the MRRP could be used as tools to manage the main canal. World Bank funded Agribusiness Value Chain Support with CSIAP (Climate Smart Irrigated Agriculture Project) under the Ministry of Agriculture which is presently in progress could also provide necessary guidelines to initiate this project.

by Eng. Mahinda Panapitiya
Engineer who worked for Mahaweli Project since its inception

Continue Reading

Trending