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Ivermectin – A possible win-win situation

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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

Pakistan-Sri Lanka ‘eye diplomacy’ 

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The writer handing over a donation to restore the eyesight of injured military personnel

Reminiscences:

I was appointed Managing Director of the Ceylon Petroleum Corporation (CPC) and Chairman of the Trincomalee Petroleum Terminals Ltd (TPTL – Indian Oil Company/ Petroleum Corporation of Sri Lanka joint venture), in February 2023, by President Ranil Wickremesinghe. I served as TPTL Chairman voluntarily. TPTL controls the world-renowned oil tank farm in Trincomalee, abandoned after World War II. Several programmes were launched to repair tanks and buildings there. I enjoyed travelling to Trincomalee, staying at Navy House and monitoring the progress of the projects. Trincomalee is a beautiful place where I spent most of my time during my naval career.

My main task as MD, CPC, was to ensure an uninterrupted supply of petroleum products to the public.

With the great initiative of the then CPC Chairman, young and energetic Uvis Mohammed, and equally capable CPC staff, we were able to do our job diligently, and all problems related to petroleum products were overcome.  My team and I were able to ensure that enough stocks were always available for any contingency.

The CPC made huge profits when we imported crude oil and processed it at our only refinery in Sapugaskanda, which could produce more than 50,000 barrels of refined fuel in one stream working day! (One barrel is equal to 210 litres). This huge facility encompassing about 65 acres has more than 1,200 employees and 65 storage tanks.

A huge loss the CPC was incurring due to wrong calculation of “out turn loss” when importing crude oil by ships and pumping it through Single Point Mooring Buoy (SPMB) at sea and transferring it through underwater fuel transfer lines to service tanks was detected and corrected immediately. That helped increase the CPC’s profits.

By August 2023, the CPC made a net profit of 74,000 million rupees (74 billion rupees)! The President was happy, the government was happy, the CPC Management was happy and the hard-working CPC staff were happy. I became a Managing Director of a very happy and successful State-Owned Enterprise (SOE). That was my first experience in working outside military/Foreign service.

I will be failing in my duty if I do not mention Sagala Rathnayake, then Chief of Staff to the President, for recommending me for the post of MD, CPC.

The only grievance they had was that we were not able to pay their 2023 Sinhala/Tamil New Year bonus due to a government circular.  After working at CPC for six months and steering it out of trouble, I was ready to move out of CPC.

   I was offered a new job as the Sri Lanka High Commissioner to Pakistan. I was delighted and my wife and son were happy. Our association with Pakistan, especially with the Pakistan Military, is very long. My son started schooling in Karachi in 1995, when I was doing the Naval War Course there. My wife Yamuna has many good friends in Pakistan. I am the first Military officer to graduate from the Karachi University in 1996 (BSc Honours in War Studies) and have a long association with the Pakistan Navy and their Special Forces. I was awarded the Nishan-e-Imtiaz  (Military) medal—the highest National award by the Pakistan Presidentm in 2019m when I was Chief of Defence Staff. I am the only Sri Lankan to have been awarded this prestigious medal so far.  I knew my son and myself would be able to play a quiet game of golf every morning at the picturesque Margalla Golf Club, owned by the Pakistan Navy, at the foot of Margalla hills, at Islamabad. The golf club is just a walking distance from the High Commissioner’s residence.

When I took over as Sri Lanka High Commissioner at Islamabad on 06 December 2023, I realised that a number of former Service Commanders had held that position earlier. The first Ceylonese High Commissioner to Pakistan, with a military background, was the first Army Commander General Anton Muthukumaru. He was concurrently Ambassador to Iran. Then distinguished Service Commanders, like General H W G Wijayakoon, General Gerry Silva, General Srilal Weerasooriya, Air Chief Marshal Jayalath Weerakkody, served as High Commissioners to Islamabad. I took over from Vice Admiral Mohan Wijewickrama (former Chief of Staff of Navy and Governor Eastern Province).

A photograph of Dr. Silva (second from right) in Brigadier
(Dr) Waquar Muzaffar’s album

One of the first visitors I received was Kawaja Hamza, a prominent Defence Correspondent in Islamabad. His request had nothing to do with Defence matters. He wanted to bring his 84-year-old father to see me; his father had his eyesight restored with corneas donated by a Sri Lankan in 1972! His eyesight is still good, but he did not know the Sri Lankan donor who gave him this most precious gift. He wanted to pay gratitude to the new Sri Lankan High Commissioner and to tell him that as a devoted Muslim, he prayed for the unknown donor every day! That reminded me of what my guru in Foreign Service, the late Foreign Minister Lakshman Kadirgamar told me when I was First Secretary/ Defence Advisor, Sri Lanka High Commission in New Delhi. That is “best diplomacy is people-to-people contacts.” This incident prompted me to research more into “Pakistan-Sri Lanka Eye Diplomacy” and what I learnt was fascinating!

Do you know the Sri Lanka Eye Donation Society has donated more than 26,000 corneas to Pakistan, since 1964 to date! That means more than 26,000 Pakistani people see the world with SRI LANKAN EYES! The Sri Lankan Eye Donation Society has provided 100,000 eye corneas to foreign countries FREE! To be exact 101,483 eye corneas during the last 65 years! More than one fourth of these donations was to one single country- Pakistan. Recent donations (in November 2024) were made to the Pakistan Military at Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi, to restore the sight of Pakistan Army personnel who suffered eye injuries due to Improvised Explosive Devices (IED) blasts. This donation was done on the 75th Anniversary of the Sri Lanka Army.

Deshabandu Dr. F. G. Hudson Silva, a distinguished old boy of Nalanda College, Colombo, started collecting eye corneas as a medical student in 1958. His first set of corneas were collected from a deceased person and were stored at his home refrigerator at Wijerama Mawatha, Colombo 7. With his wife Iranganie De Silva (nee Kularatne), he started the Sri Lanka Eye Donation Society in 1961. They persuaded Buddhists to donate their eyes upon death. This drive was hugely successful.

Their son (now in the US) was a contemporary of mine at Royal College. I pledged to donate (of course with my parents’ permission) my eyes upon my death when I was a student at Royal college in 1972 on a Poson Full Moon Poya Day. Thousands have done so.

On Vesak Full Moon Poya Day in 1964, the first eye corneas were carried in a thermos flask filled with Ice, to Singapore, by Dr Hudson Silva and his wife and a successful eye transplant surgery was performed. From that day, our eye corneas were sent to 62 different countries.

Pakistan Lions Clubs, which supported this noble gesture, built a beautiful Eye Hospital for humble people at Gulberg, Lahore, where eye surgeries are performed, and named it Dr Hudson Silva Lions Eye Hospital.

The good work has continued even after the demise of Dr Hudson Silva in 1999.

So many people have donated their eyes upon their death, including President J. R. Jayewardene, whose eye corneas were used to restore the eyesight of one Japanese and one Sri Lankan. Dr Hudson Silva became a great hero in Pakistan and he was treated with dignity and respect whenever he visited Pakistan. My friend, Brigadier (Dr) Waquar Muzaffar, the Commandant of AFIO, was able to dig into his old photographs and send me a precious photo taken in 1980, 46 years ago (when he was a medical student), with Dr Hudson Silva.

We will remember Dr and Mrs Hudson Silva with gratitude.

Bravo Zulu to Sri Lanka Eye Donation Society!

 

by Admiral Ravindra C Wijegunaratne
WV, RWP and Bar, RSP, VSV, USP, NI (M) (Pakistan), ndc, psn, Bsc
(Hons) (War Studies) (Karachi) MPhil (Madras)
Former Navy Commander and Former Chief of Defense Staff
Former Chairman, Trincomalee Petroleum Terminals Ltd
Former Managing Director Ceylon Petroleum Corporation
Former High Commissioner to Pakistan

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Features

Lasting solutions require consensus

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Social Media training

Problems and solutions in plural societies like Sri Lanka’s which have deep rooted ethnic, religious and linguistic cleavages require a consciously inclusive approach. A major challenge for any government in Sri Lanka is to correctly identify the problems faced by different groups with strong identities and find solutions to them. The durability of democratic systems in divided societies depends less on electoral victories than on institutionalised inclusion, consultation, and negotiated compromise. When problems are defined only through the lens of a single political formation, even one that enjoys a large electoral mandate, such as obtained by the NPP government, the policy prescriptions derived from that diagnosis will likely overlook the experiences of communities that may remain outside the ruling party. The result could end up being resistance to those policies, uneven implementation and eventual political backlash.

A recent survey done by the National Peace Council (NPC), in Jaffna, in the North, at a focus group discussion for young people on citizen perception in the electoral process, revealed interesting developments. The results of the NPC micro survey support the findings of the national survey by Verite Research that found that government approval rating stood at 65 percent in early February 2026. A majority of the respondents in Jaffna affirm that they feel safer and more fairly treated than in the past. There is a clear improving trend to be seen in some areas, but not in all. This survey of predominantly young and educated respondents shows 78 percent saying livelihood has improved and an equal percentage feeling safe in daily life. 75 percent express satisfaction with the new government and 64 percent believe the state treats their language and culture fairly. These are not insignificant gains in a region that bore the brunt of three decades of war.

Yet the same survey reveals deep reservations that temper this optimism. Only 25 percent are satisfied with the handling of past issues. An equal percentage see no change in land and military related concerns. Most strikingly, almost 90 percent are worried about land being taken without consent for religious purposes. A significant number are uncertain whether the future will be better. These negative sentiments cannot be brushed aside as marginal. They point to unresolved structural questions relating to land rights, demilitarisation, accountability and the locus of political power. If these issues are not addressed sooner rather than later, the current stability may prove fragile. This suggests the need to build consensus with other parties to ensure long-term stability and legitimacy, and the need for partnership to address national issues.

NPP Absence

National or local level problems solving is unlikely to be successful in the longer term if it only proceeds from the thinking of one group of people even if they are the most enlightened. Problem solving requires the engagement of those from different ethno-religious, caste and political backgrounds to get a diversity of ideas and possible solutions. It does not mean getting corrupted or having to give up the good for the worse. It means testing ideas in the public sphere. Legitimacy flows not merely from winning elections but from the quality of public reasoning that precedes decision-making. The experience of successful post-conflict societies shows that long term peace and development are built through dialogue platforms where civil society organisations, political actors, business communities, and local representatives jointly define problems before negotiating policy responses.

As a civil society organisation, the National Peace Council engages in a variety of public activities that focus on awareness and relationship building across communities. Participants in those activities include community leaders, religious clergy, local level government officials and grassroots political party representatives. However, along with other civil society organisations, NPC has been finding it difficult to get the participation of members of the NPP at those events. The excuse given for the absence of ruling party members is that they are too busy as they are involved in a plenitude of activities. The question is whether the ruling party members have too much on their plate or whether it is due to a reluctance to work with others.

The general belief is that those from the ruling party need to get special permission from the party hierarchy for activities organised by groups not under their control. The reluctance of the ruling party to permit its members to join the activities of other organisations may be the concern that they will get ideas that are different from those held by the party leadership. The concern may be that these different ideas will either corrupt the ruling party members or cause dissent within the ranks of the ruling party. But lasting reform in a plural society requires precisely this exposure. If 90 percent of surveyed youth in Jaffna are worried about land issues, then engaging them, rather than shielding party representatives from uncomfortable conversations, is essential for accurate problem identification.

North Star

The Leader of the Lanka Sama Samaja Party (LSSP), Prof Tissa Vitarana, who passed away last week, gave the example for national level problem solving. As a government minister he took on the challenge the protracted ethnic conflict that led to three decades of war. He set his mind on the solution and engaged with all but never veered from his conviction about what the solution would be. This was the North Star to him, said his son to me at his funeral, the direction to which the Compass (Malimawa) pointed at all times. Prof Vitarana held the view that in a diverse and plural society there was a need to devolve power and share power in a structured way between the majority community and minority communities. His example illustrates that engagement does not require ideological capitulation. It requires clarity of purpose combined with openness to dialogue.

The ethnic and religious peace that prevails today owes much to the efforts of people like Prof Vitarana and other like-minded persons and groups which, for many years, engaged as underdogs with those who were more powerful. The commitment to equality of citizenship, non-racism, non-extremism and non-discrimination, upheld by the present government, comes from this foundation. But the NPC survey suggests that symbolic recognition and improved daily safety are not enough. Respondents prioritise personal safety, truth regarding missing persons, return of land, language use and reduction of military involvement. They are also asking for jobs after graduation, local economic opportunity, protection of property rights, and tangible improvements that allow them to remain in Jaffna rather than migrate.

If solutions are to be lasting they cannot be unilaterally imposed by one party on the others. Lasting solutions cannot be unilateral solutions. They must emerge from a shared diagnosis of the country’s deepest problems and from a willingness to address the negative sentiments that persist beneath the surface of cautious optimism. Only then can progress be secured against reversal and anchored in the consent of the wider polity. Engaging with the opposition can help mitigate the hyper-confrontational and divisive political culture of the past. This means that the ruling party needs to consider not only how to protect its existing members by cloistering them from those who think differently but also expand its vision and membership by convincing others to join them in problem solving at multiple levels. This requires engagement and not avoidance or withdrawal.

 

by Jehan Perera

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Features

Unpacking public responses to educational reforms

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A pro-government demonstration calling for the implementation of the education reforms. (A file photo)

As the debate on educational reforms rages, I find it useful to pay as much attention to the reactions they have excited as we do to the content of the reforms. Such reactions are a reflection of how education is understood in our society, and this understanding – along with the priorities it gives rise to – must necessarily be taken into account in education policy, including and especially reform. My aim in this piece, however, is to couple this public engagement with critical reflection on the historical-structural realities that structure our possibilities in the global market, and briefly discuss the role of academics in this endeavour.

Two broad reactions

The reactions to the proposed reforms can be broadly categorised into ‘pro’ and ‘anti’. I will discuss the latter first. Most of the backlash against the reforms seems to be directed at the issue of a gay dating site, accidentally being linked to the Grade 6 English module. While the importance of rigour cannot be overstated in such a process, the sheer volume of the energies concentrated on this is also indicative of how hopelessly homophobic our society is, especially its educators, including those in trade unions. These dispositions are a crucial part of the reason why educational reforms are needed in the first place. If only there was a fraction of the interest in ‘keeping up with the rest of the world’ in terms of IT, skills, and so on, in this area as well!

Then there is the opposition mounted by teachers’ trade unions and others about the process of the reforms not being very democratic, which I (and many others in higher education, as evidenced by a recent statement, available at https://island.lk/general-educational-reforms-to-what-purpose-a-statement-by-state-university-teachers/ ) fully agree with. But I earnestly hope the conversation is not usurped by those wanting to promote heteronormativity, further entrenching bigotry only education itself can save us from. With this important qualification, I, too, believe the government should open up the reform process to the public, rather than just ‘informing’ them of it.

It is unclear both as to why the process had to be behind closed doors, as well as why the government seems to be in a hurry to push the reforms through. Considering other recent developments, like the continued extension of emergency rule, tabling of the Protection of the State from Terrorism Act (PSTA), and proposing a new Authority for the protection of the Central Highlands (as is famously known, Authorities directly come under the Executive, and, therefore, further strengthen the Presidency; a reasonable question would be as to why the existing apparatus cannot be strengthened for this purpose), this appears especially suspect.

Further, according to the Secretary to the MOE Nalaka Kaluwewa: “The full framework for the [education] reforms was already in place [when the Dissanayake government took office]” (https://www.wsws.org/en/articles/2025/08/12/wxua-a12.html, citing The Morning, July 29). Given the ideological inclinations of the former Wickremesinghe government and the IMF negotiations taking place at the time, the continuation of education reforms, initiated in such a context with very little modification, leaves little doubt as to their intent: to facilitate the churning out of cheap labour for the global market (with very little cushioning from external shocks and reproducing global inequalities), while raising enough revenue in the process to service debt.

This process privileges STEM subjects, which are “considered to contribute to higher levels of ‘employability’ among their graduates … With their emphasis on transferable skills and demonstrable competency levels, STEM subjects provide tools that are well suited for the abstraction of labour required by capitalism, particularly at the global level where comparability across a wide array of labour markets matters more than ever before” (my own previous piece in this column on 29 October 2024). Humanities and Social Sciences (HSS) subjects are deprioritised as a result. However, the wisdom of an education policy that is solely focused on responding to the global market has been questioned in this column and elsewhere, both because the global market has no reason to prioritise our needs as well as because such an orientation comes at the cost of a strategy for improving the conditions within Sri Lanka, in all sectors. This is why we need a more emancipatory vision for education geared towards building a fairer society domestically where the fruits of prosperity are enjoyed by all.

The second broad reaction to the reforms is to earnestly embrace them. The reasons behind this need to be taken seriously, although it echoes the mantra of the global market. According to one parent participating in a protest against the halting of the reform process: “The world is moving forward with new inventions and technology, but here in Sri Lanka, our children are still burdened with outdated methods. Opposition politicians send their children to international schools or abroad, while ours depend on free education. Stopping these reforms is the lowest act I’ve seen as a mother” (https://www.newsfirst.lk/2026/01/17/pro-educational-reforms-protests-spread-across-sri-lanka). While it is worth mentioning that it is not only the opposition, nor in fact only politicians, who send their children to international schools and abroad, the point holds. Updating the curriculum to reflect the changing needs of a society will invariably strengthen the case for free education. However, as mentioned before, if not combined with a vision for harnessing education’s emancipatory potential for the country, such a move would simply translate into one of integrating Sri Lanka to the world market to produce cheap labour for the colonial and neocolonial masters.

According to another parent in a similar protest: “Our children were excited about lighter schoolbags and a better future. Now they are left in despair” (https://www.newsfirst.lk/2026/01/17/pro-educational-reforms-protests-spread-across-sri-lanka). Again, a valid concern, but one that seems to be completely buying into the rhetoric of the government. As many pieces in this column have already shown, even though the structure of assessments will shift from exam-heavy to more interim forms of assessment (which is very welcome), the number of modules/subjects will actually increase, pushing a greater, not lesser, workload on students.

A file photo of a satyagraha against education reforms

What kind of education?

The ‘pro’ reactions outlined above stem from valid concerns, and, therefore, need to be taken seriously. Relatedly, we have to keep in mind that opening the process up to public engagement will not necessarily result in some of the outcomes, those particularly in the HSS academic community, would like to see, such as increasing the HSS component in the syllabus, changing weightages assigned to such subjects, reintroducing them to the basket of mandatory subjects, etc., because of the increasing traction of STEM subjects as a surer way to lock in a good future income.

Academics do have a role to play here, though: 1) actively engage with various groups of people to understand their rationales behind supporting or opposing the reforms; 2) reflect on how such preferences are constituted, and what they in turn contribute towards constituting (including the global and local patterns of accumulation and structures of oppression they perpetuate); 3) bring these reflections back into further conversations, enabling a mutually conditioning exchange; 4) collectively work out a plan for reforming education based on the above, preferably in an arrangement that directly informs policy. A reform process informed by such a dialectical exchange, and a system of education based on the results of these reflections, will have greater substantive value while also responding to the changing times.

Two important prerequisites for this kind of endeavour to succeed are that first, academics participate, irrespective of whether they publicly endorsed this government or not, and second, that the government responds with humility and accountability, without denial and shifting the blame on to individuals. While we cannot help the second, we can start with the first.

Conclusion

For a government that came into power riding the wave of ‘system change’, it is perhaps more important than for any other government that these reforms are done for the right reasons, not to mention following the right methods (of consultation and deliberation). For instance, developing soft skills or incorporating vocational education to the curriculum could be done either in a way that reproduces Sri Lanka’s marginality in the global economic order (which is ‘system preservation’), or lays the groundwork to develop a workforce first and foremost for the country, limited as this approach may be. An inextricable concern is what is denoted by ‘the country’ here: a few affluent groups, a majority ethno-religious category, or everyone living here? How we define ‘the country’ will centrally influence how education policy (among others) will be formulated, just as much as the quality of education influences how we – students, teachers, parents, policymakers, bureaucrats, ‘experts’ – think about such categories. That is precisely why more thought should go to education policymaking than perhaps any other sector.

(Hasini Lecamwasam is attached to the Department of Political Science, University of Peradeniya).

Kuppi is a politics and pedagogy happening on the margins of the lecture hall that parodies, subverts, and simultaneously reaffirms social hierarchies.

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