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Sri Lanka’s economic turmoil and value of Senanka Bibile drug policy

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By Dr. Ajith Kumara
Consultant Physician
President, All Ceylon Medical Officers Association

Prof. Senaka Bibile is the greatest medical benefactor of humanity that Sri Lanka has hitherto produced. As a student, he was an all-rounder; he excelled in in academic and extracurricular activities including sports and art. He completed his First, Second and Final M.B. Examinations, all with First Class Honours and won the coveted Djunjishaw Dadabhoy Gold Medal in Medicine and the Rockwood Gold Medal in Surgery at the finals.

Both his talent and Marxist ideology motivated him to dedicate the rest of his life to a mission to develop the medical education and also introduce a national drug policy which was overwhelmingly grabbed by many nations and organisations across the world.

Background for National Drug Policy

The capitalist system is full of flaws due to the nature of commodity production. After the world war II, there was a transient progression which was soon followed by economic recessions across the world interpreted as great depression, OPEC oil crisis, Secondary banking crisis of 1973–1975 in the UK, Latin American debt crisis and so on.

Sri Lanka also witnessed a steady deterioration of balance payment from 1960s and economic growth rate progressively declined from 4.6%which was during 1950 and 1960 to 2.6% by 1974. From 1965 to 1970, the foreign exchange allocation for drugs was cut from a total of Rs. 33 million (Rs. 20 million for private and Rs. 13 million for Civil Medical Stores’ imports) to Rs. 24 million (Rp. 14 million and Rs. 10 million, respectively). Those drastic cut downs of health expenses irrespective of growth of population and steadily rise of drug prices resulted in significant drop in per capita pharmaceutical supply compromising health care across the country. Therefore, the prime minister requested Prof Senaka Bibile to cut down expenses without compromising patient care.

By 1970, Sri Lanka had no national health or drug policy like most other countries and drugs were imported for the government sector and for the private sector separately by the civil medical stores and 134 local agents of foreign suppliers respectively. Both the government and the private sector were heavily influenced by propaganda of the transnational companies (TNC).

Major recommendations in National Drug Policy

List of essential drugs

Prof. Senaka Bibile pioneered the publication of the Ceylon Hospitals Formulary from 1957 to identify essential drugs for the hospitals and introduced the concept of List of Essential Medicines in 1958 in Sri Lanka; it was new to the world and later taken up by WHO and other countries to ensure continuous supply of essential drugs at the lower possible cost.

When preparing the drug list, many imitative drugs, which made no contribution to the therapeutic effect of a particular drug that were chosen on the basis of economy, large number of fixed combination drugs and drugs without clear therapeutic value or with high toxicity were left out. Drugs that have got a very slight structural difference to already known drugs, but with the same therapeutic effect (me-too drugs) were also deleted. So, he managed to minimise the drug list from about 4000 preparations to a reasonable number (about 600) without detrimental effect on patient care.

Centralisation of the purchase

The next major recommendation was the centralisation of purchase of both finished drugs according to the rationalised list and pharmaceutical chemicals for local manufacturers. State Pharmaceutical Cooperation (SPC) initiated this task of wholesale import of all drugs and pharmaceutical raw materials and, the purchase of locally processed pharmaceuticals. By the end of 1973, it could take over all imports.

Shopping around the world and accepting low price-bid as bulks rather than finished products helped save a lot of money. To maintain the quality of drugs, the pharmaceutical company should produce certificate of quality plus an independent certificate of quality from a reliable laboratory, an agent or an official body before accepting their bid.

He suggested the following formula to understand the price of a drug to scientifically reduce its price. (See table)

CIF value ( Cost of goods, Insurance and freight) 100Handling charges 05Import duty 25Wholesalers profit 35Retailers profit 35Price to the consumer 200

Prof. Bibile pointed out that the wholesale import of raw materials and bulk pharmaceuticals at the most favourable price (at a lowest possible CIF value) will enable drug to be obtained and sold at the lowest price rather than fighting to limit wholesalers and retailers profit.

Ignore the patent law

The other recommendation was to abolish the patent law. Until that time, Sri Lanka had not been able to purchase patent products from any other manufacturer even though the drug was manufactured in a different process. Therefore, Sri Lanka could not buy cheaper products manufactured by a process different to those used by the original patent holders. Hence, it was suggested to amend the patent law so that only process patents would apply but not the product patents similar to the manner of operating the patent law in many countries such as Japan, Sweden, Denmark, Switzerland and most of the socialist countries.

Drug distribution and advertising

Repacking of bulk imported drugs and distribution of the drugs to the government sector and also to the private sector should be done by the state trading cooperation.

Drug advertising and education of doctors about drugs via brochures from pharmaceutical firms and their representatives should cease and local manufactures too should let the cooperation to advertise on their drugs.

Nomenclature

The report strongly recommended using generic names of medications instead of their trade names in prescriptions.

State Pharmaceutical Industry

Manufacturing pharmaceuticals in the country should also be started under the guidelines set by the government according to the essential drug list using the materials imported by the state, leaving the promotion and distribution to the state. If any manufacturer proved recalcitrant, the government has the authority to nationalise them. With this recommendation, by 1973, Sri Lanka m,anufacuired 47 essential drugs and, by 1974, and it increased to 71 drugs while saving more than 450,000 USD for the country.

Quality control of drugs

It was suggested to establish a quality control laboratory with a trained staff. Initially, he suggested getting consultants for the laboratory and to train staff through the WHO until local counterparts can take over the function.

Pharmacies, Pharmacists and their training

This was one of the most neglected aspect in health system by then. He rec eived assistance from Dr. J. Chilton of the University of Glasgow and a WHO consultant in Pharmacoloy, in training of pharmacists and to recommend the setting up of model pharmacies in the Colombo hospitals. The pharmacology course was later upgraded to a two year university diploma course according to his proposals.

In addition to these, the report has addressed about the research, monitoring and continuous development of human resources and infrastructure too.

Therefore, when analysing the Bibile Policy, it is clear that it is not merely an attempt to control the prices of drugs but, a very comprehensive national strategy for pharmaceutical sector in the health system.

National Drug policy to the world

Prof. Bibile was given the opportunity to present his novel model of pharmaceutical policy at the United Nations Conference on Trade and Development in 1976 and it was soon supported by World Health Organization (WHO) and other United Nations agencies as it would give enormous benefit to the third world countries.

By the year 2,000, over 100 countries had national pharmaceutical policies and 88 countries had introduced the essential drug concept to medical and pharmacy curricula. In 1971, both Chile and Sri Lanka started centralised bulk procurement but, Chile failed due to the power of pharmaceutical companies and the lack of strong political will at their end.

In the early 1980s, Bangladesh ranked as the world’s second poorest country with the average per capita income of US$130. However, they succeeded in national pharmacological policy due to strong political commitment giving a good example to the world that if the vital ingredient of political will and commitment are there, the real progress is possible irrespective of the power of the pharmaceutical giants.

Sri Lankans failure

Signs of failure appeared from the outset of the policy implementation in Sri Lanka. In the report in 1976 written by Prof. Bibile and Dr. Sanjaya Lal, it is clearly mentioned that the government was neither monolithic nor fully consistent with its strategy and, after 1975; government changed its economic strategy and hindered the policy implementation.

By now, Sri Lanka has faced a severe economic crisis with a shortage of foreign currency and an inability to provide basic requirements such as food, education and health of the citizens. Hospitals have run out of drugs including life-saving medications and surgical items.

Nevertheless, there are numerous combinations of various types of vitamins; plenty of medications which have no proven benefits, me-too drug and many counterfeit medications in the market wasting our foreign currency! About 30% of health expenditure is spent for pharmaceuticals.

If Sri Lanka had implemented Bibile drug policy and imported drugs according to an essential medicine list, heath budget could have efficiently be utilised to buy them while avoiding wasting of foreign currency for unnecessary medications. That would be an expeditious solution to the current crisis in essential medicines. As planned earlier, if the pharmaceutical manufacturing industry is commenced, it will be an excellent way of earning the much needed foreign currency in the long term. Therefore, the implementation of Bibile drug policy is much more important today than ever as a comprehensive approach to the crisis in health system to ensure the availability of essential medications.



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Opinion

Buddhist insights into the extended mind thesis – Some observations

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It is both an honour and a pleasure to address you on this occasion as we gather to celebrate International Philosophy Day. Established by UNESCO and supported by the United Nations, this day serves as a global reminder that philosophy is not merely an academic discipline confined to universities or scholarly journals. It is, rather, a critical human practice—one that enables societies to reflect upon themselves, to question inherited assumptions, and to navigate periods of intellectual, technological, and moral transformation.

In moments of rapid change, philosophy performs a particularly vital role. It slows us down. It invites us to ask not only how things work, but what they mean, why they matter, and how we ought to live. I therefore wish to begin by expressing my appreciation to UNESCO, the United Nations, and the organisers of this year’s programme for sustaining this tradition and for selecting a theme that invites sustained reflection on mind, consciousness, and human agency.

We inhabit a world increasingly shaped by artificial intelligence, neuroscience, cognitive science, and digital technologies. These developments are not neutral. They reshape how we think, how we communicate, how we remember, and even how we imagine ourselves. As machines simulate cognitive functions once thought uniquely human, we are compelled to ask foundational philosophical questions anew:

What is the mind? Where does thinking occur? Is cognition something enclosed within the brain, or does it arise through our bodily engagement with the world? And what does it mean to be an ethical and responsible agent in a technologically extended environment?

Sri Lanka’s Philosophical Inheritance

On a day such as this, it is especially appropriate to recall that Sri Lanka possesses a long and distinguished tradition of philosophical reflection. From early Buddhist scholasticism to modern comparative philosophy, Sri Lankan thinkers have consistently engaged questions concerning knowledge, consciousness, suffering, agency, and liberation.

Within this modern intellectual history, the University of Peradeniya occupies a unique place. It has served as a centre where Buddhist philosophy, Western thought, psychology, and logic have met in creative dialogue. Scholars such as T. R. V. Murti, K. N. Jayatilleke, Padmasiri de Silva, R. D. Gunaratne, and Sarathchandra did not merely interpret Buddhist texts; they brought them into conversation with global philosophy, thereby enriching both traditions.

It is within this intellectual lineage—and with deep respect for it—that I offer the reflections that follow.

Setting the Philosophical Problem

My topic today is “Embodied Cognition and Viññāṇasota: Buddhist Insights on the Extended Mind Thesis – Some Observations.” This is not a purely historical inquiry. It is an attempt to bring Buddhist philosophy into dialogue with some of the most pressing debates in contemporary philosophy of mind and cognitive science.

At the centre of these debates lies a deceptively simple question: Where is the mind?

For much of modern philosophy, the dominant answer was clear: the mind resides inside the head. Thinking was understood as an internal process, private and hidden, occurring within the boundaries of the skull. The body was often treated as a mere vessel, and the world as an external stage upon which cognition operated.

However, this picture has increasingly come under pressure.

The Extended Mind Thesis and the 4E Turn

One of the most influential challenges to this internalist model is the Extended Mind Thesis, proposed by Andy Clark and David Chalmers. Their argument is provocative but deceptively simple: if an external tool performs the same functional role as a cognitive process inside the brain, then it should be considered part of the mind itself.

From this insight emerges the now well-known 4E framework, according to which cognition is:

Embodied – shaped by the structure and capacities of the body

Embedded – situated within physical, social, and cultural environments

Enactive – constituted through action and interaction

Extended – distributed across tools, artefacts, and practices

This framework invites us to rethink the mind not as a thing, but as an activity—something we do, rather than something we have.

Earlier Western Challenges to Internalism

It is important to note that this critique of the “mind in the head” model did not begin with cognitive science. It has deep philosophical roots.

Ludwig Wittgenstein

famously warned philosophers against imagining thought as something occurring in a hidden inner space. Such metaphors, he suggested, mystify rather than clarify our understanding of mind.

Similarly, Franz Brentano’s notion of intentionality—his claim that all mental states are about something—shifted attention away from inner substances toward relational processes. This insight shaped Husserl’s phenomenology, where consciousness is always world-directed, and Freud’s psychoanalysis, where mental life is dynamic, conflicted, and socially embedded.

Together, these thinkers prepared the conceptual ground for a more process-oriented, relational understanding of mind.

Varela and the Enactive Turn

A decisive moment in this shift came with Francisco J. Varela, whose work on enactivism challenged computational models of mind. For Varela, cognition is not the passive representation of a pre-given world, but the active bringing forth of meaning through embodied engagement.

Cognition, on this view, arises from the dynamic coupling of organism and environment. Importantly, Varela explicitly acknowledged his intellectual debt to Buddhist philosophy, particularly its insights into impermanence, non-self, and dependent origination.

Buddhist Philosophy and the Minding Process

Buddhist thought offers a remarkably sophisticated account of mind—one that is non-substantialist, relational, and processual. Across its diverse traditions, we find a consistent emphasis on mind as dependently arisen, embodied through the six sense bases, and shaped by intention and contact.

Crucially, Buddhism does not speak of a static “mind-entity”. Instead, it employs metaphors of streams, flows, and continuities, suggesting a dynamic process unfolding in relation to conditions.

Key Buddhist Concepts for Contemporary Dialogue

Let me now highlight several Buddhist concepts that are particularly relevant to contemporary discussions of embodied and extended cognition.

The notion of prapañca, as elaborated by Bhikkhu Ñāṇananda, captures the mind’s tendency toward conceptual proliferation. Through naming, interpretation, and narrative construction, the mind extends itself, creating entire experiential worlds. This is not merely a linguistic process; it is an existential one.

The Abhidhamma concept of viññāṇasota, the stream of consciousness, rejects the idea of an inner mental core. Consciousness arises and ceases moment by moment, dependent on conditions—much like a river that has no fixed identity apart from its flow.

The Yogācāra doctrine of ālayaviññāṇa adds a further dimension, recognising deep-seated dispositions, habits, and affective tendencies accumulated through experience. This anticipates modern discussions of implicit cognition, embodied memory, and learned behaviour.

Finally, the Buddhist distinction between mindful and unmindful cognition reveals a layered model of mental life—one that resonates strongly with contemporary dual-process theories.

A Buddhist Cognitive Ecology

Taken together, these insights point toward a Buddhist cognitive ecology in which mind is not an inner object but a relational activity unfolding across body, world, history, and practice.

As the Buddha famously observed, “In this fathom-long body, with its perceptions and thoughts, I declare there is the world.” This is perhaps one of the earliest and most profound articulations of an embodied, enacted, and extended conception of mind.

Conclusion

The Extended Mind Thesis challenges the idea that the mind is confined within the skull. Buddhist philosophy goes further. It invites us to reconsider whether the mind was ever “inside” to begin with.

In an age shaped by artificial intelligence, cognitive technologies, and digital environments, this question is not merely theoretical. It is ethically urgent. How we understand mind shapes how we design technologies, structure societies, and conceive human responsibility.

Buddhist philosophy offers not only conceptual clarity but also ethical guidance—reminding us that cognition is inseparable from suffering, intention, and liberation.

Dr. Charitha Herath is a former Member of Parliament of Sri Lanka (2020–2024) and an academic philosopher. Prior to entering Parliament, he served as Professor (Chair) of Philosophy at the University of Peradeniya. He was Chairman of the Committee on Public Enterprises (COPE) from 2020 to 2022, playing a key role in parliamentary oversight of public finance and state institutions. Dr. Herath previously served as Secretary to the Ministry of Mass Media and Information (2013–2015) and is the Founder and Chair of Nexus Research Group, a platform for interdisciplinary research, policy dialogue, and public intellectual engagement.

He holds a BA from the University of Peradeniya (Sri Lanka), MA degrees from Sichuan University (China) and Ohio University (USA), and a PhD from the University of Kelaniya (Sri Lanka).

(This article has been adapted from the keynote address delivered
by Dr. Charitha Herath
at the International Philosophy Day Conference at the University of Peradeniya.)

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Opinion

We do not want to be press-ganged 

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Reference ,the Indian High Commissioner’s recent comments ( The Island, 9th Jan. ) on strong India-Sri Lanka relationship and the assistance granted on recovering from the financial collapse of Sri Lanka and yet again for cyclone recovery., Sri Lankans should express their  thanks to India for standing up as a friendly neighbour.

On the Defence Cooperation agreement, the Indian High Commissioner’s assertion was that there was nothing beyond that which had been included in the text. But, dear High Commissioner, we Sri Lankans have burnt our fingers when we signed agreements with the European nations who invaded our country; they took our leaders around the Mulberry bush and made our nation pay a very high price by controlling our destiny for hundreds of years. When the Opposition parties in the Parliament requested the Sri Lankan government to reveal the contents of the Defence agreements signed with India as per the prevalent common practice, the government’s strange response was  that India did not want them disclosed.

Even the terms of the one-sided infamous Indo-Sri Lanka agreement, signed in 1987, were disclosed to the public.

Mr. High Commissioner, we are not satisfied with your reply as we are weak, economically, and unable to clearly understand your “India’s Neighbourhood First and  Mahasagar policies” . We need the details of the defence agreements signed with our government, early.

 

RANJITH SOYSA 

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Opinion

When will we learn?

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At every election—general or presidential—we do not truly vote, we simply outvote. We push out the incumbent and bring in another, whether recycled from the past or presented as “fresh.” The last time, we chose a newcomer who had spent years criticising others, conveniently ignoring the centuries of damage they inflicted during successive governments. Only now do we realise that governing is far more difficult than criticising.

There is a saying: “Even with elephants, you cannot bring back the wisdom that has passed.” But are we learning? Among our legislators, there have been individuals accused of murder, fraud, and countless illegal acts. True, the courts did not punish them—but are we so blind as to remain naive in the face of such allegations? These fraudsters and criminals, and any sane citizen living in this decade, cannot deny those realities.

Meanwhile, many of our compatriots abroad, living comfortably with their families, ignore these past crimes with blind devotion and campaign for different parties. For most of us, the wish during an election is not the welfare of the country, but simply to send our personal favourite to the council. The clearest example was the election of a teledrama actress—someone who did not even understand the Constitution—over experienced and honest politicians.

It is time to stop this bogus hero worship. Vote not for personalities, but for the country. Vote for integrity, for competence, and for the future we deserve.

 

Deshapriya Rajapaksha

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