Features
Venerable Bhante Homagama Kondanna Maha Thero, an international monk and a remarkable disciple of the Buddha

by Anoja Wijeyesekera
Bhante Kondanna who passed away in London on February 3, 2022 was a remarkable disciple of the Buddha, who communicated the message of the Enlightened One, to all who sought the truth, regardless of where they were located in the world. He travelled to every continent and communicated the message of the Buddha and taught people in Australia, Malaysia, Singapore, Sri Lanka, UK, Germany, Italy, Switzerland, USA, Canada, Mexico, Ecuador, Peru, Argentina and Brazil, to practice meditation based on the Buddha’s Four Foundations of Mindfulness, the direct path to Enlightenment.
So profound was the impact of his teachings and the meditation retreats he conducted in all these countries, that his followers from every time zone of the world, participated via Zoom, in the Pansakula ceremony held at the Kavijada Meditation Centre in Moratuwa, Sri Lanka, on February 6. They joined this event to honour their respected teacher, even though for some of them it was in the middle of the night.
His followers from Argentina and Canada spoke of their profound sadness at the demise of Bhante Kondanna whom they considered to be their “father, brother and friend.” He predicted his own death and travelled to the UK, his second home, where he died suddenly and peacefully at the Atuladassana International Buddhist Vihara, Heathrow. With no apparent illness and no cause for hospitalisation, he died exactly as he would have liked, with Ven Kassapa in attendance. A simple cremation would be held in London, in keeping with his wishes.
Bhante Kondanna devoted his entire life as a monk to the service of others and had a unique ability to transcend boundaries and empathise with anyone at a human level of compassion and understanding. He reached out to those who sought his advice and gave them the strength to transcend the vicissitudes of life, the inevitable condition of human existence. The Eight Vicissitudes of Life are praise-blame, fame-ill-fame, gain-loss, happiness-sorrow, which the Buddha identified as imposters to be confronted with equanimity.
Born in 1939, to a large family from Homagama, Sri Lanka, he had his education at Royal College, Colombo, and completed his higher education in the UK. After graduating as a Mechanical Engineer, he specialised in automotive engineering, which enabled him to pursue a lucrative career with Rolls-Royce, the prestigious car and aero engine manufacturer in the UK. With the experience thus gained, he ventured into his own car business in West Hampstead, London.
As a successful businessman in London, and known to his friends by his first name, Don, he dined at the top restaurants, wore the best Saville Row suits and drove around in a Bentley, living what most people would consider the perfect life. However, he began to see the hollowness beneath the glittering veneer of wealth and material comforts. His eyes opened to the reality of the human condition, namely, “jathi, jara, vyada and marana” (birth, old age, sickness and death) which made him completely disenchanted with his worldly life.
He was on the brink of signing a lucrative business deal which had the potential to make him enormously wealthy, when he withdrew from it all. He decided to renounce the lay life completely in 1978, and ordained as a Buddhist monk, under Ven. Dr. Hammalwa Saddhatissa Thera, the Head of the London Buddhist vihara.
At his ordination ceremony, he was given the name “Kondanna” by Ven. Sadhatissa Thero, who may have been influenced by the significance of this name in Buddhist history. Kondanna was one of the Five Ascetics to whom the Buddha preached his first sermon, the Dhammacakkapavattana Sutta, 2,600 years ago. After hearing the Buddha’s words, Kondanna attained the first stage of sainthood, sotapanna.
Bhante Homagama Kondanna obtained his higher ordination after two and a half years of study and practice, under the guidance of both Ven. Sadhatissa and Ajahn Sumedo, the Chief Abbot of Amaravati. He then proceeded to develop his meditation practice in Thailand and became a disciple of Ajahn Chah, the renowned Meditation Master. Bhante Kondanna spent more than two years in full time meditation at Ajahn Chah’s monastery namely, Wat Nong Pah Pong, in Ubon province located in the jungles of North-eastern Thailand. It was a centre that attracted many western students some of whom graduated to become Chief Abbots of Buddhist monasteries in Western countries.
At Ajahn Chah’s monastery, which followed the Forest Tradition, living conditions were extremely spartan. The one meal they consumed each day was obtained through pindapatha, (alms round of mendicants). It meant trekking through jungles to reach the little hamlets of poor peasants, who eked out a living through their land. Pindapatha being a well-established tradition in Thailand, people regarded it as a great blessing to make offerings to the monks who came on their alms round.
For the disciples of Ajahn Chah this was a daily exercise in the practice of humility and gratitude. They learned to appreciate the most basic of food, to eat only for survival, to give up indulging in taste and to transcend the pangs of hunger, till the next meal, 24 hours later. Bhante Kondanna continued this practice of having only one meal a day throughout his life.
Ajahn Chah’s guidance and unique teachings enabled his students to progress on the path. Many were the methods the master used to tear down the ego and self-view that is the most difficult defilement to overcome. The methodology adopted was one of self-realisation through direct experience and meditative insight, rather than book learning.
While Bhante Kondanna was into his second year at Ubon, Ven Saddhatissa of London, was given the task of finding an abbot for the Kavidaja Meditation centre in Moratuwa,
Sri Lanka. He thought that Bhante Kondanna would be the ideal candidate. So, in consultation with Ajahn Chah, Bhante Kondanna was requested to return by Ven Sadhatissa Thero. Unable to refuse the request of his teacher and mentor, Bhante Kondanna returned to Sri Lanka and was appointed as the Chief Abbot of the Kavidaja Meditation Centre.
From then on, Bhante Kondanna devoted his entire life for the welfare and happiness of the many, as the Buddha asked his disciples to do. He dedicated his life to the teaching of meditation both Samatha (Tranquility) and Vipassana (Insight). In Sri Lanka he conducted regular meditation retreats both in his own temple as well as at the Knuckles Mediation Centre, which he founded and at several other locations. One of his pupils, Prof. Rajah de Alwis, Professor of Civil Engineering at the Moratuwa University who followed his meditation classes at the YMBA Dehiwala, himself became a meditation teacher and introduced meditation to his engineering students, giving them a head-start in life.
Bhante Kondanna started an English Dhamma school at his temple in Moratuwa for children attending international schools. This has proved to be a great success as the 200 or more children who attend the school are also given a good grounding in meditation practice. Many of the teachers who provide voluntary services are professionals from many walks of life who are excellent in their English, dhamma knowledge as well as meditation.
Bhante Kondanna has also been the spiritual advisor of Seva Lanka Foundation, a charity that assisted poor rural communities of Sri Lanka. He was closely associated with the German Dharmaduta Society and was their anusasaka (spiritual guide) Bhante was also a regular speaker at the Maitriya Hall, Bambalapitiya, the Headquarters of the Servants of the Buddha, where he conducted meditation classes. He participated in their Centenary Celebrations in April 2021.
From the very outset, Bhante Kondanna received invitations from various parts of the world to conduct meditation retreats. This entailed travel to all parts of the world and long periods of stay outside Sri Lanka. At his pansakula ceremony it was mentioned that he spent approximately 50 years of his life outside Sri Lanka.
His easy-going manner, command of the English language, his sense of humour and simplicity enabled him to reach out to people from all walks of life, all nationalities, all ethnic groups and scores of free-thinking people from the far corners of the world, who were looking for answers to the enigma of life. His popularity as a meditation teacher grew to the extent that he ended up conducting meditation programmes in the long list of countries listed at the beginning of this article.
In South America which was totally alien to Buddhism, he attracted a large following, so much so that he received invitations from most of the south American countries, year after year. His influence was so profound that two persons from Argentina even followed him to Sri Lanka to gain ordination as Buddhist monks, at the Kavidaja Meditation centre in Moratuwa. Later, one of them went to Thailand to continue his meditation practice and the other returned to Argentina.
Bhante Kondanna was a monk who practiced what he preached and preached what he practiced. His day began with meditation long before dawn, while the rest of the day was devoted to the service of others. He lived a life of extreme simplicity, that bordered on austerity. He ate only one meal a day. Very often he obtained this meal through pindapatha (alms round), which in addition to being an act of humility is a re-affirmation of a monk’s vows of being totally dependent on the generosity of others, and of giving up personal possessions and resources. He explained that anything that a person puts into the bowl, must be eaten with gratitude and humility. Pindapatha was a practice that was followed by the Buddha.
During the first lock-down and curfew, when Bhante Kondanna was on his alms round, the local police who were arresting curfew violators, stopped him and questioned him. He replied that he was on pindapatha. The police then begged for his forgiveness and helped him on his path.
Bhante Kondanna never stood on ceremony or sought titles or positions and shunned any form of elevation and publicity. He did not promote fanfare and rituals and asked his followers to practice what the Buddha prescribed, namely Dana, Seela and Bhavana, (Generosity, Virtue and Meditation). He expressed disappointment that many people in Sri Lanka, replace Bhavana (meditation) with “puda puja” rituals, which was not what the Buddha recommended.
In his meditation classes, in addition to the instructions on the path to liberation, he advised his students on how to transcend pain through mindfulness. A few years ago, in London, he tripped on a pavement and fractured his ankle. At the hospital, the doctors wanted to give him a local anaesthetic before carrying out the procedure to re-set his ankle. He refused the anaesthetic and told that doctors that he taught his students how to transcend pain through meditation and that he has to practice what he preaches. The doctors had been astounded. Bhante Kondanna also had teeth extractions without anaesthesia much to the surprise and consternation of his dentists!
As a meditation master and guide, Bhante Kondanna leaves a great vacuum in the lives of his followers across the world. However, he made sure that he trained and guided several Sri Lankan monks who were his disciples, to learn English, practice meditation and proceed to other countries to impart the Dhamma. Ven. Dhammakusala of the Berlin Temple in Germany and Ven. Soratha at the Buddhist temple in Canberra, Australia are disciples of Ven. Homagama Kondanna. Here in Sri Lanka, Ven. Thirikunamale Sobitha Thero who was a devout follower of Ven. Kondanna will take over at the Kavidaja Mediation Centre. The torch that was lit by Bhante Kondanna Maha Thero will be carried by them to encourage human beings to strive for Enlightenment through the direct path of meditation, as extolled by the Buddha.
I would like to conclude by quoting from an article written by Bhante Kondanna “Why meditate?” which he wrote for the Centenary Volume of Dhamma Gems, the Journal of the Servants of the Buddha, in 2021. He speaks directly to the reader as follows:
“Through meditation and quiet contemplation, you will realise that, with everything being impermanent and causing so much pain, there is really no control, no power vested in me, you, or us. Even though we think this is my body, and my mind, everything is subject to automatic processes such as ageing, falling ill and dying, and so do the habitual reactions based on perceptions of what one likes and dislikes. Through meditation you will gradually realise that to live means to experience everything that is happening through awareness. That awareness is all that there is. No person, no being, just an ever-changing body and an ever-changing thought process, both of which have come together temporarily in this birth, giving the illusion of a permanent self. Meditation will help one see that the true nature of the world and of oneself is impermanence, suffering and non-self. (anicca, dukkha and anatta)
Once you realise this you have experienced the blissful state of Enlightenment. You are free of passion, desires, aversion. A state of blissful peace that comes with contentment, of not wanting, of having no desires, of just being.
Therefore, my friends, I invite you to tread the path shown by the Buddha, which is to sit in quiet contemplation, and see the truth of the universe within the body and mind.
May you all achieve the blissful state of Nibbana.”
Likewise, may Bhante Kondanna, attain that same blissful state of Nibbana, that he encouraged and guided his followers to strive for, through his life of selfless service as a Buddhist monk.
Features
Is Tax a Responsibility or a Burden? Part II

A critical policy misstep by the administration of President Gotabaya Rajapaksa was the substantial reduction in tax rates in late 2019, which significantly eroded government revenue. This drastic contraction in the fiscal base severely undermined public finance sustainability and contributed to Sri Lanka’s deepening fiscal and economic crisis in the years that followed.
The intended purpose of these series of major tax cuts aimed at boosting the economy, including slashing the VAT rate from 15% to 8% and reducing corporate and personal income taxes. Several other taxes—such as the PAYE tax, Nation Building Tax, Economic Service Charge, and Withholding Tax—were also abolished. While these measures were intended to encourage investment and ease the tax burden, they led to a sharp drop in government revenue, with total tax income falling by nearly 50% in 2020. Experts estimate that the country lost between Rs. 560 billion to Rs. 700 billion due to these cuts, severely weakening the government’s ability to fund public services and manage the economy.
Speechless NPP/JVP/AKD
Fortunately, the current government did not follow through on its election promise to remove taxes on essential goods such as food, medicine, and education-related items. Upon assuming office, they appear to have realised—albeit belatedly—that such a policy is neither fiscally practical nor compatible with the country’s economic realities. Moreover, adherence to International Monetary Fund (IMF) commitments and fiscal consolidation targets has likely influenced this course correction, reinforcing the need to maintain at least a minimal tax base on essential commodities.
Even the stalwarts of the National People’s Power (NPP), led by the JVP, are often left speechless when questioned by journalists about the feasibility of their campaign promises, particularly those lacking fiscal credibility. Similar to their eventual admission of responsibility for the 1988/89 insurrection and related violence, they now lack the courage to acknowledge their latest failure. After coming to power, they realised that the promises they made were neither practical nor sustainable—but instead of admitting their mistake, they continue to avoid accountability.
They also boast that they didn’t fail in six months as critics had predicted, but the truth is they would have undoubtedly collapsed had they kept the promises they made during the election. Their survival today is largely due to adopting centre-right economic policies—ironically, a complete departure from their own political ideology.
How Are Taxes Collected and Who’s Responsible?
The main agency responsible for collecting taxes in Sri Lanka is the Inland Revenue Department (IRD). They handle everything from registering taxpayers, to processing tax returns, and making sure that tax payments are made on time. The IRD also educates the public on how to comply with tax laws.
Alongside the IRD, other departments like Customs and Excise collect taxes on imported goods, fuel, alcohol, and tobacco products. These agencies work together to ensure the government receives revenue from different sources.
If you earn an income from an employment, rental properties, interest from fixed income earning securities such as fixed deposits/government bonds or run a business, it’s mandatory to register as a taxpayer. This involves submitting personal or business details to the IRD and receiving a tax identification number (TIN). Once registered, taxpayers must file returns (details of revenue and expenses) regularly, reporting their income and calculating the tax they owe.
However, many people find this process confusing, which is why the IRD runs educational programmes to help. For example, “Tax Week” is a special initiative where seminars, tax clinics, and registration drives are held to guide taxpayers through the process.
Challenges in Tax Collection
Collecting taxes isn’t always easy. Some taxpayers don’t fully understand their obligations, while others try to avoid paying taxes illegally. The IRD faces the difficult job of encouraging voluntary compliance while also enforcing penalties on defaulters.
To improve tax collection, authorities are investing in technology like online filing systems and digital payment options. These tools make it easier and faster for taxpayers to meet their obligations.
Efficient tax collection ensures that the government has the funds needed to deliver services and invest in development projects. When taxes are collected fairly and effectively, it builds trust between the public and the government.
Costs, Benefits, and Challenges of Collecting Taxes
It is very important to balance between spending money on tax collection and the revenue it generates. Collecting taxes might seem like a simple process — you pay, the government gets money. But behind the scenes, tax collection is a complex and costly operation. we’ll see how much it costs to collect taxes, why it’s worth it, and the challenges that come with the job.
Running a tax system isn’t free. The government spends money on staff, offices, technology, and systems to register taxpayers, process returns and enforce laws. There are also costs related to educating the public, handling disputes, and tracking down people who try to avoid taxes.
For instance, the Inland Revenue Department (IRD) of Sri Lanka has invested in digital platforms aimed at simplifying tax filing and minimising errors. Although these technological upgrades require significant upfront expenditure, they are intended to streamline processes and generate long-term cost savings. However, the full benefits of these investments have yet to materialise.
Balancing Cost of Administration/Tax Collection and Tax Revenue
A key challenge for tax authorities is balancing the cost of collecting taxes with the amount of revenue brought in. If it costs too much to collect taxes, it can reduce the net benefit to the government and society.
In some advanced countries like New Zealand, the tax collection system is known for its efficiency. The New Zealand Inland Revenue Department uses a mix of technology, clear communication, and fairness to keep costs low while maximizing revenue.
Despite the costs, effective tax collection is essential. It funds everything from hospitals and schools to roads and social welfare. More importantly, when people see taxes are collected fairly and efficiently, they are more likely to comply voluntarily. This voluntary compliance reduces enforcement costs and helps build trust between the government and citizens.
Tax authorities face ongoing challenges such as tax evasion, avoidance, and the complexity of tax laws. Educating taxpayers and simplifying tax processes are crucial steps in overcoming these problems. Not only is the transparency and fairness of tax law essential, but equally important is the way these principles are manifested in practice, as both are crucial for fostering taxpayer compliance and public trust. Therefore, we’ll look at recent cases of tax evasion and what they mean for Sri Lanka.
Why Fairness Matters
When it comes to taxes, fairness is one of the most important concerns for citizens. People want to know that everyone pays their fair share — and that the rules apply equally to all. But what exactly does fairness mean in taxation, and why does it matter?
A tax system is fair when it treats taxpayers equally and applies the law consistently. Fairness builds trust between the public and the government. When people believe the tax system is fair, they are more willing to pay their taxes voluntarily. On the other hand, if they think others are cheating or getting special treatment, compliance drops, and the government loses revenue.
Tax Evasion vs. Tax Avoidance
Many people confuse tax evasion with tax avoidance. Tax evasion is illegal — it means deliberately hiding income or falsifying information to pay less tax. Tax avoidance, on the other hand, uses legal methods to reduce tax liability, often by exploiting loopholes, treated as a legal way of “tax avoidance”, unethical though.
Until recently, Sri Lanka considered tax avoidance legal, while evasion was punishable by law. However, countries like New Zealand never treated aggressive tax avoidance as legal, closing loopholes through laws like the General Anti-Avoidance Rule (GAAR) to ensure fairness.
Recent Cases Highlighting the Importance of Fairness
Sri Lanka has witnessed a rise in high-profile tax evasion cases, underscoring the need for stronger enforcement mechanisms and clear legal frameworks to uphold fairness and protect compliant taxpayers. Notable cases include Randeniya Distilleries, fined Rs. 1.35 billion for deliberate tax avoidance, and W.M. Mendis & Co. Ltd., held liable for Rs. 3.55 billion in unpaid taxes, highlighting institutional efforts to curb evasion. However, the current campaign lacks robust enforcement strategies, risking reduced credibility if legal consequences are not consistently applied.
In contrast, New Zealand’s Inland Revenue Department exemplifies a balanced approach by integrating education with data-driven enforcement. Key legal precedents, such as Frucor Suntory (2022) and Penny and Hooper (2011), reaffirm the courts’ stance against tax avoidance schemes that undermine the intent of tax law. These cases demonstrate how transparent laws, and credible enforcement can foster compliance and trust in the tax system.
These cases illustrate New Zealand’s robust legal framework that deters tax avoidance through clear jurisprudence and the application of General Anti-Avoidance Rules (GAAR).
Learning from New Zealand
New Zealand’s tax system is often praised for its transparent, fair approach. The Inland Revenue Department takes a firm stance against both evasion and aggressive avoidance. Public education and consistent enforcement have helped maintain a high level of compliance and trust.
To improve tax fairness, Sri Lanka needs to update laws, increase transparency, and enhance taxpayer education. Fair application of tax law not only boosts revenue but also strengthens public confidence in the system.
The views and opinions expressed in this article are solely those of the author and do not necessarily reflect the official policy or position of the institution he works for. He can be contacted at saliya.a@slit.lk and www.researcher.com)
Features
A glimpse into future cholesterol control: A time without daily pills perhaps?

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka. Joint Editor, Sri Lanka Journal of Child Health
Section Editor, Ceylon Medical Journal
For millions of people worldwide, the daily ritual of taking a statin or other drugs to manage cholesterol levels is a fact of life. These powerful medications have dramatically reduced the risk of heart attacks and strokes, thereby transforming cardiovascular healthcare. However, the hassle of having to take these medicines every day is a cumbersome infringement on life itself.
Now, imagine a future where the burden of daily pills for this purpose could be replaced by a single, or at most, a few injections per year. This is NOT science fiction; it is the audacious goal of a new frontier in medicine, with revolutionary drugs currently undergoing rigorous clinical trials. These cutting-edge therapies are designed to act directly in the liver, targeting the very genetic instructions or enzymes responsible for producing “bad” cholesterol, potentially offering a more profound and long-lasting solution than ever before.
This appears to be the dawn of a new era with medicines that employ gene-silencing and enzyme-neutralisation techniques. The excitement surrounding these new treatments stems from their innovative approaches. Unlike traditional statins, which work by blocking an enzyme involved in cholesterol production, these newer drugs go further upstream, interfering with the body’s internal machinery that regulates cholesterol at a more fundamental level.
Two primary classes of these emerging therapies are making waves at present:
1. PCSK9 Inhibitors: A Deeper Dive
There are a few currently approved drugs that inhibit PCSK9 gene. But they require injections every two to four weeks. These antibody-based drugs work by binding to and neutralising a protein called PCSK9 (Proprotein Convertase Subtilisin/Kexin type 9), which acts like a “destroyer” of LDL receptors on the surface of liver cells. These LDL receptors are crucial for grabbing “bad” LDL cholesterol from the bloodstream and bringing it into the liver for processing and removal. By blocking PCSK9, these inhibitors allow more LDL receptors to remain active on liver cells, significantly boosting the liver’s capacity to clear LDL cholesterol from the blood.
The truly groundbreaking development now is a group of medicines that aim to permanently or durably turn off the PCSK9 gene itself. Instead of needing regular injections to block the protein, a single treatment could, in theory, silence the gene that produces it, offering a lifelong reduction in cholesterol.
One such investigational drug is VERVE-102, developed by Verve Therapeutics. This is designed to be a single-course treatment. It uses a modified technology to make a precise “edit” to the PCSK9 gene in liver cells, effectively switching it off. Early data from clinical trials have shown promising results, with participants achieving significant reductions in LDL cholesterol. For instance, in one cohort, a mean LDL-C reduction of 53% was observed, with a maximum reduction of 69% in a single participant. The long-term durability of this effect is what truly excites researchers, with the hope that such a treatment could eliminate the need for ongoing regular daily medication.
2. ANGPTL3 Inhibitors: A Different Angle
Another fascinating target is the angiopoietin-like protein 3 (ANGPTL3). This protein, primarily secreted by the liver, acts as an inhibitor of two key enzymes: lipoprotein lipase (LPL) and endothelial lipase (EL). These lipases are essential for breaking down triglycerides and processing lipoproteins, including LDL cholesterol. When ANGPTL3 is inhibited, LPL and EL become more active, leading to a reduction in triglycerides, LDL cholesterol, and even HDL cholesterol.
A monoclonal antibody drug called Evinacumab (Evkeeza) is an example of an ANGPTL3 inhibitor already approved for a rare genetic condition called homozygous familial hypercholesterolemia (HoFH), requiring monthly intravenous infusions. However, research is ongoing into one-time or infrequent dose ANGPTL3-targeting therapies, potentially using gene-silencing technologies similar to those for PCSK9. Some of these medicines have shown significant reductions in ANGPTL3 and various atherogenic lipoproteins in preclinical and early human studies with a single dose.
It is absolutely vital to reiterate that these revolutionary treatments are still in various stages of clinical trials. These trials are meticulously structured processes designed to ensure that any new medication is both safe and effective before it can be made available to the public. Before human trials begin, new treatments are extensively tested in laboratories and on animals to assess their basic safety and potential efficacy. Then come Phase 1 Trials, which are the first human tests, typically involving a small group of healthy volunteers (around 20-100 people) or patients with the condition. The primary goal is to assess the drug’s safety, determine a safe dosage range, and identify common side effects. For gene-editing therapies, these initial phases are particularly critical to monitor for any unintended genetic changes or off-target effects.
Then, Phase 2 Trials follow. If a drug proves to be safe in Phase 1, it moves to Phase 2, involving a larger group of patients (typically 100-300) who have the specific condition the drug aims to treat. The focus here is to evaluate the drug’s effectiveness and continue monitoring for side effects. Researchers fine-tune dosages and study how the drug impacts the disease.
Then it graduates to Phase 3 Trial. This is the most extensive and crucial phase, involving hundreds to thousands of patients over several years, often across multiple international sites. In Phase 3, the new treatment is compared against existing standard-of-care treatments or a placebo (an inactive substance) to confirm its efficacy and safety on a larger scale. This phase generates the robust data needed for regulatory approval.
The final stage are Phase 4 Trials. Even after a drug receives approval and enters the market, Phase 4 trials continue. These are post-marketing surveillance studies that monitor the drug’s long-term effects, identify any rare side effects that may not have appeared in smaller trials, and explore new uses or populations.
For gene-editing therapies like VERVE-102, the journey through these phases is even more closely scrutinised due to the permanent nature of the genetic changes they induce. While early results are exciting, only successful completion of large-scale Phase 3 trials and ongoing Phase 4 monitoring will fully confirm their long-term safety and effectiveness. Companies like Verve Therapeutics are planning to move into Phase 2 trials for VERVE-102 in the second half of 2025, a significant step forward.
Will all these new developments lead to an “Economic Earthquake” and a Shake-Up for the Pharmaceutical Industry? The potential advent of one-time or very infrequent cholesterol treatments carries enormous implications, not just for patients but also for the multi-billion-dollar pharmaceutical industry.
Statins have been one of the most successful drug classes in history, generating immense revenues for pharmaceutical companies over decades, the so-called Statin Empire.. They are widely prescribed, often for life, creating a consistent market. The prospect of a single-dose cure could, in the long run, significantly shrink this market.
Developing gene-editing therapies and complex biologic drugs like these new cholesterol treatments is incredibly expensive, requiring massive investments in research, development, and clinical trials. To recoup these costs and generate profit, these drugs are expected to command extremely high prices, at least initially. Existing PCSK9 inhibitors, for example, were initially priced around $14,000 per year, though costs have since decreased. A one-time gene-editing therapy could potentially run into hundreds of thousands of dollars per patient.
Healthcare systems and insurance providers will face a monumental challenge in determining how to pay for such expensive, high-impact treatments. While a one-time treatment might be cost-effective over a patient’s lifetime compared to decades of daily pills, the upfront cost can be a major barrier. This could lead to intense negotiations between pharmaceutical companies and payers, and potentially restricted access for patients.
Pharmaceutical companies that have historically relied on chronic, daily medications might need to undertake a pivotal change in their business strategies. The focus could shift from high-volume sales of inexpensive pills to lower-volume, high-value, transformative gene therapies. This requires different manufacturing capabilities, distribution networks, and marketing approaches and most importantly, are likely to be very expensive.
Beyond the economics, the high cost raises significant ethical questions about equitable access. Will these life-changing therapies only be available to those with comprehensive insurance or significant financial resources, creating a two-tiered system of care? This is a critical societal discussion that will undoubtedly unfold as these drugs get closer to the perennial drug market.
Epilogue
This author believes that our attitude to all these promulgations will need to be one of “Hope on the Horizon, Caution in the Present”. The research into one-time cholesterol-lowering injections is undeniably thrilling. The idea of a treatment that could potentially offer lifelong protection against cardiovascular disease with minimal ongoing effort is a medical dream. They would represent a paradigm shift in how we approach chronic diseases, moving from symptom management to root-cause intervention through genetic or enzymatic targeting.
However, it is paramount and absolutely vital for the public to understand that this future is not here, not as yet. These drugs are still experimental, undergoing rigorous scrutiny in clinical trials to ensure their safety and efficacy over the long term. While the early data is highly encouraging, the full picture of their benefits, potential risks, and accessibility will only become clear in the coming years.
For now, the message remains consistent. Work closely with your healthcare provider to manage your cholesterol, using established, approved therapies and healthy lifestyle choices. But keep an eye on the horizon: the landscape of cholesterol treatment is on the cusp of a truly revolutionary transformation.
This article was written with some
assistance from Artificial Intelligence.
Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lond), FRCPCH(UK), FSLCPaed, FCCP, Hony. FRCPCH(UK), Hony. FCGP(SL)
Features
UN’s challenge of selective accountability without international equity

Despite the prevalence of double standards in international practice, it remains in Sri Lanka’s national interest to support the principles and implementation of international law. The existence of international law, however weak, offers some level of protection that smaller countries have when faced with the predatory behaviour of more powerful states. For this reason, the Sri Lankan government must do all it can to uphold its prior commitments to the UN Human Rights Council and implement the promises it has made to the fullest extent possible.
The visit of UN High Commissioner for Human Rights, Volker Türk, later this month may possibly be overshadowed by the eruption of hostilities in the Middle East following Israel’s attack on Iran. The High Commissioner’s visit to Sri Lanka relates to the series of resolutions passed by the UN Human Rights Council over the past sixteen years since the end of the war. It will highlight the contradiction in the rules-based international order when geopolitical interests override legal commitments. These resolutions highlight the importance of protecting human rights during times of conflict and ensuring accountability for war crimes. They are part of the enduring legacy of international human rights and humanitarian law, as exemplified by the Geneva Conventions and the global post-war consensus that atrocity crimes should not go unpunished.
The High Commissioner’s visit is likely to provoke criticism that the United Nations is pursuing Sri Lanka’s adherence to international norms with greater zeal than it shows toward violations by more powerful countries. There appears to be acquiescence, indeed even tacit approval, by influential states in response to Israel’s military actions in both Iran and Gaza on the grounds of existential threats to Israel. Similar military actions were taken in 2003 by the US and the UK governments, among other international powers, to destroy weapons of mass destruction alleged to be in Iraq. One of the central arguments made by critics of the UN’s engagement in Sri Lanka is that double standards are at play. These critics contend that the United Nations disproportionately targets weaker countries, thereby reinforcing an international system that turns a blind eye to powerful countries and, in doing so, undermines the credibility and coherence of global human rights standards.
The arrival of the High Commissioner is also likely to reignite internal debate in Sri Lanka about the purpose and legitimacy of UN involvement in the country. The question is whether international standards effectively contribute to national transformation, or do they risk being reduced to symbolic gestures that satisfy external scrutiny without generating substantive change. There will be those who regard international engagement as a necessary corrective to domestic failings, and others who see it as an infringement on national sovereignty. The question of accountability for war crimes committed during the three-decade-long civil war remains a deeply divisive and sensitive issue. Sri Lanka, with its own complex and painful history, has the opportunity to lead by example by reckoning with the past unlike many other countries who justify their atrocities under the veil of national security.
International Breakdown
The modern international system emerged in the wake of two catastrophic world wars and the recognised failure of early twentieth-century diplomacy to prevent mass violence. At its core was a collective pledge to establish a rules-based international order that could maintain peace through law, institutional cooperation, and multilateral governance. The development of international human rights and humanitarian law was most pronounced in the aftermath of the mass atrocities and immense human suffering of World War II. The powerful nations of the time resolved to lead a new global order in which such horrors would never be repeated.
This vision of a rules-based international order as a safeguard against a return to the law of the jungle, where power alone determined justice was institutionalised through the United Nations, the Geneva Conventions, and the establishment of international courts such as the International Court of Justice and the International Criminal Court. However, this international system has come under increasing strain in recent decades. Recent events show that it no longer functions as originally envisioned. In practice, the consistent application of international law, regardless of the status or power of a state, is frequently compromised. The selective enforcement of legal norms, particularly by powerful countries, has eroded the legitimacy of the system and calls into question the universalism at the heart of international law.
At present, at least three major international conflicts taking place in Ukraine, Gaza, and now the confrontation between Israel and Iran, illustrate a sustained breakdown in the enforcement of international legal norms. These conflicts involve powerful states that openly defy legal obligations, with the international community, especially its more influential members, often remaining conspicuously silent. Only a handful of countries, such as South Africa, have chosen to raise issues of international law violations in these conflicts. The broader silence or selective rationalisation by powerful countries has only reinforced the perception that international law is subject to political convenience, and that its authority can be subordinated to geopolitical calculation. Earlier examples would include the ruination of prosperous countries such as Iraq, Libya and Syria.
Uphold Consistency
The Sri Lankan situation illustrates the importance of preserving an international legal system with mechanisms for credible and impartial accountability. Sri Lanka, so far, has been unable to address the issues of accountability for serious war-time human rights violations through internal mechanisms. However, the broader lesson from Sri Lanka’s experience is that international norms ought not to be applied selectively. If global institutions aspire to uphold justice by holding smaller or less powerful countries accountable, they must apply the same standards to powerful states, including Israel, Russia, and the United States. Failing to do so risks creating the perception that the international legal system is an instrument of coercion and selective punishment rather than a foundation for equitable global justice.
Despite the prevalence of double standards in international practice, it remains in Sri Lanka’s national interest to support the principles and implementation of international law. The existence of international law, however weak, offers some level of protection that smaller countries have when faced with the predatory behaviour of more powerful states. For this reason, the Sri Lankan government must do all it can to uphold its prior commitments to the UN Human Rights Council and implement the promises it has made to the fullest extent possible. In multilateral forums, including the UN, Sri Lanka must reassert these commitments as strategic assets that help to defend its sovereignty and legitimacy. At the same time, Sri Lanka needs to take up the challenge of using these international platforms to highlight the problem of selective enforcement. Sri Lanka can contribute to the broader call for a more principled and consistent application of international law by demonstrating its seriousness in protecting vulnerable populations and position itself as a responsible and principled actor in the international community.
Engaging with the past in accordance with international standards is also essential for Sri Lanka’s internal reconciliation and social cohesion. The principles of transitional justice—truth, accountability, reparations, and institutional reform—are not only universally applicable but also critical to the long-term development of any post-conflict society. These principles apply across all contexts and periods. If Sri Lanka is to evolve into a united, stable, and prosperous country, it must undertake this process, regardless of what other countries do or fail to do. Only by acknowledging and addressing its own past can Sri Lanka build a future in which its multi-ethnic and multi-religious character becomes a source of strength rather than weakness.
by Jehan Perera
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