Sri Lanka's health system crumbles amid lack of basic drugs

Collapse of tourism revenue, rise in global commodity prices and high national debt sparks sharp economic decline

The Sri Lanka National Hospital in Colombo. Across the island nation, medical supplies are becoming scarce. Reuters

Sri Lanka’s health system is the latest casualty of a worsening economic collapse which has led to chronic shortages of food and fuel amid surging national debt and a sharp rise in the worldwide price of vital commodities.

Life-saving cancer drugs are running out and hospitals have been forced to cut back standard medical procedures, focusing on accident and emergency treatment.

Even basic medical equipment is in short supply and single-use medical items are being sterilised and reused, Reuters reports.

The government has less than $2 billion worth of foreign exchange reserves, equivalent to about one month of imports, but faces significantly higher debt repayments.

The lack of foreign exchange has left President Gotabaya Rajapaksa's government unable to import essentials; fuel shortages are causing crippling power cuts and bringing thousands of protesters on to the streets demanding his ousting.

The economy, which relies heavily on tourism, has been devastated by the Covid-19 pandemic and hit by the sharp rise in oil prices after Russia's invasion of Ukraine, which has made importing enough fuel unaffordable.

Some analysts have criticised Mr Rajapaksa's government for its decision in 2019 to make deep tax cuts and delay talks with the International Monetary Fund (IMF). Those negotiations are now going ahead.

A close aide to Mr Rajapaksa has said previously that the tax cuts had been designed to boost the economy but that Covid-19 then struck.

The Sri Lanka Medical Association, the country's oldest professional medical body, wrote to Mr Rajapaksa last week warning him that even emergency treatments may have to be stopped in the coming days.

"This will result in a catastrophic number of deaths," the association said.

Saman Rathnayake, the secretary of Sri Lanka's Pharmaceuticals Ministry, said the government’s currency devaluation and rising debt means there is no quick fix. "This will not end in two months. The dollar crisis will go on."

But he said new sources of supply could help to alleviate immediate shortages.

Some medicines ordered through a credit line with neighbouring India, which supplies 80 per cent of the island's requirement, would likely arrive within two weeks.

"If this Indian credit line works, there won't be an issue for the next six months," Mr Rathnayake said.

Beyond that, Sri Lanka has sought help from the World Health Organisation, the World Bank and the Asian Development Bank.

"Their things will come after six months," he said. "That is how we've planned."

Desperate for supplies, some doctors' groups have made public appeals for donations.

Running out of endotracheal (ET) tubes used to help newborn infants with respiratory distress, the Perinatal Society of Sri Lanka issued a list of supplies that can be donated via the Health Ministry.

"We have almost used all the stocks and no ET tubes will be available in few weeks," the society's president Saman Kumara said in a letter shared on social media.

"I have instructed [staff] not to discard used ET tubes but to clean and sterilise them from now onwards as we may have to reuse them."