Delay in not ordering Covid vaccines will cost Sri Lanka millions extra

Special commodity levy on essential food and on face masks

Sri Lanka has been one of the most vaccinated countries in the world since 1947.  According to former Deputy Vice President of the WHO Rajitha Senaratne the country’s inoculation rate was 99. 9 percent and the USA was behind Sri Lanka at 99. 2 percent.  During the war with the LTTE its leader Prabakaran agreed to a two day ceasefire to carry out a vaccination program in the North.  The people who came from Nandikadal during the final stages of the war may not have been carrying much but they had their vaccination card which shows the level of awareness they had about the importance of being vaccinated. Sri Lankan governments operated an excellent system to bring down vaccines, distribute and administer them through nearly 300 Medical Officer of Health divisions. Each division had a Medical Officer of Health, a public health nurse and a Public Health Inspector. There was a midwife for every GramaNiladari division.  This was the set up until the last change of government. Today, it is unclear if these structures still exist and Sri Lanka is no more at the vaccination pinnacle. Millions of citizens are living in suspense not knowingwhen or if at all they will get a Covid vaccine and hundreds of thousands are waiting in angst not knowing when they will get their second dose of the Astra Zeneca vaccine. A large number among them have already passed the date on which their second dose became due. Last week they rushed to the Lady Ridgeway Hospital in Colombo as word spread that the vaccine was being given there. A minority whogot to the Hospital early were able to walk in and get the vaccine while the majority had to stand in queues for hours and were still not able to get the vaccine. A few days later word gotround that the vaccine was being administeredat the Eye Hospital in Colombo.  Once again people rushed to the location where the queue was long and winding only to be told that the vaccination program that day was for doctors and their families. The legitimate question here is why there was a queue if so, especially in light of reports that those who did not belong to either of these two categories got the injection on that day.

The country’s vaccination program is riddled with gaping holes because of a blatant violation of WHO guidelines for vaccine prioritization. According to these guidelines the vaccine mustbe given to frontline health workers, armed and security forces, people aged over 60 who have non communicable diseases, people aged over 60 without non communicable diseases, those aged between 50-60 and the rest of the population thereafter. The guidelines were issued because of the inevitability of the demand for vaccines exceeding supply with countries rushing to secure their quotas. Instead of following these guidelines the vaccines are being administered Willy nilly at the behest of government MPs and acolytes while hapless medical officers at vaccination sites look on. This politicization of the vaccine program has contributed significantly to the shortage of Astra Zeneca vaccines for the second dose. According to reliable sources, the Astra Zeneca vaccines which are reserved for the second round arebeing used as a first dose for some. Assurances by ministers that the government will even mix and match vaccines to ensure people get it is even more worrying as administering combinations of vaccines is yet to be approvedby the regulators. Not having a roadmap to administer the vaccine and not being transparent about whom the vaccine has been given to hasresulted in the government opening itself to accusations of the perennial cronyism which has become solidly entrenched. Last week the Mayor of Moratuwa Samanlal Fernando was remanded after he obstructed a Medical Officer of Health from giving the vaccine to people who had queued for it at the vaccination centre. He threatened to scupper the vaccination program if the 600 vaccines which were allotted for it were not administered to those he had earmarked by stamping his seal on the tokens which reportedly had been handed out. Informed sources said it was not the first time the mayor had behaved this way.  The Lankasara reported that the mayor has been able to act this way because he has the backing of Namal Rajapakse.  It reported how Minister for Road Development Johnston Fernando is also operating a similar token system in Kurunegala which will be one of three districts together with Galle and Matara where the vaccine will be administered when the program is rolled out of the Western province.  There has been no official reason given for the selection of Kurunegala which is the electoral district of Prime Minister Mahinda Rajapakse nor for that matter the choice of the two other districts which are in the South of the country and close to the Prime Minister’s hometown of Hambantota. Meanwhile, a news report which emerged in the Colombo Telegraph two weeks ago about the alleged theft of vaccines by Health Minister PavithraWanniarachchci’s husband is yet to be refuted.

The inevitability for the government is stark. The peoples’ mistrust in it is becoming deep -seated and public confidence is plummeting. ‘The fundamental issues here are people and trust. Its systemic’, explains a legislator in the opposition Eran Wickramaratne ‘To implement policy you need the right people.  It’s the same with delivering a message and administering the vaccine. You need the right messenger for the message. It has to be a health professional who is accepted and trusted by the people. Politicians must not get involved in the vaccine programwhich should be left to health officials to administer’.  

The light at the end of the tunnel for Sri Lanka’s vaccination program is a dim one as there is no certainty from where the country will secure the vaccines it needs, when they will be available and whether they will be available when they are needed to complete the vaccine cycle.  The reality is that Sri Lanka only has the promise of vaccines and nothing in hand except for the 500, 000 Sinopharm doses which arrived in the country last week.

The government’s incompetence at cultivating robust foreign relations get highlighted when sources relate accounts of how some western states have slammed the door on its face when it tried to negotiate for the vaccine and directed it instead to Covax. While the government is trying to purchase the vaccine through official channels, the opposition is also reportedly negotiating for it by capitalizing on the enduring relations it has with the international community.  

The government’s lost opportunities to secure the vaccine have now become legendary.  While other countries were pre ordering vaccines for their citizens, sometimes in multiples of the required numbers to ensure they have a buffer, the Sri Lankan government has been accused of promoting the Dhammika Paniya which was not medically endorsed and relying on vaccine handouts to fight the virus. Of the vaccines received so far, Sri Lanka has purchased only 500, 000 vaccines from India.  The rest have been donations from India, China and the Covaxfacility.  

The delay in pre ordering the vaccine will blow a hole in Sri Lanka’s almost empty coffers despite proclamations to the contrary by Minister Fernando and Sports Minister NamalRajapakse that the country has enough money. Ironically Minister Fernando is now going round with the begging bowl asking wealthy Sri Lankans to cough up money to purchase the Astra Zeneca vaccine, reportedly from a country in the Middle East, at US$ 20 each.  Sources point out had Sri Lanka pre ordered the Covishield vaccine, produced at the Serum Institute in India under license from Astra Zeneca, it could have been purchased for US$ 2. 15 each. The government eventually had to pay US$ 5.25 dollars for a vaccine, which is more than double, when it bought it from India. Both the Sputnik V which costs around US$ 9.95 dollars each and Sinopharm which costs about US$ 76 dollars each could also have been bought for less if they had been pre ordered said the source.  Sri Lanka needs approximately 15 million vaccines and two rounds will make this 30 million.  What would have cost Sri Lanka around US$ 65 million will now cost more than double and the burning question is if the country has money to spend on the required quantity of vaccines.      

The absence of medical professionals in the frontlines of the country’s fight against Covid is becoming increasingly discernible and is not only a cause for criticism but more of concern. The magnanimity which drove German Chancellor Angela Merkel to say that she will leave the fight against Covid to doctors and scientists has hardly rubbed off here. At the start the government resisted acceding to the demands of the collective of medical associations for a continuous 14 day lockdown to break the cycle of the virus without allowing it to perpetuate. It was only last week that the government subsequently came round and agreed to it although why it did not do so earlier is anybody’s guess. As Wickramaratne put it, its better to err on the side of the health professionals and go in for a major containment to arrest the situation because the cost to the economy will be greater if not. However, the responsibility does not stop there as there will have to be absolute clarity about what measures are needed beyond this in the next three months and how they will be implemented.

Last week the leader of the Janatha VimukthiPeramuna asked the President and the government for an inquiry into how the country’s Covid situation degenerated to where it is now.  

Public confidence in the government took a further bashing after news broke of its plan to import 227 luxury vehicles at a cost of more than two billion rupees for parliamentarians to carry out their work. Either because it realized its faux pas or to throw people off the scent, a subsequent statement from the Prime Minister’s office crowed that the decision had been revoked following the Prime Minister’s intervention. Given the government’s mastery at subterfuge the denial will hardly suffice to convince people that the deal is off especially with speculation being rife that it may not be able to cancel the Letters of Credit which have already been opened by the leasing arm of the Bank of Ceylon through whom the government had been planning to buy the vehicles to circumvent the ban on importing vehicles.

The government’s decision to impose a special commodity levy on a range of essential food items and face masks will add  to the peoples’ already burgeoning economic woes.   The levies which are being introduced to protect the country’s dwindling foreign reserves will come into effect retrospectively from 18 May. Levies of between one and 800 rupees were imposed on legumes such as chickpeas and split peas, dried chilli, red onions, garlic, spices, apples, dried lemons, yoghurt and grapes.  A 100 rupee levy was slapped on, on a kilo of face masks which was the only non- food levy. (SW)  

 

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