Patients at the receiving end of drug companies

By Uditha KUMARASINGHE

One-time Director of the Medical Research Institute Prof.Tissa Vitarana throughout specialised in medical research. In later years he ventured into the cauldron of turbulent politics, perhaps to carry forward the mission of his kinsman, Trotskyite guru Dr.N.M.Perera. Senior Minister for Scientific Affairs Prof. Tissa Vitarana told the Sunday Observer that there are people in Tamil Nadu who treat the problems affecting the Tamils in Sri Lanka as a matter of concern for them. They want to make political capital out of it by pretending to be the saviours of the Tamils and demanding even a separate state for them.

The Minister said if one were to look at what is happening in Tamil Nadu itself, it is clear that the majority of the people in Tamil Nadu don't want to separate from India. They don't stand for separatism. If at all, It is only a very small minority who hold that view. Therefore, there is no reason as to why we should not satisfy the aspirations of our people. We can achieve that through devolution and that is the best way to prevent separatism.

He said people are now beginning to think on national lines and not on narrow communal lines. It gathers momentum. The Minister is confident that the socialist parties will become powerful again. The LSSP brings people together across the communal divide as one Sri Lankan nation. The socialist parties advocate that the people should abandon this communal frame of mind and think on national lines.

Excerpts of the interview:

Q: As a specialist in medical science, how do you explain the importance of a national Medicinal Drug Policy to the country by which exploitation of poor patients could be checked? What is the delay in implementing this policy?

A: The Medicinal Drug Policy that is suitable for our country and for all third world countries was developed by Prof. Senaka Bibile long ago and we began its implementation during the 1970 coalition Government.

This policy which has now been accepted by the World Health Organisation and the United Nations is being applied in over 90 countries in different parts of the world.

It is said that in Sri Lanka where it originated due to the efforts of Prof. Senaka Bibile is still not properly implemented. The basis of this national drug policy is that there is an essential list of drugs which has since increased to about 350 different medicines which could treat all illnesses that affect the people.

These essential drugs could be bought at the cheapest possible price ensuring good quality by following the procedure of calling for worldwide tenders for generic drugs. Generic drugs means the medicines which are identified by their pharmaceutical name for a particular illness.

Each of these drugs can be produced by different companies. What happens in practice is that each company gives its own brand name to their product and fixes its own price. Through advertisements they secure as much markets as possible. Therefore, there is a big competition among these drug manufacturers. The bigger companies who have better advertising and marketing practices win over the doctors and the public to sell their products even though they are more expensive.

As we know a patient's life is more important. If a doctor prescribes a particular medicine in its brand name, however expensive it is, the patient will buy it. So multinational drug companies sell their products by winning over doctors and compelling patients to buy expensive drugs unnecessarily.

To overcome this problem, Prof. Senaka Bibile said that we should give the generic name and advertise worldwide.

Then you will get the manufacturers who produce generic drugs which are much cheaper. So he set up a procedure whereby anyone eligible to tender should be able to produce a certificate of good manufacturing practice for his product.

You could buy good quality generic products, at the lowest prices by an open tender procedure. That is the practice that should go into a good national drug policy.

To do this properly, there must be an independent drug regulatory authority to decide what is best for the patient and what is good from the point of view of efficacy.

Q: Will devolution of power be a workable solution so long as Tamil Nadu jingoists are all out to instigate Eelamists to seek their far-flung dream?

A: If you look at the history of this whole problem in Sri Lanka, there was a time when the Tamil speaking people only wanted their Tamil language to be made an official language along with Sinhala. Later it became a racial problem and blew up to this level because Tamil language was denied an official language status.

Then it became the question of dignity, rights and the ability of the Tamil people to decide on matters that concerned them by themselves. It went to the extreme where they felt that they couldn't get it within a unitary state. So this is the situation which has to be changed. They want to share power and decision making where it concerns.

India doesn't want separatism. They will do everything possible to prevent separation in Sri Lanka, because if that infection catches on India, then it would lead to break up whole of India into small states. India will help Sri Lanka to remain as one united country and as such we have nothing to fear from India.

There are people in Tamil Nadu who see the problems affecting the Tamils in Sri Lanka is a matter of concern for them. They want to make political capital out of it by pretending to be the saviours of the Tamils here and even demanding a separate state.

The majority of the people in Tamil Nadu don't want to separate from India. They don't stand for separatism except for a very small minority who hold a dissenting view.

Q: Even after power devolution what prevents another band of powerful Tamil terrorists apparently with foreign support unleash a reign of terror in pursuit of Eelam?

A: As I told you earlier, if you don't give a share of power, that dissatisfaction builds up among the Tamil people will be exploited by these people who are a very small minority who wants separatism. We must not allow Tamil people once again to be misled and made the scapegoat of wrong policies in our country.

Q:In the context of human rights, do you think imposing solutions from without would amount to interference with the sovereignty of nations where countries have their own democratic mechanisms?

A: Yes certainly. The human rights issue has been made into a weapon for powerful countries such as US, UK and many European countries to exercise control over smaller countries by raising the issue of human rights. The US, UK and European countries who talk loudly about the protection of human rights, have been the biggest violators of human rights historically. Even though they forget that, they continue to be the violators of human rights because they control the media and it is put under the carpet.

When a small issue arises relating to any country that does not bow down to their policies, then they make use of this human rights weapon to attack that country.

The classic example is Vietnam. The Americans bombed this small country using more bombs than what were dropped on Europe during the second World War. In addition, they used toxic chemicals and Agent Orange to destroy the foliage to detect and kill Vietnamese soldiers.

The whole history of Vietnam war was a complete violation of human rights. Up to now no compensation have been given for what they have done.

There are hundreds of thousands of Vietnamis who have fallen ill as a result of the use of the Agent Orange. If there are small issues or differences between Buddhists and Catholics in Vietnam, they claim that there is human rights violations and exert pressure on Vietnam.

This is the type of policy which these countries follow. When Sri Lanka follows an independent foreign policy and ends the terrorist war and their "divide and rule" policy which they would like to perpetuate in our country, they react against us using this human rights issue. It is very sad to see Opposition Leader and various other Opposition MPs trying to encourage these foreign forces to meddle in our affairs. We should try to prevent it at all cost.

Q: New legislation on election laws have proposed the system of First-Past-the-Post 70 percent and 30 percent Proportional Representation, doing away with much abused "manape". Could you explain its benefits to the country?

A: The Present electoral system was introduced by the 1978 constitution. The whole purpose of this constitution was to enable multinational corporations and big powers to exploit our economy.

This neoliberal economic exploitation required that the people should not be able to protest against the harm done to them as a result of the exploitation of our economy. It simply means that multinational corporations from America or Europe should be allowed to make full use of our raw materials and our labour at cheapest possible rates and get the profits out of exporting these products.

Earlier under the First-Past-The-Posts system, there was an elected representative for each electorate and the people could go to him to get their problems sorted out. It may be at local body level or Parliamentary election level.

At present, the whole district is the electorate at Parliamentary level. If you take even Pradeshiya Sabhas, the whole division is the electorate so that there is no one particular person representing the voters and take responsibility for their problems.

As a result of this system, the distance between the voters and the elected representatives has been widened tremendously. The voters have to elect either a very powerful person or a very rich person. Under the old electoral system where there are smaller units, even the poor candidates can be elected to represent the people. So you will not have the type of malpractices come up and the corruption will be far easier to the controlled. The elected representative under the observation of the voter can't run riot.

Q: Will not the settlement of FUTA strike with salary increases have its domino effect on other professionals such as doctors, engineers or architects?

A: FUTA salary increase is one aspect of their issue. They have raised various other issues on education itself, higher education autonomy and sufficient financial allocation for higher education.

Higher salaries to doctors, lecturers and university professors are given to prevent the brain-drain. Today nearly half of those who obtain post graduate qualifications are leaving the country. Since the salaries here and abroad are so different.

The working conditions are also different. Anyone who, leaves the country is tempted to stay abroad. So we have to pay a reasonable salary-not necessarily what they get in a developed country-to enable them to build a knowledge economy.

We cannot build a knowledge economy without having quality university teachers. This the problem which confronts the country. Here we have to accept the fact that there will be salary differences. There will be those who will have to be paid because of their special contribution to the economy and the society.

That is what has to be recognized and accepted. In this context, we have to be realistic and see how we can ensure a good quality university education for our children. The question you raised is whether that will have a domino effect on others. My view is that depending on the contribution to develop knowledge economy and to the development of our economy in general, these people should be rewarded.

If it is all right for an entrepreneur to make millions using his entrepreneurial skills, here there are people with special scientific or other skills which they have acquired through extra learning and research who need to be rewarded because of the contribution they make. I am one as a socialists who stands for a society where there will be no real salary anomalies.

In today's capitalist world, there are more inequalities. We have to make use of those inequalities in a way that it will improve our society. Therefore, we have to accept that university lecturers have to be paid more than teachers in schools and other grades of blue collar workers in other sections of the economy. If we are to move forward, that fact has to be accepted by the society.

Q: Marxist parties have ceased to be the voice of workers as well as peasants. The LSSP led strikes are only a vestige of a bygone era. What has gone wrong with these socialist parties?

A:Socialist parties in Sri Lanka have suffered from two major factors. One is the worldwide advance of neoliberal and capitalist thinking and the collapse of the Soviet Union, causing a setback to socialism which became a dirty word. If you look at socialist parties throughout the world, they all had setbacks.

It is only now starting with Latin America that socialist parties are moving ahead to capture power once again. More than half of the governments in Latin America are now socialist-led or socialist- centered. This reversal take place worldwide as the capitalist economies have begun to collapse. There is a deep economic crisis in the capitalist system and the next step would be the socialism. In Sri Lanka too, it will be likewise.

The pro-Sinhala members of the LSSP left the party on the language issue and joined the SLFP. The SLFP grew up at the expense of the LSSP and the CP. Similarly with regard to Tamil communal politics there was the development of the Federal Party.

Tamil people who were the supporters of the socialist parties-LSSP and the CP left them and joined the Federal Party. So there was a loss on both sides.

The results of communal politics which is still there in our country is very unfortunate. We are against communal politics. Unfortunately so long as the people think on communal lines, we are going to be divided and we have no future as a nation.

We will go on fighting and there will be conflicts as we saw in the last 30 years. So if we don't get together which is the policy that the socialist parties are advocating and we have to get the people to abandon the communal frame of mind and think on national lines. Now people are beginning to think on national lines and not on narrow communal basis. That process gathers momentum . I am sure that the socialist parties will grow and become powerful parties once again.

Q: As a Senior Minister would you like to talk about the present "stand off" between executive and judiciary?

A: All I would say briefly is that Leader of the LSSP Dr. N.M. Perera has written a booklet, "A critical analysis of the 1978 budget". In that booklet, he made it very clear that so long as you have a executive presidential system with this tremendous amount of power which has been given to the Executive President through the constitution there could be a conflict among the executive, legislature and judiciary.

In his booklet, Dr. N.M. Perera made it very clear that before long invariably there will be conflicts arising among these three arms of government. That is what we are interesting today.

The problems that are confronting us today arise from the 1978 constitution. It is time to change this constitution and introduce a new constitution which will unite our nation as one Sri Lankan nation by addressing the national question. We should have a constitution that will give power to the people and devolve power right down to the village to empower the people and also to get rid of the executive presidency-and make sure that the executive comes under the control of parliament returning to a Prime Minister-led Cabinet system controlled by Parliament. Once we do that, we will be able to prevent this type of separation of powers which are leading to conflicts due to this constitution.

Q: Have you not groomed any of your kinsmen to pass the mantle of your distinguished uncle, the financial wizard Dr. N.M. Perera?

A: I am sure there are very bright young people and given the opportunities, there will be N.M. Perera's coming up from the LSSP and also from other parties as well.