Drugs running out, surgeries cancelled as Sri Lanka's health system buckles

Rosanne White was first diagnosed with cancer eight years ago and lost a kidney. After the cancer returned five years ago, an oncologist in Sri Lanka's commercial capital Colombo started her on Bevacizumab last May, a treatment she was responding to.

White, a 58-year-old Sri Lankan retiree, said she had received the injections free of charge as part of the country's universal government health system, which the vast majority of its 22 million people depend on.

But after 13 rounds of treatment, White said she now cannot find the injection in government hospitals.

Bevacizumab costs 113,000 Sri Lankan rupees (US$359) per shot in the private market and, because she does not have insurance, White said the costs were eating into her limited savings.

"We have to call the hospital before going in for treatment to find out if our medication is available," White told Reuters. "But what do you do when the nurses say the hospital doesn't have the medication?"

White's struggle to find Bevacizumab in state-run facilities is an early sign of how Sri Lanka's healthcare system is close to collapse, under the weight of the island nation's worst economic crisis. As well as shortages of vital drugs, some procedures and tests have been suspended.

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

Reuters spoke to two government officials, six doctors and a healthcare union leader who said they had not seen Sri Lanka's health system in such a bad way before.

An internal memo from a major state-run hospital in Colombo seen by Reuters said that only emergency, casualty and malignancy surgeries would be conducted from Apr 7 onwards because of a lack of surgical supplies.

Sri Lanka's health ministry did not respond to detailed questions from Reuters about the problems facing the sector.

The economy, which relies heavily on tourism, has been devastated by the COVID-19 pandemic and hit by the sharp rise in oil prices in the wake of the war in Ukraine, which has made importing enough fuel unaffordable.

Some analysts have also criticised Rajapaksa's administration 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 the Rajapaksas has said previously that the tax cuts had been designed to boost the economy, but that COVID-19 then struck.

Sri Lanka now has just US$1.93 billion in foreign exchange reserves, the equivalent of less than a month's imports, while government debt repayments of twice that amount are due in 2022.

The Sri Lanka Medical Association, the country's oldest professional medical body, wrote to 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.