Johann De Zilwa urges authorities to upgrade the state healthcare sector
Compiled by Yamini Sequeira

Q: Was Sri Lanka’s healthcare sector positioned to cope with a global pandemic?

A: COVID-19 is the defining global health crisis of our time. Although it was predicted that developing nations would find it a struggle, Sri Lanka has coped well with the pandemic thus far compared to the more advanced healthcare systems in the world.

Outpatient facilities are readily available to the public in government clinics and hospitals situated in major towns and cities. Laboratory and radiology facilities are also provided by various hospitals throughout the country.

Although we have a universal healthcare system that extends free and subsidised services, much more investment is needed for infrastructure, and the procurement of advanced technology and diagnostic equipment.

However, there is growing concern that the rising numbers of COVID-19 cases will take much needed attention away from the treatment and surveillance of routine communicable diseases in the public healthcare sector.

Q: What is your assessment of the nation’s response to the pandemic? Do you believe there is adequate compliance?

A: The pandemic was controlled very well during the first wave in March-April last year. However, there was a lapse in compliance by a large number of individuals (including some corporates), which led to the second wave gathering momentum.

The adverse economic impact on the country following the first wave was notable so people realised that the fallout may be far worse than the disease itself. And this led to many organisations recalling employees to the workplace without taking adequate precautions to mitigate or stop the spread of COVID-19.

Avoiding infection as much as possible is my best advice even as new drugs and treatments are being discovered, to help control the spread and reduce mortality – especially among the elderly and immunocompromised, and anyone with comorbidities.

A larger proportion of people from less advantaged backgrounds tend to have many underlying comorbidities that haven’t been treated and as a result, are far more susceptible to the harmful effects of the coronavirus.

Q: How is Sri Lanka positioned when it comes to manufacturing and exporting healthcare supplies?

A: Price control regulations (with the maximum retail price set for over 70 molecules) make it difficult to invest in new facilities especially as Sri Lanka is a relatively small market for pharmaceuticals.

Our exports are limited as we aren’t sufficiently competitive on prices compared to countries such as India, Pakistan and Bangladesh. They have far greater economies of scale due to their far larger populations and much lower costs when exports are taken into account.

While extending benefits to consumers, price controls act as a serious obstacle to future investment for the manufacture of newer and popular molecules in Sri Lanka as larger volumes are needed to make it worthwhile. The government has helped local manufacturers through a buyback agreement with hospitals.

Q: What are the other healthcare challenges that came to light during the pandemic?

A: The challenges include having to work with limited staff due to physical distancing, absenteeism because of strict quarantine measures, and ensuring staff safety and health. These issues have resulted in us making many changes to our operations.

In addition, the increasing cost of materials and delays in logistics have been real challenges. There have been delays from most private and government institutions, which is quite understandable; but such delays have severe repercussions for customers and patients who need to receive healthcare on time.

Q: Sri Lanka has for long aspired to position itself as a hub for medical tourism. What more needs to be in place for this to be achieved?

A: An increase in medical tourism needs ease of entry to the country for medical and healthcare treatments; and a focus on certain areas and specialisation in noncommunicable diseases (NCDs) – such as cardiovascular disease, diabetes, cancer and chronic obstructive pulmonary diseases – which are rising in South Asia.

Changes in leading risk factors – particularly dietary habits, tobacco use and high blood pressure – are thought to exacerbate the mounting burden of death and disability due to NCDs.

Improvements in life expectancy, increasing socioeconomic development and urbanisation in South Asia are expected to further escalate the occurrence of NCDs. Publicising Sri Lanka’s capability in this field through exhibitions in key markets will be needed.

The government must seriously consider the future of healthcare on the island. Developed and affluent countries are making regular advances in digital healthcare technologies such as AI, virtual and augmented reality (VR and AR), 3D printing, robotics and nanotechnology.

Sri Lanka also needs to adopt these new advanced technologies if it is to be viewed as a hub for medical tourism in the future.

For instance, AR and VR imaging have reduced human error, and ensured that treatment is more precise. These immersive technologies are bringing about transformational change in the healthcare sector.

The interviewee is a Director and the Chief Marketing Officer of Astron