Devex CheckUp: How Sri Lanka’s crisis has hollowed out its hospitals

As Sri Lanka celebrates its new year today, protesters have been camped outside President Gotabaya Rajapaksa’s office in Colombo for six straight days to demand the president’s resignation over his failure to address the economic crisis. With the country in turmoil — fuel, electricity, and food are all running out due to a shortage of foreign exchange, the cabinet has resigned, and the government has announced that it will default on its foreign debt — the health system is also in a state of emergency as hospitals and pharmacies run short of supplies and medicine.  

Amruta has been speaking with high-ranking public health officials in Colombo to understand the situation.

• Sri Lanka imports almost 90% of its medicines, but the current crisis has affected the access and availability of drugs both in the private and public sectors. After the Sri Lankan rupee was devalued last month, prices rose and importers saw profits drop — which meant they stopped bringing in certain drugs, Dr. Ravindra Rannan-Eliya, the executive director of the Institute for Health Policy in Colombo, tells Amruta. While requests for foreign aid and donations are rising, he believes long-term solutions will be more holistic: “This is primarily an economic crisis, and until we solve that everything else is Band-Aid,” he said.

• As hospitals across the country run short of drugs to treat cancer, renal, and heart ailments, as well as blood thinners and stents, some medicines are being ordered through a credit line with India — but even those are only expected to last for the next six months. Sri Lanka has also sought help from WHO, the World Bank, and the Asian Development Bank, Reuters reports. So far, the World Bank has provided $10 million to buy essential medicine and equipment, according to the government. 

• Civil society groups are now organizing efforts to collect information on drug shortages that will be passed on to organizations assisting in the procurement and logistics. “We have to take interim action to stay alive,” Rannan-Eliya says.

Spilling the tea

Dr. Neil Buddy Shah has been appointed chief executive of the Clinton Health Access Initiative, or CHAI, a global health organization working to reduce the burden of disease in low- and middle-income countries.

Shah comes to CHAI from GiveWell, where he was managing director for just under two years. Before that, he co-founded IDInsight, a global development data analytics and advisory firm. He takes over from interim CEOs who’ve been leading since Dr. Iain Barton left the post in July, just over a year into his tenure.

Read: Neil Buddy Shah, managing director at GiveWell, joins CHAI as CEO

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Mother love

In Kenya, approximately 1 in 5 female adolescents aged 15-19 are either pregnant or already mothers, according to a 2014 survey. And with a shortage of mental health workers — the country has fewer than 500 such specialists to serve a population of over 50 million — community-based initiatives are being promoted to fill this gap for pregnant and parenting teens.

“I started working when my child was 3 months [old]. And since my child is disabled, I didn’t know how to take care of him or where to take him for therapy. I used to just sit in the house and cry. I was depressed,” one teen tells Anthony Langat in this report for Devex. She turned to Nivishe Foundation, which says its mental health interventions have helped more than 10,000 young people since 2019.

Read: Kenyan NGOs fill mental health service gap for pregnant adolescents

ICYMI: Anthony has also reported on a community health digitization program in Kenya that aims to increase health access across the country. Pro subscribers can read the report.

Death by numbers

Last month, we published an exclusive story that detailed how India asked WHO to withhold the upcoming release of its COVID-19 excess deaths estimates by 10 years.

While WHO’s announcement is expected by the end of April, sources tell us this is not the first time India has sought to silence evidence of excess deaths caused by the pandemic. One researcher associated with a study that estimated the deaths to be eight times the official figure, tells Amruta the work remains unpublished due to pressure from the Indian government after a major multilateral development bank withdrew its support, fearing backlash from India.

+ Do you know of other studies on excess mortality that have been blocked by donors or governments? Let us know at checkup@devex.com.

Recap: The pushback against WHO's imminent COVID-19 excess deaths estimate

You only get one shot

Just a single dose of an HPV vaccine delivers solid protection against the virus that causes cervical cancer, WHO’s Strategic Advisory Group of Experts on Immunization recently concluded. Calling it a “game-changer,” WHO said this finding could mean that doses reach more girls across the world. As of 2020, just 13% of girls globally had received two doses, well below the target rate of 90%.

Help wanted

As development organizations staff up their Ukraine response teams, our colleague Justin Sablich is keeping a running list of the jobs available to respond to the crisis. That includes global health positions such as:

• Age and disability working group coordinator at HelpAge International in Ukraine.

• Emergency program coordinator at INTERSOS in Lviv, Ukraine.

See the whole list: The globaldev organizations hiring in response to Ukraine crisis

+ Ready for a career leap? Check out our Career Center where you can explore our job board to see other hirings in globaldev and access valuable insights and tips from career experts.

By the numbers

That’s the percentage of digital health pilot projects that have gone on to scale or achieve institutionalization, writes Dan Bui, a digital health care policy researcher, in an op-ed for Devex. Still, he says, new digital health tools — such as “mobile money” technology for medical payments — could be a key to making universal health coverage a reality by creating more efficient systems.

Opinion: How mobile money can help get to universal health coverage

What we’re reading

Sierra Leone is building a mental health system from scratch. [New York Times]

Tedros calls out the racism in how Ethiopia's and other crises are treated compared to Ukraine's. [AP]

Poor health care coverage in China’s rural areas could be disastrous as new COVID-19 variants hit such populations. [Grid News]