A spiralling medical crisis grips Sri Lanka as over 150 essential drugs run out in state hospitals, forcing doctors to halt prescriptions and leaving patients in fear, desperation and financial ruin.
A deepening crisis has struck Sri Lanka’s public health system as the shortage of essential drugs and medical equipment grows increasingly severe. According to the Government Medical Officers Association, the situation has now reached a point where doctors have stopped issuing prescriptions for medicines and equipment unavailable in the state system. Patients who rely entirely on public hospitals are now facing uncertainty, financial hardship and delays in vital treatments. The worsening drug shortage has placed patient care services under immense strain and exposed significant failures in the country’s health administration, procurement processes and crisis management.
The GMOA reported that the shortage of essential medicines has resurfaced with alarming intensity. Their survey shows that more than 150 essential drugs in categories such as antibiotics, anesthetics, respiratory medicines, painkillers and life sustaining treatments for non communicable diseases are no longer available in adequate quantities. The shortage has extended to drugs required for eye patients, a shortage the GMOA describes as unprecedented and dangerous. These shortages directly affect surgical care and essential treatments, forcing patients to turn to the private sector for drugs and even the equipment required for critical operations including heart surgeries. When patients cannot afford these costly medical supplies, surgeries simply cannot be performed, creating a major public health injustice.
The GMOA insists that it is the core responsibility of the government and the Ministry of Health to ensure continuous availability of quality medicines, surgical equipment, laboratory reagents and radiological supplies throughout the hospital network. However, despite repeated warnings, the shortages that reached tragic levels in 2023 are returning. Doctors note that delays in procurement throughout 2024 have been acknowledged by the Minister of Health, yet no meaningful short term solution has been implemented even after nearly two years of recurring problems. This has raised questions about whether procurement inefficiencies are being neglected or allowed to worsen intentionally, creating an environment for emergency purchases that could benefit certain interest groups.
As the scarcity of drugs increases, doctors find themselves caught in a vulnerable position. Traditionally, when essential medicines and equipment were unavailable in government hospitals, doctors recommended external purchases from private pharmacies or laboratories with the patient’s informed consent. This long standing practice ensured that patients received timely treatment despite systemic shortages. However, recent controversies surrounding external prescriptions and a highly criticized circular issued by the Ministry of Health have created fear among doctors that they may face legal action or public vilification for attempting to help patients. This has generated confusion, risk and professional insecurity for medical practitioners.
As a result, doctors across the country have stopped issuing prescriptions or recommendations for medicines, tests and equipment unavailable in hospital stocks. The GMOA states that this decision is a form of professional action intended to pressure authorities to fulfil their duty by providing the required medicines in the state health system. The GMOA argues that doctors should not be turned into scapegoats for systemic failures when it is the Ministry of Health that holds the responsibility to supply essential medical resources.
Below is the press release, issued by the GMOA
Press Release
The Impact on Patient Care Services Amid the Recurring Shortage of Medicines and Equipment in the Hospital System
For the free health service in this country to continue providing high-quality care to the people, it is imperative to maintain a continuous supply of standardized medicines to the hospital system.
It is the primary responsibility of the government and the Ministry of Health to provide, without any shortage, a consistent supply of medicines, surgical and medical equipment, laboratory reagents, and equipment required for radiological tests to the entire hospital system.
In 2023, the shortage of medicines and equipment escalated into a national tragedy. The Government Medical Officers’ Association has continuously emphasized the need to identify the root causes and implement a sustainable program to prevent a repeat of this crisis.
Furthermore, the Association has actively fulfilled its role by proposing solutions and assisting in their implementation.
Reports from our branch networks indicate that the shortage of medicines and equipment, which had previously eased, is worsening again. The lack of adequate supplies of essential medicines and equipment is creating various obstacles and severely impacting patient care services.
According to a survey conducted by the Government Medical Officers’ Association, there are currently over 150 medicines in the hospital system with insufficient stock.
This includes critical categories such as antibiotics, anesthetics, drugs for respiratory and non-communicable diseases, painkillers, and a significant shortage of medicines for eye patients.
The Minister of Health has repeatedly admitted to the drug shortage in the hospital system, citing delays in the 2024 procurement process as the cause.
Given that the entire procurement process is monitorable, the failure to implement short-term solutions to these delays over nearly two years points to a profound inefficiency within the Ministry of Health.
As the drug shortage deepens, it creates opportunities for emergency purchases, raising the question of whether a solvable problem has been deliberately allowed to worsen.
When medicines and equipment are unavailable in the hospital system, patients are forced to purchase them from the private sector for their treatments and surgeries. In critical procedures, including heart surgeries, the inability of a patient to afford unavailable equipment can lead to the cancellation of the surgery—a grave injustice to the patient.
Historically, when the Ministry of Health fails to provide necessary supplies, doctors have acted in good faith by issuing prescriptions and recommendations for patients to obtain these items from the private sector, with patient consent, to ensure continuity of care.
However, past discussions and a subsequent Ministry circular regarding the external procurement of unavailable medicines have created legal and professional uncertainty for doctors, leading to widespread confusion.
Doctors who work in good faith and take risks for their patients are now being unjustly accused in legal and social media forums.
As a professional action, doctors across the country have now stopped issuing prescriptions and recommendations for obtaining externally sourced medicines and equipment that are not available in hospitals.
One objective of this measure is to compel the responsible authorities to fulfill their duty of continuously supplying all medicines and equipment required for patient care.
A transparent, formal process must be established to ensure the continuous supply of medicines and equipment. This requires resolving efficiency and coordination issues in procurement and eliminating fraud and misconduct.
Similarly, a more efficient and systematic method must be established for drug distribution and management to ensure the required medicines are available to the patient in the right quantity and at the right time within the hospital system.
Free healthcare is an irreplaceable responsibility of any government. All parties are therefore obliged to ensure the continuous provision of quality, high-standard medicines to the hospital system and the public.
The innocent sick people of this country are the ultimate victims of this injustice caused by the shortage of medicines and equipment. We emphatically state that the government and the Ministry of Health must immediately intervene and treat the resolution of this worsening crisis as a highest priority, implementing a sustainable short-term, medium-term, and long-term program.
