Posted on 25 June 2020
This seminar was organised by the Sri Lankan Ministry of Health and Indigenous Medicine, the WHO Collaborating Centre for Global Health Histories at the University of York, the Wellcome Trust, the Nuffield Council on Bioethics, and the Commonwealth Centre for Digital Health.
Dr Suranga Dolamulla, a Wellcome Trust Senior Research Fellow, outlined historically important debates regarding antibiotic demand. He described negotiations among World Health Organisation member states and international organisations to increase antibiotic supply, and the difficulty countries faced in producing antibiotics themselves. Dr Dolamulla gave specific examples, including Yugoslavia, India, Chile and Pakistan, which were assisted by the United Nations Technical Assistance Administration. In particular, India’s pharmaceutical industry has its roots in penicillin production in Pune, which was the beginning of local production in the 1950s. However, overproduction of antibiotics and their misuse in India has led to AMR, making drugs ineffective against infections such as Treponema pallidum. Sri Lanka, by contrast, only began producing antibiotics three decades later, which may be why progress against leading infections has been slow. On the other hand, Dr Dolamulla said that gradual antibiotic production may have helped to prevent excessive AMR. He concluded that it was debatable to what extent both scenarios had affected the AMR problem in Sri Lanka.
Dr B.V.S.H. Benaragama, the Deputy Director-General of Laboratory Services of the Ministry of Health is taking the lead on combatting AMR in Sri Lanka. He discussed technological opportunities to procure, distribute, market, and manage antibiotic production and use. Professor Vajira H.W. Dissanayake, who holds several positions at the University of Colombo and is the Chairman of the Commonwealth Centre for Digital Health, discussed the definition and applications of digital health for AMR. He emphasised the cost-effectiveness of this approach in middle-income countries. To use antibiotics efficiently, he said, the microbiome of bacterial infections needs to be assessed, rather than the single pathogen only.
The seminar was followed by a highly interactive Q & A session, which included a discussion about the pros and cons of e-pharmacy and e-prescriptions and the cost-effectiveness of producing antibiotics in Sri Lanka rather than procuring them from external suppliers.
We are indebted to our speakers for sharing their expertise and are grateful to our audience for their enthusiastic participation. We thank the Wellcome Trust for making this seminar possible.
Find the full recording here.
Event report by Alexandra Bradbury. MA, Medical History student, University of York.