By: Staff Writer
December 12, Colombo (LNW): Sri Lanka’s decision to use US$150 million in World Bank IDA financing to purchase a large fleet of vehicles for health-sector workers has stirred debate not only about financial priorities but also about the deeper systemic weaknesses in the country’s public health infrastructure.
While the funds fall under the Primary Health Care System Improvement Project (2024–2028 a programme aimed at strengthening non-communicable disease prevention, elderly and palliative care, and climate-resilient health services the government’s use of this money for an extensive transport procurement plan reveals how the health system has been operating under severe logistical strain for years.
Across Sri Lanka’s districts, midwives, public health inspectors, community nurses and field-monitoring officers often work with minimal or outdated transport.
Many rely on personal motorbikes, hired three-wheelers or irregular public transport to reach remote households, conduct maternal and child health visits, carry out screenings, investigate disease outbreaks or transport medical samples.
The lack of mobility not only slows service delivery but can also compromise patient care, particularly in rural and estate communities where distance and terrain are major obstacles.
The government’s request to purchase more than 4,000 vehicles, including scooters, motorbikes, clinical-waste lorries, freezer trucks, double cabs, vans, buses, forklifts and an ambulance boat, therefore reflects far more than a procurement choice.
It exposes the hidden operational backbone required for primary health care to function at all.
Officials argue that without adequate transportation, the World Bank-mandated goals of early detection of non-communicable diseases, home-based care, community outreach, screening programmes and emergency preparedness would remain on paper rather than translate into actual impact.
Supporters of the plan say that the transport deficit is a structural problem decades in the making.
Sri Lanka’s public health system, often praised internationally for its maternal and child health achievements, has silently accumulated logistical debt meaning that for many years, core frontline services have been expected to perform without corresponding investment in vehicles, equipment, IT systems or cold-chain capacity.
The new vehicle procurement, they argue, is not a deviation but a necessary precondition for delivering the outcomes the World Bank expects.
However, this interpretation has not silenced concerns. Critics point out that the scale of the procurement including thousands of two-wheelers and dozens of heavy vehiclesrisks overshadowing other essential components of primary health care reform.
They warn that relying heavily on capital purchases may dilute attention from systemic needs such as training, chronic-disease management protocols, diagnostic capacity, digital health records and community-level health education.
Others question whether the use of IDA financing for large-scale imports complies strictly with the World Bank’s results framework, noting that any major reallocation of funds typically requires explicit justification and approval.
Still, the controversy highlights an uncomfortable reality: Sri Lanka’s primary health care network cannot deliver modern, community-based services without fixing the most basic element of all mobility.
Whether the vehicle procurement proves transformative or merely a temporary patch will depend on how effectively it is integrated into broader reforms, accountability mechanisms and measurable improvements in public health outcomes.
