Sri Lanka’s ongoing Asian Development Bank (ADB)-funded Health Sector Enhancement Project (HSEP) progress has been slowed down by improper prioritisation of procurement, underutilisation of allocated funds and accountability issues, according to the Quarterly Progress Report submitted by the Health Ministry to the Finance Ministry.
The outcome and the status of the US$ 60 million (Rs.12 billion) HSEP has been indicated in the Quarterly Progress Report for the Quarter – 1st of July to 30th September 2021.
This amount comprising $37.5 million in concessionary loans, $12.5 million grant and $10 million equivalent from the Government of Sri Lanka in counterpart funds is being implemented through a project investment modality.
It has been observed that the project was marred with a host of problems due to the irregular and inconsistent procurement of equipment and deviation from the scientifically agreed prioritization, the report said.
This project is for the enhancement of primary health care to strengthen healthcare and prevention, formulation of policies in that regard and capacity building in the Uva, Sabaragamuwa, Central and North Central Provinces.
Accordingly, the proposal made by Ranil Wickremasinghe, the former Prime Minister in his capacity as the then Minister of National Policies and Economic Affairs in 2018, to enter into the necessary agreements to secure the relevant funds, was approved by the Cabinet of the previous regime.
With the rapid increase in COVID-19 cases and the surfacing of new variants, Sri Lanka had to face shortages of medical resources, including hospital beds and medical equipment.
Under the present pandemic situation the project also provided crucial resources for the immediate emergency response to the corona virus disease since March–April 2020.
The COVID-19 reallocation budget had been prepared by the Health Ministry in addition to HESP’s general estimates as an additional investment
had to be utilised to improve the efficiency and equity of health care in Sri Lanka and expand access to primary and secondary level of health services during the pandemic period.
This COVID-19 reallocation budget relating to emergency response activities paved the way for improper prioritisation of procurement, under-utilisation of allocated funds and accountability issues, the assessment report of the budget estimates revealed.
As stipulated in the report, it is evident that most of the project goals are lagging behind without completion.
Also, it demands thorough investigation and justifications for the deviations and inconsistencies from the original project allocations and government policies.
The vehicle budget estimated at $ 4.8 million (Rs. 1 billion) being allocated has been fully exhausted amidst vehicle import restrictions imposed by the government.
There is no indication whatsoever in the HSEP progress report as to who has authorised and for what purpose such amounts are spent instead of purchasing vehicles when the country is facing difficulties to keep the basic and fundamental health care services operational.
According to the reallocation budget, there was an increase of equipment and furniture estimated at Rs. 19 billion from the previous allocation of Rs. 9 billion estimated in the original budget.
Procurement of reagents and consumables for COVID-19 (TRPCR test) under Contract awarded stipulates a massive amount of Rs. 112 Million.
This matter needs to be investigated and explained as to what has been purchased at what cost and whether such purchased pricing is as per market acceptable pricing, official sources said.
It has been observed further that a next Generation Genetic Sequencer which had been purchased at a colossal amount of Rs. 90 million some time back is still lying in boxes at Apeksha Hospital without being utilised due to incompleteness of ancillary equipment, computational systems and trained personnel to operate these complex medical systems.