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Ravi Rannan-Eliya Profile picture
Ravi Rannan-Eliya
@ravirannaneliya
Physician, economist, researcher. Views here my own. Executive Director @ihplk, Institute for Health Policy https://t.co/CBpJrZz6Gv
Feb 27, 2023 • 7 tweets • 2 min read
I have to say this is nonsensical from a public finance perspective, unless this is pure ideology which is what I think it is.
A treasury that lacks the cash for essential MOH medicines does not have money to pay for private care.
dailymirror.lk/top_story/Govt… The President is entitled to his ideological peccadillos, and he is the legitimate President and Finance Minister, even if few ppl voted for him.
But he is enabled by all those health stakeholders who refuse to call for higher taxes or to lobby Parliament for that.
Feb 22, 2023 • 10 tweets • 4 min read
We are finally releasing the latest update to our #SLOTS @ihplk polling of General Election voting intent!

The NPP/JVP and SJB were running neck-and-neck amongst likely voters in January 2023 with 32% and 31% each. Both were well ahead of the UNP and SLPP who were on 9% and 8%. Image The past year has seen big swings in support for the major parties. The main trend is a collapse in support for the SLPP since 03/22. The NPP/JVP were the big winners initially, but they peaked in 08/22, after which they lost support to a UNP surge, which itself peaked in 10/22. Image
Nov 22, 2022 • 6 tweets • 2 min read
One of our big problems is that our officials and politicians are easily hoodwinked by foreigners, and don't ever do due diligence.
A cursory search on this Kreate Design Ltd investor makes me highly skeptical that it itself has this kind of money...
ft.lk/front-page/Lot… If this is the same firm, Singapore govt records indicate it's a 5 yr old firm with only SDG 150k in paid up capital and 4 officers:
companies.sg/business/20172…
Aug 13, 2022 • 5 tweets • 2 min read
It's past time we stop pandering & subsidies to private business, who've helped collapse d economy whilst enjoying cheap power + low taxes.
Fact is new PUCL tariff is still cheap compared to our competitors. I would raise prices more & protect d poor.
1/3
 dailymirror.lk/business__main… This is how d old prices and d new industry prices compare with competitors.👇🏾
If manufacturers, tourist sector, etc can't complete with these new prices (+ devalued rupee), then frankly we need them to shut down, so capital can be reallocated to more competitive exporters. 2/3
Apr 29, 2022 • 5 tweets • 2 min read
Not sure @indica if it's growing, but no doubt it's been an addiction—Dutch disease— that has blinded and debilitated us.
Exporting the bodies of our kith and kin to sweat for others generates more forex than our traditional exports and as much as our main industrial exports. I was shocked to realise a few years back that Sri Lankan households earned more income from pay sent from abroad than total wages paid by our private formal sector.*
That gush of remittances has overvalued our rupee for decades.
Apr 29, 2022 • 5 tweets • 2 min read
If a new cabinet wants to ask the public to make sacrifices, accept fuel price rises, etc, a good place to demonstrate solidarity would be to give up these personal luxury vehicles bought at tax payer's expense.@hettige_siri Many rich countries only give a dedicated vehicle to their PM and select cabinet ministers who need them for security reasons, and require the rest to borrow from a pool. This is the UK ministerial code👇🏾 Image
Jun 6, 2021 • 8 tweets • 3 min read
Epidemiologists think (& some govts know) that whatever vaccine is used, a 3rd & more boosters will be needed. This is not a Sinopharm only issue. The UK Govt has already purchased 60m Pfizer third booster doses for later this yr.
@munza14 @Arshathz @Rumindahg @johandelivera As of today, I don't think any country in the world has sufficient vaccine protection to achieve herd immunity against all variants. Even UK is facing an increase in cases despite partial lockdown, hi rates of testing, and relatively high vax.
@Arshathz
Jun 5, 2021 • 6 tweets • 3 min read
Just a reminder. @NewsWireLK @AzzamAmeen
At @ihplk, we publish daily three sets of testing numbers: Last 24h, Trend in TCR and Test positivity.
The TCR is the same as test positivity, just reversed.
Eg if TCR=8, Test positivity= 1/8= 12.5%.
@sajithsamlk
newswire.lk/2021/06/05/gmo…
May 26, 2021 • 8 tweets • 3 min read
Some comments on the Dominic Cummings live testimony.

On hand washing, he's absolutely right. I think even today many of our docs, and even WHO spend too much time messaging about washing hands. Airflow and airborne infection is much more important. Very important revelations on why UK dropped testing. 1) UK SAGE didn't model the impact of testing on control till May. Despite the data from China from Feb. So UK govt never considered using testing to control spread until far too late.
2) Also assumed UK couldn't do TTI.
May 26, 2021 • 4 tweets • 2 min read
I don't see evidence that UK is emulating Australia/NZ.
There would need to be a political and social commitment to stopping local transmission—there's no sign of this. Eg Relaxing despite Indian variant outbreaks, public resistance to localized controls, etc
@yohes1 They are just trying what they did before: "live with the virus", but with slower transmission and fewer deaths b'cos of vax. Problem is that it made it inevitable they would have new variants entering and becoming dominant, unlike Aus/NZ. Also increases risk of new UK variants.
May 26, 2021 • 9 tweets • 2 min read
I don't have 100% confidence lockdown will work. But I am 100% sure that we need to do it, since we don't have any good options.
@nads_tweets
I have to find the time to write properly on this, but briefly:
1/9 1) A repeated cycle of lockdown, growing transmission, lockdown, etc is very economically damaging. Global evidence is very clear. Adequate vax also unlikely to happen this year. Also risks from Indian variant are very high, if it's hidden in a larger outbreak. 2/9
May 25, 2021 • 4 tweets • 2 min read
Quick comment on this @FT_SriLanka story about our COVID vax orders & World Bank funding.
WB can support vaccination w/o paying for vax, eg finance d cold chain. But right now, I suspect its $80m cannot be used to finance either Sinopharm or Sputnik 1/4
ft.lk/front-page/Que… 1. Sputnik is still awaiting WHO EUL (expected Jun) so is not yet eligible for WB $$.
2. Sinopharm has WHO EUL approval & qualifies, but initially this only covers its Beijing plant, which I understand will be prioritized to COVAX. So doses from its other factories not eligible.
May 25, 2021 • 7 tweets • 3 min read
This is the kind of action that undermines the COVID-19 response. I have several issues with this reported effort to vaccinate GMOA relatives:
1) Lack of MOH transparency
2) Favouritism that will undermine HCW solidarity
3) Epidemiological irrationality
dailymirror.lk/top_story/PHIs… #1 Given the challenge we face, public confidence/trust is vital. It must be earned, not assumed. It requires transparency. If there is a rationale, authorities shld first explain & officials should not say they have no idea. Govt cannot blame public/social media for being upset.
May 16, 2021 • 5 tweets • 1 min read
Some lessons here about how serious the threat is from the Indian B1.617 variant & on how competent leaders do things. Our politicians express a desire to copy Singapore, but they rarely take to heart Singapore's emphasis on competency. 1/5
sg.news.yahoo.com/virulent-mutan… One, the new Singapore airport outbreak involves the Indian variant infecting fully vaccinated airport staff: 19 out of 28. A grim reminder that it can easily overcome vaccination. I am pretty sure these workers were vaccinated with Pfizer also. 2/5
May 14, 2021 • 5 tweets • 2 min read
There is some misunderstanding going on.
We expect & there is increasing data that taking 2 jabs of a COVID vax will give you more protection than 1 jab (also 3 more than 2). J&J probably will do better as 2 jabs, but they did their clinical trial for 1 jab.
@RealAndRav1 So 1 jab of a vax marketed as a 2 jab vax will give some, but less protection, although how much less by will vary. Available data indicate the best performing vax (ie Pfizer/Sputnik) will give decent protection with 1 jab, equivalent to 2 doses of less effective vax such as AZ.
May 14, 2021 • 7 tweets • 2 min read
A nice, incisive, although somewhat long 😩, analysis by @samarajiva @Economynext of the weaknesses of our judicial institutions and how it holds back growth. @hettige_siri
economynext.com/sri-lanka-stat… He raises an important point in relation to the Port City debate. The BOI's precursor, the GCEC and Katunayake FTZ, were an effort in 1978 to accelerate growth by bypassing the constraints in our weak institutions. China did the same in 1979, when it set up its first SEZ.
May 14, 2021 • 9 tweets • 2 min read
Unfortunately, we suffer from a lot of Sinophobia, so let me make two comments on this. 1. WHO's recommendation on Sinopharm is that it should be given to people with NCDs b'cos of the favourable benefit-risk assessment.👇🏾 That is the likely benefits of the vax outweigh the likely negative impacts esp since NCDs significantly increase risk of COVID death. Image
May 10, 2021 • 7 tweets • 2 min read
Important question @glassmanamanda

Yes, unfortunately that is my understanding: China, HK, Macau and Taiwan.

However:
1. if Fosun only sells inside greater China, then it will release other Chinese vax doses for export. 2. In practice many LMICs are not buying Pfizer b'cos price/conditions are too onerous. I wonder if there might be pressure to yield those rights to Fosun if Fosun sets a lower price.
May 10, 2021 • 8 tweets • 4 min read
This is breaking news that is BIG at many levels!

Germany's BioNTech has signed a manufacturing deal with China's Fosun to make 1 billion doses/yr of the BT/Pfizer mRNA vax in China.
@himalkk @Jamz5251 @poliohunt @glassmanamanda @yates_rob
scmp.com/business/compa… Let me say this—Thank God for the Germans! Let's pray that the US does not try to scupper this 🙏🏾.

I have been calling for US-China cooperation on vax production. But it ain't happening and I can't see the Biden administration ever allowing Pfizer to do this.
@glassmanamanda
May 9, 2021 • 6 tweets • 3 min read
Quick comment on this story that govt plans to modify the EPF system to a part pension scheme, since it's something we looked at repeatedly over the years @ihplk often with @ilo or @WorldBank . 1/n
sundaytimes.lk/210509/busines… In principle, shifting to a pension scheme is better. IMHO we need a full national pension system. Changing EPF would provide a more secure and longer-lived income during retirement than the current lump sum benefit, which many spend within 2-3 yrs.
But two big caveats.
May 9, 2021 • 7 tweets • 3 min read
Sri Lankan leaders suffer from a colonial mentality—not colonial subservience to China—but mental servitude to Western thinking. @CharukaLive
The evidence on optimal testing rates was produced by Sri Lankan/Sri Lankan-Australian researchers, and MOH/Govt have just ignored it. As our 🇱🇰 research @ihplk shows, testing benefit increases with the ratio of tests to cases (TCR):

Rannan-Eliya et al. Increased Intensity Of PCR Testing Reduced COVID-19 Transmission Within Countries During The First Pandemic Wave. Health Affairs, 2021
doi.org/10.1377/hlthaf…