“Vehicle Plan for WB project Reflects Structural Gaps in Public Health”

Sri Lanka’s decision to divert US$150 million in World Bank IDA funds into a massive vehicle procurement programme has exposed a truth long whispered inside the health sector: frontline public health services have been running on a fragile, hollowed-out system, where workers are expected to deliver community care without the most basic tools to reach the communities they serve.

The move made under the banner of the Primary Health Care System Improvement Project (2024–2028) has ignited questions about whether the government is using development financing to plug years of chronic neglect rather than to deliver the reforms the World Bank originally intended.

At its core, the IDA project was designed to tackle non-communicable diseases, strengthen elderly care and improve climate-resilient health services.

But the Cabinet’s approval of more than 4,000 vehicles, from scooters and motorbikes to clinical-waste Lorries, double cabs, freezer trucks and even an ambulance boat, signals a far more uncomfortable reality:

Sri Lanka’s community health network is so under-resourced that basic mobility—not medical expertise, not diagnostic capacity, not technology has become the number one barrier to delivering care.

Field staff describe a system where midwives walk miles to reach pregnant mothers, public health inspectors borrow motorcycles, and nurses rely on irregular public transport to respond to outbreaks or deliver home-based care.

These are not isolated incidents they are symptoms of a system that has been chronically weakened while political administrations repeatedly underfunded operational essentials.

Government officials insist the procurement is fully justified, arguing that without transport, the World Bank’s objectives cannot be met. In their view, the fleet represents long-overdue investment: the physical foundation upon which community-based care must stand.

Their argument, however, raises a far more serious question why did the health system collapse to a point where imported vehicles funded by foreign loans are the only way to keep frontline services functioning?

Critics point out that using IDA credit—a concessional financing tool meant to strengthen public health outcomes for what resembles a large-scale import programme risks undermining the project’s integrity.

 They warn that the sudden shift from health-system reform to vehicle acquisition may not fully align with the World Bank’s approval criteria, and could trigger compliance scrutiny if objectives appear diluted or redirected.

There are also concerns about procurement transparency, given Sri Lanka’s history of inflated tenders, politically favoured suppliers, and weak oversight in large purchases.

 The size of the fleet far exceeding standard replacement cycles has raised eyebrows among health-sector analysts who fear that expensive equipment may end up under-utilised or poorly maintained once the project ends.

Still, the controversy reveals a brutal truth: Sri Lanka’s health system is no longer failing at the marginsit is failing at the fundamentals.

Vehicles may temporarily help frontline workers reach patients, but they cannot by themselves fix the deeper deficiencies in diagnostics, staffing, community health planning and long-term prevention strategies.

Unless this procurement is paired with real reform, serious monitoring, and a transparent results framework, Sri Lanka risks turning a rare opportunity for structural health improvement into yet another band-aid solution bought on borrowed money.