News Desk
MALE’ — For years, a pair of spectacles at EyeCare cost around MVR 8,000. The same spectacles are now available at a new state optical shop for MVR 2,000. That gap, replicated across thousands of medicines and medical products, is what President Dr Mohamed Muizzu is calling a racket. He has a more pointed name for it: the medical mafia.
One could argue the President is poking his nose into private business. But his actions are not driven by instinct alone. Behind the intervention lies data — extensive data mining and statistical analysis that mapped the scale of the problem in numbers the government could not ignore. It may well be the first time a Maldivian administration has relied on a serious statistical model to confront a domestic policy crisis of this kind. To his credit, President Muizzu listened.
The accusation is not without basis. Private pharmacies in the Maldives were reportedly selling medicines at profit margins of between 1,000 and 2,000 percent before the government imposed price controls. Aasandha’s own managing director told a parliamentary committee that margins reached 500 to 600 percent just two years ago. Seventy percent of the medicine market is controlled by private companies. The state controls 30 percent. That ratio, built up over decades without meaningful regulation, is what the current government is now trying to reverse.
A Crisis Years in the Making
What is clear is that the medicine shortage did not begin with price controls. Dr Shah Mahir, the Managing Director of State Pharma and a former head of the MFDA, told the parliamentary SOE Committee that the crisis built gradually over years while authorities failed to intervene. The public only felt it once the problem had grown past the point where it could be quietly managed.
Three structural problems sit at the heart of it. There is no real-time system to track medicine availability across the country. Doctors cannot see what STO holds in stock. Pharmacies are not consistently checked during registration to ensure they carry essential medicines. The Maldives’ small population makes it commercially unattractive to major pharmaceutical companies, limiting the range of suppliers willing to engage. And of the more than 4,000 medicines on the Approved Drug List, only around 1,300 are actually imported, with the rest stuck due to expired documentation.
The Maximum Retail Price mechanism, which under the Health Services Act should have put a ceiling on what pharmacies could charge, was never implemented. Pharmacies resisted it. The state did not push hard enough. The result was a market where margins ran to four figures and patients paid whatever was asked.
ADK, EyeCare and the Shape of Private Power
The companies Muizzu is taking on are not small operators. ADK is the dominant private hospital in Male’, operating on heavily subsidised land and, according to reports over the years, receiving subsidised electricity as well. It has expanded beyond healthcare into restaurant, gym and commercial ventures, turning its subsidised plot in the capital into one of the most commercially productive pieces of real estate in the country. It is also a major medicine importer and wholesaler, with interests extending into hospitality and education, all built on the bounties of that subsidised plot of land in the heart of Male’, which places it at the intersection of two of the government’s most pressing concerns: Aasandha arrears and medicine supply.
ADK is reportedly owed MVR 250 million in unpaid Aasandha payments since late 2023. That debt is real and it matters. A hospital that is owed a quarter of a billion rufiyaa by the state has a genuine reason to struggle with procurement. The government and ADK are locked in a circular problem: the state cannot pay what it owes, so ADK cannot buy what it needs, so patients cannot get what they require. Blaming the private sector for the shortage without addressing the arrears is only half a diagnosis.
What the Government Is Building
The state’s response is structural. State Pharma was established in September last year and opened its first pharmacy at IGMH this week, in the OPD area where the old Life Support Pharmacy used to operate. It runs 24 hours. It will stock commonly used medicines, supply other outlets and import drugs not currently available in the Maldives. From July, all medicine-related work currently handled by STO will transfer to State Pharma. The company is hiring 19 pharmacists and pharmacist assistants in Male’, with applications open until 30 May. The vacancies are a small window into a larger problem the government has not yet seriously tackled.
Pharmacy in the Maldives is overwhelmingly staffed by expatriates. It appears on the national human resource shortage list, which means the state acknowledges the gap, but acknowledgement has not translated into any sustained programme to train and retain Maldivian pharmacists at the scale the sector needs. State Pharma is hiring now because it has to. Whether the government uses this moment to build a pipeline of Maldivian pharmacy professionals or simply fills the posts with expatriates again and moves on, will say something about how seriously it takes the structural side of the medicine crisis versus the political side.
A new state optical shop is open. A 24-hour state pharmacy is running. STO has been directed to stock all essential medicines on the MFDA list. The government has promised full availability within weeks.
Dr Shah said an ERP system will be introduced to track stock levels across pharmacies in real time and allow authorities to predict shortages before they become crises. He also made a point that cuts to the heart of the debate: essential medicines should be treated like basic commodities. Flour and sugar are regulated. Medicine should be no different.
The Question the Government Has Not Yet Answered
The structural argument is sound. The political will appears genuine. But the transition from a market where private companies control 70 percent of supply to one where the state can guarantee availability is not a matter of weeks. It requires sustained procurement capacity, reliable funding for Aasandha, functional relationships with international pharmaceutical suppliers and a regulatory regime that actually enforces the rules that already exist on paper.
The Aasandha arrears to ADK and other providers have not been resolved. The bulk procurement programme covers only a limited range of medicines. The documentation problem limiting imports to 1,300 of the 4,000 listed medicines has only been partially addressed through a temporary regulatory fix.
President Muizzu has named the problem clearly and moved faster than any previous government to build state alternatives. Whether the state can actually deliver on what the private sector has failed to provide, at scale, consistently and without the same procurement failures that created the crisis in the first place, is the question that the opening of one pharmacy at IGMH does not yet answer.
The spectacles are cheaper. The medicine shelves are not full. One of those things makes for a good press conference. The other is what people notice when they actually need a prescription filled.
