Note: This article was written soon after the 2015 Presidential Election.
Who will win the health battle in Sri Lanka: People or Big Corporations?
Sri Lanka was a typical low income country in most ways except with regards to health indicators.
For many decades, maternal mortality and life expectancy were impressive. Indicators related to general well-being such as literacy and population growth rate have been well above regional and other low income countries (box I).
However Sri Lanka spends a very small amount of money on health sector. In order to correct for the size of the country, per capita health expenditure is calculated. This is total public and private health expenditure for that relevant year divided by the mid-year population (box II)
The intriguing observation here is that Sri Lanka has been able to have health and other indices comparable to countries which spend thousands of dollars per person on health by spending less than 100 dollars per person.
An example, UK has spent almost 40 times as that of Sri Lanka to have slightly better indices.
This is not comprehensible. This can’t be, but that is the reality.
Why and how did this happen?
Answer to that question may produce a well-researched scientific paper. For the time being, however, here is a brief and quick highlight of the potential contributing factors.
One
is the unique social fabric seen in Sri Lanka. People are in contact with other people all the time. No decision is taken without contacting friends or relatives. Hence the anti-health agents, such as tobacco or fast-food industry, who are responsible for the bulk of modern day mortality and morbidity, find it difficult to fool the people only with mainstream advertising and other usual marketing strategies.
Two
is the selfless dedication of people, professionals including media and our leaders in the quest for a healthier nation. This dedication ranges from the emphasis on the value of grass root level primary health care to the policy making discussions occurring at the higher levels of the administration.
This has reached a new height in Sri Lanka, especially with the recent presidential polls held in the country.
For the first time in the country’s political history, Ceylon Tobacco Company (CTC) and behaviour of its officials have been discussed in heated, closely monitored political debates, including in cabinet meetings.
A bill was presented weeks after the new president had been sworn in to increase the size of the pictorial warnings on cigarette packets. Health Minister accused that CTC paid massive bribes to thwart anti-tobacco campaign spearheaded by the then health minister who is the current president. And the government is going to introduce Essential Drugs Policy bill, soon.
Arguably, the stage is set for a significant improvement in the health sector indicators in the coming years. However, complacency from the people as well as professionals including media, may turn around the tables. In that unfortunate situation, the indicators will suffer. So will the people of Sri Lanka.
Hence, let us keep a close look at what is going on.
Let us closely monitor the important health and other well-being indicators in the coming months and years.
That way we would know, and hopefully control, who wins in the end: people or big Corporations.
By
Mahesh Rajasuriya
