Gamani Corea Foundation’s 16th round table discussion

By Lynn Ockersz

Non-Communicable Diseases (NCDs) are surging in Sri Lanka currently. Coupled with this development is a rapidly rising ageing population in the country and connected problems, Dr. Palitha Abeykoon said, while addressing a range of local health issues and their consequences at the Gamani Corea Foundation’s (GCF) 16th round table discussion held at the BMICH on January 30th.

Dr. Abeykoon, who, among other positions, is the chairman of the National Authority on Tobacco and Alcohol, pointed to the following principal problems, besides other pressing matters in the local health sector, in an issues paper he presented at the GCF forum: ‘Equity and access issues have come to the fore against a backdrop of severe resource constraints. Patients are driven to pay out of pocket to meet their health needs in the public health sector. Such expenses are estimated at 50 percent per patient. While NCDs are very much to the fore, “mobility and mortality” afflict a considerable proportion of the aged. A fast-ageing population compounds these issues. Besides, the potential for more pandemics is very much present.

‘The number of elders in the local population is escalating. Consequently, NCDs will be on the rise and we will see a proliferation of mental health problems and other disabilities linked to ageing, going forward. The current severe socio-economic crisis makes health financing a huge challenge.

‘There is a crop of external factors that compounds our health sector issues. Some of these are: the global climate crisis, asymmetries in economic performance among countries at the regional and global level, conflicts in the Middle East and Europe and tensions in the Indian Ocean.

‘Sri Lanka’s National Medicines Regulatory Authority (NMRA) is one of the strongest in the region but it is bedeviled by a lack of good governance.’

Dr. Anil Jasinghe, Secretary, Minstry of Environment, who moderated the forum said at this juncture that, ‘Bad governance is the main culprit. Non-adherance to the basics of good governance is rampant locally. Even among some technocrats and bureaucrats anarchy prevails. The principle of equity is violated in some top bodies.’

Emeritus Professor of Medicine and Consultant Physician Dr. Saroj Jayasinghe, presenting an issues paper, made the following points among a range of other matters: ‘For the past 50 years we have been saying the same thing in relation to Sri Lanka’s health questions and reforms, and that is indeed the issue.

‘With regard to efficiency in health administration and participatory decision-making, we have been paying only lip service in Sri Lanka. A blueprint to revive the health sector in the long term is needed. However, the proposal for a National Health Commssion is a step in the right direction. Empowering the public is also of vital significance.

‘We need to focus, among other matters, on tertiary care, structural reforms, health technology assessments and the strengthening of links between health sector reform and social reform.

‘Service innovations in the areas of primary health care, clinic/ hospital visits, screening and the hospital work force are important. ‘We need MOH type institutions for NCDs as well. Mobilizing resources is important but we need to remember that the private sector in healthcare will collapse in the absence of state sector personnel. However, the public sector could exist independently, while the private sector cannot do so.’

Following Prof. Jayasinghe’s presentation, a lively discussion followed on the issues raised with audience and panel participation. Winding-up proceedings GCF Chairman Dr. Lloyd Fernando said that the Foundation would be taking up the matters that were discussed with the government in the days to come. He stressed on the need for national planning in the health sphere and undercored the importance of a holistic approach in this undertaking.