National program to eradicate dengue menace:

Cuban bacteria in market soon

By Uditha KUMARASINGHE

Health Minister Maithripala Sirisena said the Government has already deposited funds to import BTI bacteria from Cuba to eradicate the dengue epidemic. The Minister in an exclusive interview with the Sunday Observer said as a pilot project, arrangements have been made to import 10,000 units of the BTI bacteria which would cost around US$ 2,60,000.

The Minister said the shortage of nearly 80 percent of essential drugs has been addressed while a committee has also been appointed with the joint representation of Health Ministry and the Finance Ministry to address the shortage of drugs.

Q: What is the progress the health sector has made and what are your plans to develop the sector?

A: Despite certain shortcomings, our free health service has maintained standards compared to health sectors in other countries.

Around Rs. 8,000 - 9,000 billion is spent by the Government annually on the health sector for medicine and prevention of diseases. The WHO, international organisations and various foreign countries are also helping us with the provision of financial and other resources to improve our health sector.

Therefore, our health sector has made a significant progress during the past few years. Compared to world figures, there is a decrease on child mortality while the maternal mortality rate is also at a minimum level. There is a marked growth in the life-span of our population.

To further develop the health sector, measures have to be taken to rectify the existing problems in the health sector. There is an urgent need to properly manage the services rendered by the health sector.

There are shortcomings in our health sector institutions mainly due to the lack of coordination among the employees. They have been divided into various groups and work individually without any coordination. Collective feeling and amity are essential to develop the health sector. We have to take steps to overcome the shortage of drugs and combat the dengue epidemic.

A national program has been launched to combat dengue. Steps should be taken to reduce the number of patients who die of various noninfectious diseases such as diabetes, heart disease and high blood pressure. We have to spend a huge amount of money from the national health budget on kidney diseases and cancer. Sometimes we have to spend nearly Rs.2 million on a cancer patient.

Nearly five percent of our national health budget is spent to provide treatment to kidney patients in Anuradhapura, Polonnaruwa, Dehiattakandiya, Medawachchiya and Kebithigollewa.

Climate change due to the use of advanced technology has caused health problems across the globe.

Medical experts cannot predict about diseases and the amount of drugs needed a year. The drugs are purchased and distributed based on the rough estimates formulated. When some infectious disease occurrs, it is a sudden situation. In addition, various diseases are spread due to natural disasters.

This may also lead to create problems within the health sector. It is necessary to successfully face these situations. I hope to give priority to the prevention of diseases. All problems in hospitals such as the shortage of drugs, doctors, equipment and staff have arisen due to overcrowding of patients in hospitals. In order to minimise this, steps should be taken to prevent diseases. The Health Ministry should give priority to prevention of diseases. This would reduce the number of patients attending hospitals. I hope to launch programs to develop the health sector by focusing on all these key areas.

Q: What are the measures taken to overcome the shortage of drugs?

A: I took over this Ministry three months ago. Nearly 80 percent of the drugs in short supply have been procured. There is another 20 percent shortage of these essential drugs. When these drugs are purchased, we have to follow some tender procedures and legal provisions. Some companies produce their drugs after we place an order. Thus, it takes time to import these drugs. There are some shortcomings in this system. As a result of a joint effort by the Health Ministry and Finance Ministry, a committee functions with the joint representation of these two ministries to take immediate action on the shortage of drugs. In addition, a Drug Assessment Committee is also functioning as a main advisory committee in this regard in association with these institutions, I wish to formulate a policy to purchase drugs. We were able to overcome a series of shortcomings in the process of purchasing drugs during the past three months. But there are more shortcomings which have to be rectified. All these will be rectified in the near future.

Q: What are the steps taken by you regarding the malpractices in the purchase of drugs in the past?

A: Punishing somebody for a mistake is one thing while not allowing room for such mistakes is another. Malpractices occur due to the import of drugs suddenly, purchase of drugs from the market and violating tender procedures. In order to prevent these malpractices in future, I have formulated a joint program in collaboration with the State Pharmaceutical Corporation, Supplies Division of the Health Ministry and the Technical Committees. If malpractices take place, I will take stern action.

Q: Have you laid emphasis on a National Health Policy?

A: I am unable to formulate a National Health Policy with immediately as I took over the Ministry three months ago. I have to attend to the urgent needs and overcome shortcomings in the health sector. I hope to focus attention and take necessary measures to formulate a National Health Policy and a National Drugs Policy next year.

Q: How has the Ministry intervened to minimise shortcomings in the health sector?

A: I have already taken measures to overcome the shortage of drugs and equipment. We do not have short term answers to the lack of human resources in the health sector such as doctors and nurses. Steps should be taken to strengthen the provincial health service. In order to prevent a large number of patients coming to urban hospitals, necessary resources such as doctors and nurses should be given to the rural hospitals and provincial health centres. The Northern and the Eastern provinces have also been integrated to the rest of the country. When we distribute resources, we have to consider this situation as well.

What are your plans to develop the health sector in the North and the East provinces?

A: More development aid and other health sector aid are flowing to the North and the East. The WHO, World Bank, ICRC and various countries also provide aid. In our islandwide health development program, we have considered the situation in the North and the East provinces as well.

Q: What is the outcome of the national program implemented by the Ministry to combat dengue?

A: Within the first month, after assuming office, I set up a Presidential Task Force to eradicate dengue. The Environment Ministry, Education Ministry, Provincial Councils and various other Local Government institutions have extended their support to eradicate dengue.

Health Ministry officials have launched a house to house campaign to educate people on dengue. The three Armed Forces and the Police also play a leading role in the dengue eradication campaign. We have declared August 2,9,21 and 28 as special days on our national dengue prevention program. August 16 to 22 has been declared as the National Dengue Prevention Week.

When we conduct surveys in some areas, we could see there is 50 to 60 percent unclean areas in the surroundings of some houses which may lead to Dengue.

We have decided to take legal action against those who fail to clean their gardens.

How long will it take to import the BTI bacteria

After we deposit money, Cuba health sector officials commence producing this bacteria. We have already informed the Cuban authorities to send this bacteria to us as soon as possible. Instructions have also been given to the experts in technology to immediately release the local BTI bacteria to the market.

Q: Is there any shortage of doctors, nurses and other staff members in the health sector?

A: Certainly. But this is not a situation that has been created suddenly. At present there is a dearth of doctors and nurses as the North and the East provinces have also returned to normalcy. But we have to resolve this problem entirely based on the number of doctors annually passing out from the Medical Colleges and the number of nurses trained per year. However, we intend to properly manage the existing cadre of doctors and nurses to address this issue.