Healthcare for All

Sri Lanka is one of the few developing countries with a completely free health care system. This has paid dividends in the form of excellent health indices that are generally on par with those of the developed world. In fact, the World Health Organization (WHO), organising their 70th annual World Health Day today (April 7) has highlighted Sri Lanka’s progress in the health sector on their WHD website and further honoured the country by having some of the main international WHD events in Colombo.

This year’s WHD theme is a familiar one for Sri Lanka: “Universal Health Coverage (UHC): Everyone, Everywhere”. This is exactly what Sri Lankan Governments have done since 1948. This does not mean that Sri Lanka is free of any health concerns – dengue is again rising for instance, but overall our heath system has accomplished a lot over the last 70 years.

But the WHO faces a huge challenge elsewhere. Half the world is currently lacking access to appropriate medical services. Another 100 million people have been forced into poverty from paying for medical bills or services. The WHO thus wants to see one billion more people gain access to healthcare services by 2023. This initiative starts on World Health Day today.

The WHO has showcased a success story from Sri Lanka to illustrate the benefits of UHC. According to the WHO: “Sanath Kumara was only 16 when he had an accident and suffered severe injuries to his spinal cord. Sanath was treated in the Rheumatology and Rehabilitation Hospital in Ragama. The hospital’s main goal is to optimize and maintain physical, sensory, intellectual, psychological and social functions. Patients receive care from a team of 350 professionals which include medical staff and speech, occupational and physiotherapists. As part of his therapy, the staff at the hospital encouraged Sanath to take part in para-athletic sports. All his emergency procedures, surgery and physiotherapy have been paid for by the Sri Lankan health system. Ragama, in which Sanath’s hospital is located, provides services ‘free at the point of delivery’ to people from all corners of the country.”

UHC has been one of the main drivers of Sri Lanka’s remarkable health gains. Government policies have ensured easy access to medical services for the whole population, including in rural areas. With the support of the WHO, Sri Lanka is developing a ‘Strategic Framework for Sustainable Development of Health’ and a ‘Sustainable Health Financing Roadmap for Health’. Both will help ensure and sustain equitable financing for health, including increased Government health spending. Free, comprehensive and continuous care is made available to the population by the State.

In President Maithripala Sirisena, Prime Minister Ranil Wickremesinghe and Health Minister Dr. Rajitha Senaratne, Sri Lankans are fortunate to have three leaders who have shown a lifelong commitment to the free healthcare system. Under the guidance of the President and the Prime Minister, Dr. Senaratne has been instrumental in drastically reducing the prices of nearly 50 essential drugs, Intra Ocular Lenses and cardio stents. Cancer and kidney patients now receive lifelong free treatment. Sri Lanka also became the second country in the region to eradicate malaria and the country’s vaccination drive is regarded as a success. Sri Lanka’s very low infant mortality rate is on par with that of the US and ahead of other South Asian countries, which earned Sri Lanka a citation from the UN under the “Every Child Alive” initiative.

Several new hospitals are coming up including South Asia’s largest renal hospital in Polonnaruwa and existing hospitals are being expanded and renovated. Sri Lanka’s anti-tobacco drive has been so successful that cigarette consumption has gone down by an astonishing one billion sticks over the last three years. Very soon, Sri Lanka will become the first country in the world to fulfill all obligations of the Framework Convention on Tobacco Control (FCTC) with the introduction of completely plain packaging and the restriction on loose cigarette sales.

Sri Lanka faces the challenge posed by illegal narcotics and liquor consumption which lead to a huge health cost. Moreover, as Sanath Kumara’s story shows accidents have a hidden health cost - the State spends millions of rupees every year on treating crash victims. Sri Lanka also has a vibrant private healthcare sector, but this needs to be more tightly controlled as some of the fees are clearly outrageous. Proper standards must also be ensured at private hospitals vis-à-vis facilities and qualified personnel.

Sri Lanka – and the rest of the world – will have to spend more on healthcare in the coming years as the very success of modern medicines has led to a Silver Generation living well into their 80s and even the 90s. UHC is a lifeline for the elderly and the poor (who cannot anyway afford to go to a private hospital) and the State has an obligation to continue it. We should justifiably be proud of our acclaimed heath system, but the health sector trade unions must act with more responsibility as patients’ lives are at stake. A better dialogue and understanding between the authorities and TUs will further strengthen our health sector.