Daily News Editorial

Health care for poor patients

14 December 2016

The high price of drugs has been a vexed issue for many years. Even though the State health service is free, there are many medicines that patients have to buy from outside pharmacies. Many of these drugs are expensive and many poor patients cannot afford to buy them. One of three main promises of the Yahapalana Government that came to power in January 2015 was reducing the high prices of drugs or at least those of the most essential drugs needed by the majority of patients, especially those suffering from Non Communicable Diseases (NCDs).

True to its word the Government rapidly moved in this direction under the guidance of President Maithripala Sirisena, a former health minister himself. Health Minister Dr. Rajitha Senaratne shared the President’s enthusiasm for this endeavour. Accordingly the Government was able to announce a price reduction for around 48 essential drugs a few months back. This was hailed by many medical experts and commentators as a major breakthrough in health care in the country which is one of the few developing countries with a completely free health care programme.

This has proved to be a great boon for patients who suffer from a variety of health problems. Their medical bills have seen a substantial amount of savings. The lack of knowledge about generic drugs costs among the general populace and the misplaced belief that anything foreign must be better than locally produced drugs has compounded this problem. Indeed many patients dislike doctors who do not prescribe expensive drugs. The authorities must launch a major programme through the media to educate the public on the importance of generic drugs and how they can save money in the long run by using those drugs.

Indeed, the health minister has disclosed that the government has been able to save billions of rupees by its multi-pronged approach to the drug industry - reduce the prices of essential drugs with an emphasis on generic drugs and also by manufacturing many drugs locally. While the state owned State Pharmaceutical Manufacturing Corporation has been engaged in this role for decades, many foreign companies are now setting up their own plants here. As the minister pointed out, this could ultimately prove to be a foreign exchange earner for Sri Lanka because the plants will be able to export any excess production to other countries in this region. After many decades Sri Lanka is finally close to realising the goals enunciated by the late Prof. Senaka Bibile. To his credit, many Senaratne has always been an ardent advocate of the Senaka Bibile proposals and all right thinking citizens must be pleased that the late visionary’s dreams are coming true.

Reduced drug prices must not lull us into State of complacency. Prevention must remain the primary goal especially when it comes to NCDs which are now responsible for the majority of deaths in the country. Sri Lanka has had a remarkable success rate vis a vis infectious diseases many of which are under control. Sri Lanka has a very successful vaccination programme as well. The country was recently honoured by the World Health Organisation as only the second country in South Asia to have eliminated Malaria after The Maldives. Sri Lanka must strive to maintain the success level with NCDs such as heart attacks and diabetes which have become major killer diseases mainly due to lifestyle changes. Our medical research efforts must also be ramped up, led by the Medical Research Institute.

The Government must also be commended for making every possible to effort to deuce tobacco consumption. There were reports in the media that the revenue earned by the government from the sale of cigarettes has reduced exactly by half. While this may at first be alarming from a purely economic point of view just think of the billions of rupees spent by the government to treat the victims of tobacco. Most of the patients in the island’s cancer hospitals are tobacco addicts for whose treatments the Government spends heavily. Any additional revenue the Government earns from tobacco goes back to the health system to treat its victims. However, with reduced consumption the number of victims will also be less and hence the health costs too will be less. The Government has also decided not to allow the sale of loose cigarettes which will further reduce consumption. Many curbs have been placed on alcohol consumption as well which will also lead to reduced Health care costs.

Our health infrastructure is already of a high standard but there is room for improvement. We hope some of the savings and revenue from recent health sector achievements can be used for this purpose. There was an advertisement sometime back which extolled the virtues of the expressway network by showing an ambulance transporting patients from Matara to Colombo in two hours whereas as the real goal should have been improving the hospitals in Matara to the standards of those in Colombo. Our health service should then be able to take on any challenge posed in a constantly changing health environment.