Go beyond ceremony, Mr. Minister

It may be a cliché that health is wealth but above and beyond that of-quoted phrase is a wealth of truth. For people and a nation to be wealthy or for poverty eradication, health is not only vitally important but also an issue of life and death.
Recently, our longest serving Health and Nutrition Minister Nimal Siripala de Silva was appointed chairman of the executive board of the World Health Organisation. Huge posters, hoardings and banners appeared all over the country, hailing this appointment as a great achievement for the country and the minister personally. A big ceremony was also held at the BMICH to felicitate the minister while some state propaganda organs described this appointment as a vindication of Sri Lanka's status in the world and claimed it made amends for Sri Lanka's removal from the United Nations Human Rights Council. Comparing the two posts is like putting sticking plaster for a heart ailment.

According to world health experts, the post of chairman of the WHO executive board is largely ceremonial and rotational. No elections are held to this post unlike the seat in the UNHRC.

Whether ceremonial or not, Minister de Silva now has an opportunity to justify his position as chairman of the WHO executive board by doing what he needs to do in his own country because charity like health begins at home. For instance, there are several important steps he needs to take to correct various structural and unseen imbalances and injustices so that the country's health service could be restored in a manner that gives priority to the well-being of the patient. As a start, the minister would do well to take steps to move a constitutional amendment to the constitution and make health a fundamental right of the people. The constitution's fundamental rights chapter guarantees many civic and political rights but unfortunately health has not been included though Sri Lanka has signed the covenant to this effect.

The Law and Society Trust and the People's Movement for the Rights of Patients some years ago submitted a draft amendment to make health a fundamental right. This was submitted to both the Minister of Health and the Minister of Constitutional Affairs. Both of them agreed it was a vital and urgent need. As usual, they agreed to act fast on it, but almost three years have passed and little or nothing has been done. The civic actions groups hope that during this period when Minister de Silva holds this prestigious post in the WHO, he will also write his name in the hearts of the Sri Lankan people by taking steps to make health a fundamental right. This may be one small paragraph in the constitution, but it will be a giant leap for millions of suffering patients who would have a solid foundation to take action against any ill-treatment, mistreatment or violation of their fundamental right to health.

Another important step the Health Minister could take during this period is the implementation of a charter of patients' rights and responsibilities. Many countries which have effective health policies work on such charters to guarantee that their health services give priority to the well-being of the patients. Here again, a comprehensive charter, drafted by the LST and the PMRP was submitted to the minister more than three years ago. Again in this case, too, he assured quick action to effectively implement the charter but so far it appears to be still paralysed under the sick bed of the Health Ministry bureaucracy. Many readers might be surprised to know that besides these two major lapses -- the omission of health from the Constitution's fundamental rights chapter and the absence of a patients' charter - Sri Lanka also does not have a national health policy.

A national health policy includes guidelines on how Sri Lanka could tap the full potential in the various forms of medicine known and practised in this country for generations. They include allopathy or western medicine, Ayurveda, homeopathy, acupuncture and other forms. A vital part of any national health policy is also a national medicinal drugs policy. Again, in this case also a comprehensive draft worked out after several days of consultation among all stakeholders was handed over to the Health Minister three years ago. It was approved by the cabinet and a high-level national standing committee comprising medical professors, pharmacologists and other experts were appointed to work out legislation essentially to provide quality drugs to all the people at affordable prices. The standing committee met several times and legislation is known to be 80 percent ready but like so many important issues, the minister and ministry officials appear to be paralysed or plagued by sickness when it comes to introducing legislation and implementing it. We hope the minister will act quickly on this issue also so that at the end of his ceremonial term, he would be able to say he turned the ceremonial post into some concrete action for his people and thus set an example to the world.



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