Guyana boosts response to chronic non-communicable diseases
February 27, 2007
“ Guyana 's investment in health is not merely one being driven by a moral or ethical inclination. It is driven mostly by the realisation that a healthy population is an essential prerequisite for economic growth. In short, it is development. Health and development are intrinsically linked and cannot be separated.”
This point was stressed by Minister of Health Dr. Leslie Ramsammy, yesterday, as he launched a National Oversight Committee for Chronic Non Communicable Diseases (CNCD), a category that accounts for more than 80 percent of the mortality in developing countries.
The committee was launched in recognition of the significant burden that Guyana continues to carry because of CNCDs, which include cardiovascular diseases (coronary artery disease, stroke and hypertension), diabetes and cancer.
The newly established committee includes stakeholders from other government ministries (Home Affairs, Education, Human Services and Social Security, Culture, Youth and Sport and Agriculture), various departments at the Ministry of Health, technical agencies and Non-Governmental Organisations (NGOs).
The Oversight Committee will be chaired by the Minister of Health and its secretariat would be based at the Ministry.
The Committee was formed to coordinate and implement activities relating to the National Strategic Plan for Chronic Non-Communicable Diseases and is responsible for public policy and advocacy, surveillance, health promotion and disease prevention, as well as, integrated management of CNCDs and risk factors.
Delivering remarks at the launching at the Ministry of Health, Minister Ramsammy noted that Guyana has made important advances in health.
“Such improvement has come about because the Government has seen the importance of investment in health. Thus, in 1964, Guyana was investing US$16 per capita on health. We were among the top countries in the region when it came to investment in health. Today, there are more than 60 countries around the world investing less than US$16 per capita. We failed to sustain that level of investment in the health sector after independence because of the economic struggles of the 70s and 80s. In part, the shock of the rapid increases of oil prices was reflected in deteriorating investment in health. Thus, by 1991, we had dropped to the lowest in the Region and among the lowest in the world at about US$7 per capita,” he said.
However, since then the country has reversed the trend of decreasing investment and in 2007 budgeted to spend US$67 per capita. “This is still not among the highest in CARICOM, but it is almost ten times, the expenditure of 1991. And in terms of percentage of the national budget, Guyana has effectively caught up with the rest of the countries of CARICOM. Guyana is investing 11% of the national budget to health in 2007. Even as we have caught up with the rest of CARICOM in terms of the budgetary percentage going to health, we are still far below these countries in terms of per capita investment in health. The next lowest in terms of per capita investment in health is Suriname at about $US153 per capita. But only 60% or about US$93 comes from the Government. Yet this accounts for 17.7% of the national budget of Suriname ,” he said.
In this context, he noted that Guyana has to prioritise to utilise available resources effectively. “We know that an average of about 5,000 persons die each year in Guyana . On a daily basis, the communicable diseases dominate our attention. HIV is a killer. Malaria causes many people to be sick. TB causes many people to be sick. Diarrhoea may bring death to many children. Acute respiratory infections may cause death in children. The fact, however, is that the majority of people who show up at the health facilities for care come because of one or the other of the chronic non-communicable diseases.
Among the top five causes of illnesses in Guyana , all of them, with the exception of HIV, are chronic non-communicable diseases. Most of the deaths in Guyana are accounted for by chronic non-communicable diseases. Chronic non-communicable diseases must, therefore, be a priority for us,” he emphasised.
According to Minister Ramsammy, government spends about $1B for the diagnosis and treatment of diabetes. The estimate does not take into consideration the prevention efforts or the prevention, diagnosis and treatment of diabetes-related complications. And it does not take into consideration the cost of hospitalisation.
“This would mean that in excess of 10% of the total health investment in the national allocation to the health sector ought to be going to the prevention and treatment of diabetes. A similar amount is likely to be spent on hypertension and even more on cardiovascular diseases. A similar amount, if not more, should be expended on cardiovascular diseases. What about cancer? What about disability that comes from accidents and violence? Thus, the picture is clear, unless we do something to reduce the scope of the problem, our budget for health will be untenable,” he observed.
The Minister noted that the Millennium Development Goals do not address CNCDs and this presents a large void in the health sector's response. It is for this reason that Guyana is among other countries lobbying the United Nations to have CNCDs included as the ‘MDG Plus'.
Meanwhile, the Ministry also launched ‘Guidelines to Manage Type 2 Diabetes' at the said ceremony. Minister Ramsammy noted that this will be implemented at all public health facilities and will be used as a base line for the minimum level of care to be delivered at regional hospitals and the Georgetown Public Hospital Corporation.