YES ……THAT CAN BE DONE.
Udeni J Dasanayake (ujd 201)
Millions of people, including innocent children, are dying unnecessarily. Moreover, additional millions are suffering from easily preventable diseases in the world today and wasting their entire productive lives. Various governments and the organizations dedicated to improving health are spending trillions to improve the health infrastructure daily. A large number of medical doctors, nurses, and other health care workers are being recruited to the health sector more than ever before. Expensive and advanced medical technology for diagnosis and management of diseases are being introduced more than before. Expensive medical treatment modalities are also being introduced regularly. Medical authorities are allocating large sums of money for medical research, training, and health sector development. In spite of the above improvements, millions of innocent people are still suffering from easily preventable diseases and waste their productive lives.
As a clinician with decades of experience in Southeast Asia, I attribute this challenging medical scenario to poor health planning and implementation without taking the political will in to account. Most of the countries are ruled by democratic political systems. Most ruling politicians put their efforts to secure personal stability, success, and survival but they put minimum effort towards the development of the country. Different special interest groups have properly understood the politician’s behavior and they manipulate the politicians to achieve their selfish marketing objectives. Unfortunately, most top medical officials, planners, and the other responsible medical authorities are in a desperate situation in between these two negative forces. This highly complicated bitter truth is slowly eroding the best practices of global health. This is the hidden part of the ice burg that top health officials should be proactively identified and manage as a future challenge in generating political priority. Based on my limited experience, I assume that this negative scenario is more profound in developing countries compared to developed countries.
Politicians have the authority of financial allocation to the health sector. They also have their hidden agendas for their future survival and make use of this opportunity with the help of special interest groups. They always ready to allocate their health budget with the intention of creating their future mandate. They always trying to influence the health recruitment processes and try to select less capable political supporters. They always try to allocate money not for the health priorities and for satisfying their political supporters. Top health official must carefully identify their needs and expectations. They should have the ability to trade off this condition and find positive solutions through continuous negotiations based on scientific explanations and awareness. Top health officials should convince the state leaders, leaders of international health organizations, opposition political leaders, powerful trade union leaders and community leaders without compromising countries health needs and not antagonizing politicians.
Current medical authorities spending large sums of money for the implementation of health improvements only observing the superficial part of the ice burg. This will not work or produce the expected outcomes. This unfortunate politicization victimized the top health leaders and health policy makers unproductively. Health officials should think about this challenge and must find a valid solution to implement unbiased health development plan. Top medical officials, medical policy makers and planers must properly understand this truth. If health officials work to rule without listening to the political concerns, health implementation is never going to work
This has proven in the recent health sector development in Brazil . They decentralized the entire medical system through a centrally coordinated health management system called ‘Unified Health System’ (SUS). They always get the social support and control through a public health council. They had over 20,000 highly effective centrally controlling family health care units all over the country. These units visit families and taking care of their health needs effectively. Through this big event they could reduce infant mortality and maternal mortality drastically.
This is how I am looking at the topic of generating political priority to improve global health. I have contributed my ideas based on my limited exposure in South East Asian social and political systems and never assume these political and social systems are similar to other parts of the world. But I strongly believe that the human needs, human behavior, and the value of the human life have strong similarities. Therefore I am very much confident that the above system with modifications will be effective to improve global health.
1. Arnquist, S., A. Ellner, and R. Weintraub, HIV/AIDS in Brazil; Delivering Prevention in a Decentralized Health System. 2011: Harvard Business Publishing.