Health is wealth Nadira GUNATILLEKE Health sector of Sri Lanka has achieved many goals during the past few years under the guidance of President Mahinda Rajapaksa and through the hard work of Health Minister Maithipala Sirisena. Here are some of the landmarks of the massive development that took place in the health sector during past few years. President Rajapaksa during one of his visits to a hospital. Sri Lanka has already achieved three Millennium Development Goals (MDG) in the health sector. The country has also recorded the lowest infant and maternal mortality rates in the SEARO region. The infant mortality rate was 140 per 10,000 live births in 1945 and now it is only 11.3 which is lower than that was achieved by countries considerably wealthier than Sri Lanka. The maternal mortality rate was 155 per 10,000 live births in 1945 and now it is only 1.4. The World Health Organisation (WHO) set eight MDGs to be achieved by 189 countries by 2015 and Sri Lanka has already achieved five of them. The life expectancy of Sri Lanka has increased by 35 years since 1948 and it is now 75 years. It is one of the MDGs achieved by Sri Lanka. Sri Lanka is the first country in the SEARO region and the fourth country in the world which adopted the International Convention in connection with controlling the use of tobacco and alcohol consumption. It is included in the MDGs set by the WHO. Apart from adopting the convention, Sri Lanka launched `Mathata Thitha'(Full stop to tobacco and alcohol). Sri Lanka has already achieved the MDG in connection with environment. A special team from the United Nations (UN) visited Sri Lanka in order to find out the secret behind achieving three Millennium Development Goals (MDGs) very successfully even before seven years of the targeted year which is 2015. According to the Second progress report on Millennium Development Goals, still Sri Lanka remains as one of the very few countries in the region with low level HIV epidemic. High literacy, the relatively high status of women and a good access to health care services act as a protective barrier against the spread of HIV infection in Sri Lanka. Sri Lankan Government has developed a national multi-sectoral strategy to combat HIV/AIDS.The overall malaria control methods are improving significantly and a sharp drop in the number of reported cases (196 in 2007) with no deaths, shows that the National Malaria Control Program has been effective, even in the traditional disease-prone Northern districts. Landmark achievement Increasing the number of hours of OPD service is another landmark achievement made under the direction of President Mahinda Rajapaksa. The percentage of patients who seek medical treatment from the OPDs of state hospitals between 4.00 pm and 8.00 pm has gone up by 15 to 20 percent. The drug requirement has also gone up by 30 per cent. Health Ministry will further extend OPD service hours. Earlier the state hospitals' OPD service was available for the public from 8.00 am to 4.00 pm. Under the direction of President Mahinda Rajapaksa arrangements were made to expand it up to 24 hours step by step. Now it is available from 8.00 am to 8.00 pm. Earlier patients seek the service of private hospitals after 4.00 pm but now they obtain medical treatment from state hospital OPDs free of charge. The amount of drugs required for Sri Lanka has gone up by 35 per cent. At the moment the Government spends 14,000 million on that. Non Communicable Diseases (NCDs) are on the rise in Sri Lanka due to urbanization etc. A three year National Plan will be drafted shortly to control the rise of Non Communicable Diseases (NCDs) in Sri Lanka. This will be done as stated in Mahinda Chinthana - Vision for the future. It was proposed to appoint one health officer on NCD to every district and set up three counseling centres on NCD in each district. Medical equipment required for 70 such centres have already been provided. The rise of NCDs is one of the significant problems faced by all developed countries in the world. Even rural areas of Sri Lanka are in danger when it comes to rapidly increasing NCDs. Advanced health care system and growing elderly population, changes in food habits and lifestyle etc are some of the main are the major reasons for this situation. National Nutrition Council The National Nutrition Council set up on January 14. It was set up by President Mahinda Rajapaksa on a proposal made by Health Minister Maithripala Sirisena. Many other line ministries and institutions such as Education Ministry, Agriculture Ministry, Trade Ministry, Environment Ministry and Social Services Ministry etc are a part of this council. The proposed National Council will be focused on children's and mothers' nutrition. It will implement the National Nutrition Program countrywide in a more effective manner. UNICEF is one of the International organizations that plays a major role in upgrading nutrition among Sri Lankan mothers and children. During the past, Governments implemented various programs time to time to eradicate malnutrition among Sri Lankan mothers and children. But non of them were combined efforts by all relevant ministries and institutions. Therefore those programs did not bring good results. Health Minister Maithripala Sirisena took a decision to combine State Pharmaceutical Corporation (SPC) and the State Pharmaceutical Manufacturing Corporation (SPMC) and establish one institution to offer a better service to the public. The two institutions brought under one management establishing one institution. The decision was taken after consulting scholars, professionals and the public and considering their views. According to the relevant act it was proposed to set up one institution, SPC, but two institutions, SPC and SPMC established instead of one institution. The State Pharmaceuticals Corporation was established in 1971 under the State Industrial Corporations Act Number 49 of 1957. The work of formulating some new bills and amendments to some existing acts (a total of seven) are about to be completed and they will be presented to the Cabinet and then to the Parliament soon by Health Minister Maithripala Sirisena. Priority has been given to introduce new legislations to Mosquito Breeding Control Act and Tobacco and Alcohol Control Act. Legal action After introducing amendments the law enforcement officers will be able take legal action against mosquito breeders after three days of issuing notices to them. At the moment the mosquito breeders get seven days before taking legal action against them. The cigarette packets should clearly indicates the words which means smoking cause death. Drug Authority to be established under the same amendments. Another significant act to be amended is Private Medical Institutions Registration Act. Once amended the State Health Authorities will be able to intervene in a more effective way when medical negligence and suspicious deaths occur in private hospitals. At the moment there is no adequate legislations to intervene and do justice for the people who face various problems during obtaining medical treatment from private hospitals. The new acts and amendments will upgrade and strengthen the free health service of the country. National HIV/AIDS Policy The National Drug Policy will be presented to the Parliament before the end of this year. The formulation of the two bills have already been completed. The two bills to be presented to the Parliament after presenting them to the cabinet. Certain circulars related to the implementation of the policy to be issued by January. Other circulars to be issued later. Health Minister Maithripala Sirisena thanked President Mahinda Rajapaksa for assisting him to accelerate the work of two bills in connection with the National Drug Policy. The Health Ministry launched the National HIV/AIDS Policy marking another landmark in the Sri Lankan health sector. The main objectives of the policy are to prevent HIV and other sexually transmitted infections in Sri Lanka through effective strategies aimed at reducing sexual transmission, mother to child transmission and transmission through blood and blood products in order to improve the quality of life of people infected and or affected by HIV/AIDS through minimizing stigma and discrimination and providing care and support. Dengue controlled through the Presidential Task Force set up to control dengue. The National Dengue Control Program was supported by the armed forces, police and all relevant state institutions. Communicable diseases have gone down from 24 percent to 13 percent. Vision 2020 Program is aimed at preventing blindness and other eye problems. It offers free spectacles and many other facilities free of charge. The ministry spends over Rs. 21,000 million only to buy drugs. The Ministry recruited around 15,000 new nurses in order to meet the full demand for nurses. Around 5000 medical professionals were recruited during past few years. Now all state hospitals have MBBS doctors. Training specialist doctors taking place continuously. Cancer treatment decentralized and now cancer treatment available at Kandy, Karapitiya, Kurunegala, Baticaloa and many other teaching hospitals. Neuro Trauma Treatment Units are also available in many state hospitals for the use of accident victims.