Ramsammy advocates free CARICOM health care towards MDG
MINISTER with the portfolio, Dr. Leslie Ramsammy has advocated that health care be made free for all Caribbean Community (CARICOM) citizens.
Speaking at the 21st meeting of the Council for Human and Social Development (COHSOD) last week, he, however, acknowledged that the goal of ‘Health for All’ has remained elusive because the partnership, the much needed collaboration of global stakeholders, remains impeded by a preoccupation with parochialism.
“The new robust partnership model that has evolved during this last decade has led to an unprecedented mobilisation of resources for health and yet we have not quite reached the goal of Health for All,” he said.
Health for All was the concept outlined in the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care (PHC), Almaty (formerly Alma-Ata), in September 1978. It expressed the need for urgent action by all governments, health and development workers and the world community to protect and promote the health of all the people and was the first international declaration underlining the importance of primary health care.
Ramsammy said: “In 1978, the world got together in the Alma-Ata Declaration to guarantee Health for All by 2000. World leaders had agreed that health was an integral part of development and that the only way to eliminate poverty was by ensuring that health was driving the development process.”
He said, following that declaration, even in rich countries like the United States (U.S.), the goal had become mostly elusive by 2000.
“Health for All by 2000 had failed and we realised that the dream of Health for All had to be deferred. We articulated the MDGs (Millennium Development Goals) as our new call and set about an aspiration of Health for All in yet another pursuit for better lives for the citizens of the world as we extended the date to 2015,” Ramsammy explained.
He said the failure to ensure Health for All by 2000 was evident in the startling statistics reflected in the world, which showed that:
* malaria was killing more than one million people per year, mostly children, because life saving medicines were not accessible in developing countries;
* five million people were dying each year from AIDS. Most persons in the developing countries did not know their HIV status and those who knew did not have access to life saving medicines;
* more than 15 million children were dying each year from preventable causes, mostly because life saving vaccines and medicines were unavailable to them;
* more than 500,000 women were dying from preventable causes related to pregnancy;
* there were 20 to 30 health workers per 10,000 people in the developed countries in 2000, while the ratio was between one and three health workers per 10,000 people in the developing countries and
* while life expectancy in some countries, developed countries mostly, was increasing, in most developing countries it had stagnated and even dropped in at least a dozen countries.

Life expectancy

“No country in the Americas should have a life expectancy of below 75 by 2025 and there should be no country in the world with a life expectancy of below 70 by 2025,” Ramsammy said.
He said, for Guyana, by 1990, 12 years after Alma-Ata, the promise of Health for All was still only a distant dream.
“We emerged into the 1990s, the last decade before the promise of Health for All, with fewer Guyanese with access to effective health care than when Health for All was first articulated in 1978,” Ramsammy admitted.
He said the life expectancy of the Guyanese people was poised to drop below the 1975 level and they were on the verge of below 60 which was achieved by 1964.
Ramsammy said there were several major problems still plaguing public health, such as:
* maternal mortality was more than 320 per 100,000;
* child mortality was in excess of 120 per 1,000;
* access to the most essential medicines was less than 20 percent;
* the physical infrastructure was in a dilapidated state and
* health systems were weak and management and accountability poor.
“It was a place of despair and the Government investment in health had fallen to about US$6 per capita. This was a time when Guyana had obviously delinked health from development,” he posited.
But, in more recent years, Ramsammy said, Guyana has made some success, to date, with Health for All.
Still, he noted that, as the services offered increase, so is the need for a larger number of health workers.
In that regard, Ramsammy emphasised that the concept of Health For All has changed, dramatically, from 10 years ago.
He said, presently, Guyana has 6.2 health workers for every 1,000 persons and emergency medicine is not an option. Rather it is imperative to develop capacity because lack of access is unacceptable.
Ramsammy said Guyana has demonstrated that, in a short space of time, it can develop capacity and the will and proper policies would see challenges to development dissipating.
He said, too, that partnerships are key to making progress, something that Guyana has demonstrated time and time again.
Ramsammy said the shift in paradigm was a must.

Global partnership

“Through a different kind of global partnership for health, we have had progress in making health a public good and found a way to bring the world together to improve our chances to provide Health for All and achieve equity for citizens everywhere,” he said.
Ramsammy said, in the last ten years, since the declaration of the MDGs, there has been a renewed pursuit that saw the concept of partnerships being embraced with more enthusiasm and greater urgency.
He maintained, though, that, while the more robust embrace of partnerships and collaborations since 2000 has led to dramatic improvement in health, there is still a vast distance to travel to attain Health for All and to guarantee global attainment of the MDGs.
Ramsammy said, to protect and promote Health for All, several things need to be done, primarily ensuring provision of quality, safe and efficacious medicines and access to medical technology and other commodities, which are essential to any health system.
“Access to medicines and commodities, indeed, is an indispensable need to guarantee Health for All and the promotion of long, productive, disability free lives for our people, all of our people, everywhere,” he declared.
Ramsammy identified partners in the fight for Health for All as the President’s Emergency Fund for AIDS Relief (PEPFAR), the World Bank MAP Programme, the Inter-American Development Bank (IDB) Health Sector Institutional Strengthening Programmes, Global Alliance for Vaccines and Immunisation (GAVI), Global Fund, Global Health Initiative, Clinton Foundation and the European (EU) Partnership Programmes with the World Health Organisation (WHO), among many others.