— as gov’t allocates $51.7B to health sector

By Navendra Seoraj
A NUMBER of health programmes, which were affected by either the novel coronavirus (COVID-19) or by “poor” management under the past administration, will be resuscitated by the new People’s Progressive Party/Civic (PPP/C) government, said Minister of Public Infrastructure, Juan Edghill while presenting Budget 2020 to the National Assembly on Wednesday.

He lamented that the PPP/C Government inherited a Ministry of Health that was in an “unhealthy state” because the last government neglected some of the most basic public health programmes.

This, he said, includes the immunisation programme, the HIV/AIDS programme, chronic non-communicable diseases (NCDs) programmes and the mental health programme.

“Many hospitals, health centres and health posts across the country are in a state of disrepair, and lack the most basic of equipment. In addition, there is an acute shortage of drugs and medical supplies across every region, as pharmaceuticals were not procured since 2017.
“These chronic shortages compounded by the mismanagement of the healthcare system, has compromised the care for thousands of Guyanese,” Minister Edghill lamented.

As an immediate measure of relief, he said Budget 2020 will provide for the purchase of adequate drugs and medical supplies; the purchase of test kits and anti-retrovirals for HIV patients; the repair of the diagnostic imaging capacity of many of the hospitals; and fix many of the infrastructural defects at facilities across the country.
To this end, government has allocated $51.7 billion or 15.7 per cent of the total budget for the health sector, for 2020.

DRUGS AND MEDICAL SUPPLIES
Of this amount, $14.3 billion is budgeted for the procurement of drugs and medical supplies, said Minister Edghill, noting that corrective action to facilitate the procurement of emergency supplies of drugs and medical supplies, to the tune of $3.2 billion, is already underway. And, a full review of quantification and procurement practices is being undertaken.
Additionally, the state of affairs with regards to NCDs is of concern because of the COVID-19 pandemic. In addition to the shortage of essential drugs, many of the employees from the NCDs Unit have been reassigned to COVID-19 response and scheduled training has been deferred.

As of June 30, 2020, only 12 of the 50 planned workplace outreaches for 2020 were undertaken. Additionally, data collection for NCDs reporting has also been challenged due to the emergency public health measures restricting movement.

“We have to resume the planning of progressive health policy measures to contain the onset of NCDs through risk factor reduction,” said Minister Edghill.
The pandemic has also challenged the National AIDS Programme, which only achieved testing for 6,659 persons for January to June, of an annual target of 70,000.
To make matters worse, the country suffered from a “stock out” of the HIV rapid test kits. The National Public Health Reference Laboratory has since restricted HIV testing to critical or emergency cases and priority target groups.
Government has, however, budgeted $143.3 million for HIV-related drugs and medical supplies, and is also seeking Global Fund support to significantly bolster national testing capacities.

LONG-LASTING INSECTICIDAL NETS
In the area of malaria control, government is preparing to undertake another cycle of distribution of long-lasting insecticidal nets with procurement slated to commence this year.

The malaria programme for this year, however, has also faced with the challenge of reduced capacity due to COVID-19 restrictions. Timely data gathering and reporting, has adversely affected the performance of this programme.
The former has suffered from a reduced reporting rate of only 23 per cent for January to mid-June. But government has requested assistance for support in procuring rapid test kits for expanded testing.

“With regard to our immunisation programme, it must be noted that with the onset of the pandemic, it was almost inevitable that we would face challenges, as persons reduced their out-of-the-house activities.

“As such, we will be working to launch outreach and house-to-house immunisation activities to ensure our vaccination coverage does not significantly decline. We have also budgeted $17 million to commence the construction of a cold storage bond in Region Six to ensure that we are able to maintain a sufficient supply of vaccines in-country,” said Minister Edghill.

Another programme that will focus on outreaches, in light of COVID-19, will be the Family and Primary Health Care Programme. The Programme has prioritised the conduct of mobile family planning and obstetrics outreaches for 2020.
Both are critical, as unplanned pregnancies are expected to increase, given the restrictions to movement due to COVID-19, said Minister Edghill. Expectant mothers are also likely to not make regular clinic visits.

The Guyana Public Hospital Corporation’s (GPHC) maternity block has since been configured to accommodate suspected COVID-19 pregnancies.
“The situation at GPHC requires aggressive attention. Our only national referral hospital has been suffering from issues of overcrowding and insufficient infection prevention and control standards for quite some time,” said Minister Edghill.

Government has since budgeted $15 million to continue the extension of the accident and emergency and medical outpatient departments.
Additionally, government has budgeted another $20 million to commence the design of a four-storey building to relocate the pharmacy and medical records services, and to create on-call accommodation for medical personnel.

“Overall, we have budgeted $11 billion for GPHC, for 2020, which includes $2.5 billion for drugs and medical supplies. The overall budgeted amount represents $1.4 billion more than was expended for the GPHC in 2019,” said Minister Edghill.

SMART HOSPITAL INITIATIVES
“As we fix these immediate needs, the government has already started to look at medium- and long-term projects in the health sector. These include completing the SMART Hospital initiatives at Diamond, Paramakatoi, Mabaruma, Leonora and Lethem. Funding has been allocated for the redevelopment of the West Demerara, Suddie and Bartica Hospitals,” said the minister.

Preliminary discussions are also being undertaken to operationalise a national electronic patient information system. In addition, government has received several enquiries from local and international organisations to develop speciality care facilities in Guyana and is also considering the establishment of a medical research institute, as they work to modernise the delivery of healthcare in Guyana.