With the sudden and globally devastating advent of the COVID-19 pandemic having cruelly exposed the weaknesses of the health sector in developing countries, the World Health Organization (WHO) Council on the Economics of Health for All is advocating with a renewed sense of urgency that clear and ambitious goals be set for mobilising investments towards financing for health as a long-term investment rather than a short-term cost. The call, we are told, is backed by scientists who are essentially seeking a radical re-direction of countries’ resources to put ‘Health for All’ at the forefront of national development forward planning rather than allow it to become hostage to what is loosely described as what we can afford.
Perhaps the great tragedy about a report of this nature is that it is probably not likely to get the studied attention of leaders in government (at the level of Cabinet, for example) since, in poor countries (and here we include Guyana) where careful contemplation of a report on this nature can do us a world of good, leaders in government are usually otherwise occupied.
Essentially, the WHO report is a wakeup call from the scientists to governments for radical redirection of countries’ economies to put ‘Health for All’ at the forefront of their development planning. It makes the call in the face of what has become the hard-to-push-back global COVID-19 pandemic coupled with what is now the incremental menace of the vicissitudes of the global climate phenomenon that can over time, literally close down human existence as we know it.
What the scientists are seeking here is a shift in the mindset of politicians whose spending priorities tend to be directed towards prestige projects. The upshot of this is that all too frequently, projects like new, better equipped hospitals and the training of health professionals become slotted into a queue that transforms them into turn-taking projects. They do not respond to a line of reasoning that dictates that health should be ‘put first’.
Here in Guyana, health care has long been dragged down the same turn-taking path, the net effect of this being that it has not undergone, for decades, what one can describe as transformational change.
A few things stand out about our health sector. First, advancements in health care delivery have not kept pace with the range of health-related challenges to which Guyana (like the rest of the world) has become vulnerable; secondly, such upgrading of the quality of the health-related services as have materialised in Guyana over several years have been to a large extent, a function of private sector investment, that is to say, the advent of private health care institutions. Needless to say, the extent to which these private institutions have contributed to the emergence of an enhanced health care sector is debatable since the cost of private health care in Guyana is beyond the reach of many ordinary Guyanese. Finally, there having been a woefully insufficient effort of government, over time, to considerably upgrade state-funded health care facilities across Guyana has reduced the sector to a condition of popular and regrettable ridicule with the wages and salaries of frontline workers, including nurses being nothing short of scandalous.
At its core, what the WHO is urging is a reassessment of health care and its significance by countries in a manner that ceases to cause the health sector to be seen as a run-of-the-mill service rather than a pillar on which the holistic development of the country rests. COVID-19 has been an eye-opener. It caught us in pretty much the same mindset as had traditionally been applied in the official contemplations of the health sector and just where it is positioned in the constellation of broader development priorities. That weakness, in effect, has made the challenge of mounting a better response to the pandemic more challenging than it might have been if our conceptual approach to health care was more reflective of an understanding of the reality that without a state-administered health service that benefits from attention consistent with the extent of its importance, the broader development of our country is really on a hiding to nowhere.
