Financing sustainability and long-term effectiveness of the health sector

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DEAR EDITOR, last week in the Solomon Islands the Deputy Prime Minister and Finance Minister, the Hon. Manasseh Sogavare spoke at a welcome gathering at the Mendana Hotel where he addressed a party of visiting Asia Development Bank (ADB) Directors.

Mr. Sogavare was reported to have acknowledged the valuable contributions by ADB in the Solomon Islands over several years and he stressed the 45 years of sustained partnership and how much ADB’s financing, technical assistance, policy advice and willingness to respond to the country’s needs had been appreciated.

The Deputy Prime Minister went on to mention, specifically, the many benefits the Solomons had received from the ADB including improvements to the transport infrastructure with development projects in the areas of roads, bridges, wharves as well as susidised shipping routes.

Mr. Sogavare then highlighted the the lack of basic infrastructure and services for the majority of the people, saying Solomon Islands needing investment and growth in the infrastructure, services, social spending, and disaster risk management.

He said, “All these require large amount of concessional financing.”

One aspect of what the deputy Prime Minister picked up on, and was of special interest to me, was his acknowledgement of the technical and capacity support rendered by ADB on the preparatory work for the National Referral Hospital (NRH) relocation project.

I feel sure all will agree with what Mr. Sogavare said about the laudable assistance of the ADB in particular about aiding the country’s infrastructure and the technical and capacity support for the NRH relocation project.

Given the reported poor state of health services particularly in the Western Province, however, as highlighted in an open forum held in Gizo in mid- September this year, I was hoping to be able to learn more of the ADB’s assistance to the Solomon Islands health and medical services during the ADB Directors visit.

I mention this for several reasons and explain why I raise it

Firstly, in the Gizo forum, the Director for Provincial Health Services in the Western Province had said 14 health facilities were now closed as well as health facilities and all health activities were facing big challenges due to drug shortages, storage and delivery services.

Out of the Province’s 63 health facilities 14 were already closed down due to deterioration and land issues.

The closure of many health clinics throughout the Solomon Islands due to deterioration is a major concern that I have cited on previous occasions and I think of the many communities across the length and breadth of the country were the sick and those needing medical attention locally are being deprived of their basic human rights to medical care when needing help.

My second point is the fact that in June this year, the ADB’s Board of Directors approved a total financing package of $195 million to support the delivery of accessible, affordable, and high quality health services in Papua New Guinea (PNG).

The financing package was reported to comprise of two regular loans worth $100 million and $45.10 million and a $49.90 million concessional loan—all sourced from ADB’s ordinary capital resources balance sheet—to help PNG’s efforts in achieving universal health coverage.

Interestingly, ADB’s Health Specialist for the Pacific, Ms Inez Mikkelsen- Lopez, said at the time (quote)

“PNG’s poor health outcomes are the result of deteriorating healthcare services caused by volatile and unpredictable health financing as well as weaknesses in government systems and in health sector capacities.”

“Limited investments in the country’s health infrastructure as well as suboptimal health sector governance also undermine service delivery.”

All of what the ADB’s Health Specialist for the Pacific was quoted as having said about the health sector in PNG sounds all too familiar in respect of the Solomon Islands situation.

It would be my hope, therefore, that the ADB might further aid the Solomon Islands, if requested, to enable the long-term sustainability and effective use of the country’s health sector financing and deficiencies in rural health facilities and patient’s welfare.

Yours sincerely

Frank Short

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