As the rays of the sun filtered through the branches of the trees in the garden, Aldoris, the choon-paan karaya, came down the lane in his food-laden tuk-tuk with music breaking the silence of the neighbourhood. “Mata poddak parakkuwuney dengue gana hoyana aya ava apey paththa pariksha karanna (I got a bit late as dengue [...]
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“Mata poddak parakkuwuney dengue gana hoyana aya ava apey paththa pariksha karanna (I got a bit late as dengue inspectors had come to our area),” he said, doling out hot ‘maalu paans’ . “Mae sarei dengue prashnaya wena avurudu walata wada godak ugrai wagey (This time the dengue problem seems to be worse than other years),” said Serapina . “Janathawata waga keemak thiyenawa wathu piti pirisinduwa thaba ganna (People also have to be responsible and keep their gardens clean),” noted Kussi Amma Sera . “Magey nedey kenukata dengue haduna. Eya hariyata duk vinda (One of my relatives got dengue and she suffered a lot),” added Mabel Rasthiyadu .
Dengue is somewhat the focus this week as there is also an economic impact going by a Sunday Times Business report last week, where it was stated that the economic repercussions of dengue in Sri Lanka are seen through sudden workforce absences, lost wages and overwhelmed healthcare systems. Low productivity is also an issue.
Softlogic Life Insurance Executive Vice President Chief Financial Officer Nuwan Withanage was quoted as saying in that report that: “The recovery period for most patients is one to three weeks, with severe cases exceeding this time. The general decline in productivity across various sectors such as apparel and other manufacturing industries owing to high absenteeism and operational disruptions will hamper business continuity.”
While dengue is endemic, Sri Lanka’s focus in dealing with it has been somewhat ad hoc. “We wake up only when it becomes a problem when dengue prevention should be an all-year exercise,” said a health specialist.
Lower spending on health – largely as government politicians perceive this as a problem due to restricted spending in accordance with the International Monetary Fund (IMF) programme – was also an issue.
In the wider context of the economy, reduced spending on preventive healthcare invariably results in a higher cost for post-care treatment. But one of the ways in reducing alcohol and tobacco consumption is through taxation where higher taxes on these products have in fact seen success in this area.
Planning to assess the bigger picture on how productivity and loss of income owing to illnesses has impacted the economy, I reached out to Dr. Ravindra P. Rannan-Eliya, Executive Director & Fellow of the Institute of Health Policy (IHP), whose institute has done work on the link between the economy and health.
“All health services are underfunded and it’s a myth for government politicians to say the IMF won’t allow more health-related funding. It’s not true that the IMF wants this reduced. The IMF wants more tax collection and spending more on health is not an issue,” he said.
He said when COVID-19 struck in 2020, local PHIs stopped dengue work due to lack of funds. “It was okay at that time as there was no spike in dengue cases. But dengue is endemic in Asia, and Australia for instance reported nearly 10,000 deaths from COVID-19 in the past 12 months. As is always the case, health issues affect productivity as people feel sick and mothers have to stay off work to attend to their sick children,” Dr. Rannan Eliya said, adding that dengue remains a disease even in Singapore and Malaysia largely due to climate change and urbanisation. It is an issue even in richer countries.
“Dengue is a treatable disease and can be clinically managed. We need more local health services like Malaysia or Singapore which have similar British-colonial origin services. Meanwhile, we have decided that COVID-19 is no more a disease here, but COVID-19 in my mind is more dangerous than the flu,” he said.
There are no comprehensive reports on the connection between health and the economy and its implications on productivity and income. Even if 10 per cent of a workforce of about 8.5 million falls ill, the economic impact is huge – not only on productivity and loss of income but also the cost to the health sector.
In a study titled ‘Impact of COVID-19 on Major Sectors in the Sri Lankan Economy’, by Messrs K.G.N. Senanayaka and R.A.B. Abeygunawardana of the Faculty of Science, University of Colombo, the researchers said that the COVID-19 pandemic significantly impacted both public health and the economy of Sri Lanka, leading to a prolonged economic recession.
The study analysed the performance of the seven major sectors of the Sri Lankan economy during the pandemic period to quantify the effect of different factors of the pandemic such as lockdown, number of COVID patients and deaths, individually on each sector. The research considered the contribution to the GDP of sectors in the Sri Lankan economy as a measure of the performance of each sector.
“The results of the panel regression imply that both the health and education sectors had been negatively affected by the number of COVID patients. The lockdowns have reduced the performance of the manufacturing and agriculture sectors, but the pandemic has not affected the construction, fishing and transportation sectors. Thus, the pandemic has resulted in diverse impacts on various sectors, with some remaining unaffected and others experiencing different effects, emphasising the importance of developing sector-specific strategies to address their unique challenges,” the report said.
In another study by the Rajarata University of Sri Lanka on the productivity of women, it was stated that the impact of illness on the productivity of Sri Lankan women is significant, with a total productivity loss of 28.9 days per episode of maternal ill health. “This loss is attributed to various maternal ill health conditions, which affect the daily life of pregnant women and their ability to perform household tasks. The study highlights the need for better care and support during pregnancy to mitigate these losses and improve the overall productivity of women in Sri Lanka,” it said.
In another July 2022 Sri Lankan study published in the Lancet Global Health magazine and undertaken by Anne Thushara Matthias and Saroj Jayasinghe, it was stated that threats to health from an economic crisis are multifold. “Stress and lack of health care can increase cardiovascular morbidities. Malnutrition can affect generations of children. Communicable diseases can increase due to rising costs of amenities and the weakening of preventive and control measures. These multiple crises have the potential to cripple health systems,” it said.
It may be an appropriate time to undertake a study of the impact of illnesses and disease on the economy. A better understanding of the link and economic cost of regular, endemic illnesses could enable policymakers to be better prepared to face the future with health prevention being the main focus.
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Print Edition – The Sunday Times, Sri Lanka
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