Tag: prescription

Universal health insurance a first for Maldives

Parliament yesterday passed a bill to bring universal health coverage to Maldivian citizens for the first time in the nation’s history. The bill was submitted by Nolhivaram MP Mohamed ‘Colonel’ Nasheed and unanimously approved by with 72 votes.

“Previously, the public paid for health care and the need applied for subsidies under the welfare system, or sought assistance from well-connected friends and family,” the President Press Secretary Mohamed Zuhair explained. “This bill means a lot.”

According to the bill citizens receive government-sponsored coverage up to Rf100,000 (US$6,500) per year. Zuhair said the bill includes provisions for citizens who require further financial assistance.

Expatriate workers are also eligible for coverage providing their employers pay a upfront fee of Rf1,000 (US$65).

The Aasandha (well-being) program was officially signed at Artificial Beach today with hundreds of Maldivian citizens in attendance. The mood was positive.

“This will make it much easier for everybody in the Maldives,” said onlooker Mariyam Hafseena. “Before we had to pay for treatment and medication, which is expensive. Now it will be free. We never expected this would happen, it’s a surprise and we are very happy!”

A statement from the Mexican government recalled that universal health insurance was approved in Mexico eight years ago. “Mexico and the Republic of Maldives are developing countries, but with our universal health insurance programs our people’s health care can be better than that of developed countries such as the United States.”

Health Minister Aminath Jameel said the program brought “excellent and comprehensive health care for all from the public and private health sectors.”

Aasandha is a public-private partnership with Allied Insurance. Under the agreement, Allied will split the scheme’s shared 60-40 with the government. The actual insurance premium will be paid by the government, while claims, billing and public awareness will be handled by the private partner.

Provision of the service was said to have been made available through a collaboration with London-based international banking organisation Lloyd’s and the US-based Global Assurance Group.

The service will cover emergency treatment, including overseas if the treatment is not available locally, inpatient and outpatient services, domestic emergency evacuation, medicine under prescription, and diagnostic and therapeutic services.

Maldivians regularly travel to Sri Lanka, India and Singapore for medical treatment, including giving birth. Allied has also claimed that its premium package now allows for coverage everywhere in the world including the US and Canada.

Zuhair confirmed that the government has agreements with medical centers in these countries and can provide coverage for treatment at designated centers as well as travel stipends.

Coverage for treatment abroad is limited to high-income individuals, however Zuhair understood that the some government funds would be available to needy families.

The universal deal also comes with universal responsibility.

Zuhair said the public is expected “to appropriately follow a healthy lifestyle”, reiterating that the new system does not equate with a free-for-all dispensary. At the same time, the government “is challenged to raise the standards of medical service and continuously improve the care available in the Maldives.”

Plans for such improvements are in place. One recently proposed plan would shift the pharmaceutical industry to generic drugs, which the World Health Organisation considers more affordable and reliable than brand-name products.

The same plan would also streamline the prescription process, cutting back on paperwork and reducing patient stress.

The new health insurance plan will become active on January 1, 2012. Zuhair said citizens can expect minimal paperwork responsibilities.

“The new system should be very easy,” he said. “We are working to cut down paperwork and keep all the information in a central database. More will be handled by the government.”

Zuhair advised the public to attentively update their identification cards, as these will be necessary to receive treatment under the Aasandha plan.

Parliament yesterday also passed a pre-school bill, submitted by Meedhoo MP Ahmed Siyam Mohamed and approved with 71 votes, and an archive bill submitted by Manadhoo MP Mohamed Thoriq, approved with 66 votes.

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Antibiotics “most misused drug in the Maldives”: ADK COO

Over-prescription and sale of over-the-counter antibiotics is leading to a rise of resistant super-bugs, the World Health Organisation (WHO) has warned, with the Maldives no exception.

“Antibiotics are the most misused drugs in the country,” ADK Chief Operating Officer Ahmed Jamsheed told Minivan News today. “People are becoming resistant, and in certain cases they might not even need the antiobiotics.”

The WHO is discussing the overuse of antibiotics and growth of superbugs at the 64th meeting of the Regional Committee for South-East Asia, in Jaipur this week.

Director General Dr Margaret Chan said, “we have taken antibiotics and other antimicrobials for granted. And we have failed to handle these precious, yet fragile medicines with appropriate care. The message is clear. The world is on the brink of losing its miracle cures.”

Jamsheed said he has seen patients with headaches prescribed with powerful antibiotics, such as ciprofloxacin. He says a lack of systematic supervision allows pharmacists, who are not educated in medicine, to give antibiotics to anyone who asks regardless of a prescription.

“We have a very rudimentary diagnostic capacity in the Maldives,” said Jamsheed. “Hospitals and physicians are not properly monitored, and patients have a lot of independence to choose the drug they want. There are few national guidelines.”

According to Jamsheed, hospital diagnoses are compromised by inadequate facilities. He said that as organisms  mutate, doctors are not able to keep up. Bacteria samples are usually outsourced, and communication can take weeks. “In some cases, we may not be able to recognise and diagnose a disease until we’ve already lost a few patients,” he said.

Superbugs, or super bacterium, are bacteria that carry several resistant genes and are difficult to treat. When a disease is inappropriately or excessively treated with antibiotics, the body develops an immunity which encourages the bacteria to grow stronger.

Dr Chan said many non-communicable diseases, such as heart disease and cancers, are triggered by “population ageing, rapid unplanned urbanization, and the globalisation of unhealthy lifestyles.”

Chan also noted that “irrational and inappropriate use of antimicrobials is by far the biggest driver of drug resistance.” As communities become more drug resistant, treatments could become more complicated and costly.

ADK Managing Director Ahmed Affal said education was important. “There is an increasing number of antibiotics being prescribed in the Maldives, and we need to talk more. Research shows that there will be problems, as organisms become more resistant.”

Affal said that the majority of cases at ADK are fevers and infections, although heart disease, hypertension, and renal infections are on the rise. “Antibiotics are commonly used for lung infections, and sometimes are given as a preventative measure,” he said.

Speakers at the WHO conference suggested that climate change could accelerate the growth of superbugs. Jamsheed told Minivan News that Maldivians could be more at risk for dengue fever and chikungunya, as well as viral diseases. He predicted that if these diseases were to become more common, the misuse of antibiotics would increase as well and people would become more drug resistant.

“The Maldives is not isolated,” Jamsheed said. “We import almost everything, and any bacteria that is growing elsewhere in the region and the world will certainly be transmitted here.”

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