By Dr Ahmed Alarabi.
Tripoli, 16 August:
Building an effective health system is undoubtedly amongst the most pressing challenges confronting the new National . . .[restrict]Congress, and shortly the new government, in Libya today.
Libya inherited a dying health sector from the Qaddafi regime, with long history of neglect, mismanagement and corruption. Consequently, even a vast investment of resources to reform and refurnish it will take significant time to bear fruit.
More importantly, such efforts will never succeed without clear and firm policies integrated with accountable healthcare administration, capable of achieving future targets and objectives on time and on budget, and guided by competent leadership.
Scope of the problem
Forty-two years of negligence and corruption in the health sector practiced by the previous regime, followed by the upheaval of an eight-month war, exhausted a system already struggling to maintain itself. The problem is compounded by an acute lack of expertise in the service, with too few highly qualified Libyans capable of performing the jobs required.
There has also been the issue of a lack of government supervision over the private health sector, which has led to further deterioration in health services being provided to Libyan patients. The dearth of legislation regulating the doctor/patient relationship has, in too many cases, led to a failure to respect patient autonomy, low morals amongst health professionals, and high levels of corruption throughout the system.
These deficiencies have correspondingly led to the unacceptably slow introduction of new treatments; a lack of cooperation and communication between the multidisciplinary health departments, and consequently a poor implementation of public health programmes.
Infections like tuberculosis, polio, malaria, filariasis, gastroenteritis, and respiratory infections continue to be the leading causes of death. Rising cases of HIV/AIDS also constitute a real cause for concern.
Strength and opportunity
In order to rectify these deficiencies, the Libyan health sector needs a programme to bring in and develop accountable and qualified management staff, aided by international experts, to lead reform throughout the system more generally.
Such reforms will not come cheaply, but if the will is there, then the resources are there also.
Libya is wealthy country, which already produces some 1.6 million barrels of oil a day, a figure that is only set to increase over the next few years. Combine that with other natural resources, especially gas and solar energy potential, as well as the fruits of a potential construction boom, and it becomes clear the Libya has the resources necessary to fund large-scale investments in the health system.
Libya also has the added advantage of a relatively small population, making provision of high-quality universal care that much more of a possibility.
Moreover, Libya’s position in the Mediterranean region gives it easy access to the more developed healthcare systems to be found in Europe, making it possible to draw on expertise and equipment from there. Not only that, but sending Libyan medical staff to Europe for proper training and exposure to international standards should also be possible.
The momentous political reforms and the development of democracy in Libya should definitely make it easier to build a more transparent health system, with effective anti-corruption mechanisms built in.
Importantly, improved conditions will hopefully also prevent the migration overseas of some of our brightest young people, and may even result in people who had previously fled the country coming back.
With the right levels of domestic dedication and international assistance, Libya could start to begin building a proper and effective health system, starting with primary healthcare. Investment in both human resources and modern medical equipment will be essential, but it must be underpinned by a relentless drive to reform and improve the management structures that have blighted our health care system for so long.
It is also important to increase general awareness amongst the Libyan population of disease identification and self-care, to ensure that patients can be treated in the quickest possible time.
Libya can have a health system to be proud of, but the work to get there must start now.