Health in South Asia: Future of Kerala depends on its willingness to learn from past

doi:10.1136/bmj.328.7454.1497

BMJ 2004;328:1497 (19 June), doi:10.1136/bmj.328.7454.1497

Letter

Health in South Asia

Future of Kerala depends on its willingness to learn from past

The first 150 words of the full text of this article appear below.

EDITOR—The Kerala model in health, cited by Bhutta etal in the theme issue on health in South Asia as replicablefor South Asian countries,¹ is facing serious threats. The statehas a triple burden of communicable, non-communicable, and traumaticdiseases.

Stupendous growth of the private sector has resulted in skyrocketinghealthcare costs. Lured by the hi tech sophistication of theprivate sector, people are abandoning basic principles of primaryhealth care. Even poor people prefer private hospitals, anda major reason for sustaining poverty is healthcare cost.² Thegovernment is reducing its investments in health and educationdue to fiscal crises and pressure from funding and lending agencies.The opening up of the medical education sector to private entrepreneurs,lack of guidelines for the private practice of government doctors,and shortage of doctors for rural areas are all disturbing developments.Transfer of healthcare institutions under local self-governments. . . [Full text of this article]

V Mohanan Nair, Fogarty international fellow

Joint Centre for Bioethics, 88 College Street, University of Toronto, Toronto, ON, Canada M5G 1L4 v.mohanannair@utoronto.ca

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