Editorial | Tufton’s frank discourse on health
More than anything else, what Christopher Tufton is getting right, up to now, is tone. Plus, he is seeing no need to reinvent the wheel when he knows he is unlikely to improve upon the design.
So, while there has been some expansion of projects - like last week's announcement of the allocation of an additional J$100 million to ongoing projects - Dr Tufton, the health minister, has essentially maintained the previous administration's public awareness/education campaign about the Aedes aegypti mosquito as the vector for the dreaded chikungunya (chik-V), ZIKV and other diseases, and the public's role in its control. Indeed, his immediate predecessor, Horace Dalley's, initiative of using an army of young people in communities to help identify mosquito-breeding sites remains in place.
Insofar that there are differences is not so much with Mr Dalley - who was a mere three months in the job before his party lost the government - but with the unfortunate Fenton Ferguson, whose muddled communication of the chik-V epidemic eroded public confidence in his management of the problem, engineering a crisis of trust that followed him into other issues.
Last Thursday, Dr Tufton, who is a PhD and not a medical doctor, reported that Jamaica, so far, had 16 confirmed cases of 1,387 suspected cases of the Zika virus. But, unlike Dr Ferguson, who saw political spectres and overemphasised 'confirmed' cases in the chik-V numbers, Dr Tufton provided a fuller dose of reality. He pointed out that the confirmed cases were likely to be "a small portion" of the numbers of people likely to be infected with ZIKV. Additionally, as health ministry officials pointed out, even at this point, discrepancies are often rooted in under-reporting by doctors.
It, however, doesn't end there. Dr Tufton, for instance, noted a World Health Organization estimate that up to 70 per cent (or nearly 1.9 million people) of Jamaica's 2.70 million population could become infected with ZIKV. That, on the face of, is a frightening number, especially in the context of the linking of ZIKV with microcephaly, or children being born with small heads, and confirmation that the disease may be communicable via sex.
The important fact here is that Jamaica could face a major epidemic, the aversion or scaling back of which can't be left only to the Government. It demands, too, people taking personal responsibility for their environment and personal health to lessen the chances of contracting and spreading the virus.
CULTURE OF SECRECY
By talking frankly about the possible numbers, Dr Tufton is challenging an old, reflexive culture of secrecy and opaqueness of bureaucrats, which weakens communication and creates information deficits. The more information people have, the less they can plead ignorance.
We expect that this sense of reality that Dr Tufton has brought to the dialogue on ZIKV will be applied right across his ministerial portfolio, not least to the discourse on how Jamaica funds its health-care system, whose budget this fiscal year, of J$52.9 billion, or nine per cent of projected expenditure, and whether it is deemed to be inadequate for what is expected, given the administration's commitment to free health care. That allocation is unlikely to be increased given the Government's fiscal constraints.
When Dr Tufton was executive director of the think tank, CaPRI, it produced an analysis of the problem wrought by that no-user-fee policy. It's worth discussing.