Interview with Dr. Leslie Ramsammy, Minister of Health: Creating a quality supply chain in Guyana for quality health care

How has HIV/AIDS impacted Guyana?

Dr. Leslie Ramsammy: HIV/AIDS is a serious public health problem for Guyana—and a developmental issue as well. The issue of how countries can access affordable antiretroviral drugs has become central to our trade discussions. It is one of the few public health issues that has impacted our development in the traditional ‘economic sphere’ of trade.

What are some of the challenges that you have seen that are specific to the supply chain?

Dr. Leslie Ramsammy: Quality health care is impossible without commodities and a high-quality, well-functioning supply chain system. The doctor can diagnose but diagnosis is not always possible or reliable without commodities. We need glucose test strips to make a diagnosis, we need HIV test kits, and we need laboratory reagents for our laboratory tests. After the diagnosis, to either relieve the symptoms or to cure, we need drugs. So by just putting it that simply, we can see how important the supply chain is.

What are some examples of the kind of activities the Ministry of Health is engaged in to ensure a more reliable supply of commodities?

Dr. Leslie Ramsammy: Guyana is not willing to concede anything. We may be a developing country, but for our supply chain we want to develop systems that are no less than what a developed country would have. We have been thrilled to have SCMS with us over the past few years. It is a partnership that has contributed significantly to addressing supply chain challenges. The supply chain is indispensable to the delivery of quality health care. We will not succeed in our response to any public health challenge—from HIV to malaria, tuberculosis to diabetes—unless we have an effective supply chain.

How has SCMS helped you, or how can we help you, achieve your vision?

Dr. Leslie Ramsammy: With SCMS we have a sensitive partner, one who understands our weaknesses and our deficiencies and helps us build on our strengths. Our storage today is better than at any time in our country’s history. More people have been trained in supply chain management. We have made progress in managing our information systems and in managing our finances. SCMS has worked well with us and has contributed to these improvements in a significant way. I hope we can continue these improvements so that when all of us who are presently involved leave the system, we will leave behind a legacy: a system that is working much better. Countries like Guyana must ensure that they are building sustainable systems.

What are your thoughts on sustainability?

Dr. Leslie Ramsammy: Sustainability is the greatest challenge of HIV. We used to have restrictions for HIV treatment, for example, a CD4 (white blood cell count) below 200 before starting treatment. Now, whether we have come to an agreement or not, all of us are providing treatment at a threshold of 350. And the next step is coming, when it doesn’t matter what your CD4 is; once you are HIV-positive, you are going on treatment. That will change the dynamic very suddenly. A country could suddenly go from treating 5,000 people to 15,000 people.

It’s evident you have a lot of leadership and passion around HIV/AIDS. Why is this issue so close to you?

Dr. Leslie Ramsammy: Health is a development issue and one of the most important economic investments we can make. If we are not investing in health, we are not investing in development, because healthy people are simply more productive. Investing in health is no longer a debatable issue. The time to act is now.

I understand that there is no waiting list for treatment in Guyana.

Dr. Leslie Ramsammy: Every single diagnosed HIV client in our country who has an opportunistic infection or who has a CD4 under 350 is on treatment. The systems that we have in place are not perfect, but we will not paralyze our system waiting for perfection. Guyana is extremely proud of what we have accomplished so far, with the recognition that there is much more to do. We hope that we can become a model for other resource-poor countries in the world—and that we can learn from them, too.