ABSTRACT

Demands for intervention in health matters always seem to outstrip resources for the provision of health care. Much more money may be available for health care in the North than in the South, but there never seems to be enough. Costs continue to rise as the sophistication of treatment based on the latest research continues to develop. In the North, demographic changes mean that expenditure on health care is being skewed toward the needs of an aging population while in the South the trend is toward care of children and younger adults doomed by the misery of HIV/AIDS (Warren, 1996). Generally, there is a positive correlation between national income and expenditure on health care (Musgrove et al.,

2002). As GNI (gross national income) increases so does the amount of public money spent on health care (Carrin and Politi, 1997). There are exceptions to this conclusion. For example, if life expectancy at birth and U5MR are taken as a reliable indicators of national health, then Sri Lanka, with its life expectancy of 73 years and a U5MR of 15, must be allocating a disproportionate amount of revenue toward health care since its GNI is > USD 1000

per capita

(UNICEF, 2004). A life expectancy of about 62 years and a U5MR of about 90 would seem to be more typical of a country with a GNI similar to that of Sri Lanka. Provision for public health interventions has a political dimension.