CKDu research: Why the Health Ministry? January 6, 2014, 7:42 pm
This letter refers to a newspaper item "Funds wasted on kidney disease research – GMOA’ which appeared in The Island of 1 Jan. 2014. According to this news item, the Government Medical Officers’ Association (GMOA) General C ommittee member Dr. Navin de Soyz a accused the government of allocating Rs. 350 million for the National Science Foundation (NSF) to conduct research on C hronic Kidney Disease of Unknown Etiology (C KDu). Dr. Navin de Soyza has warned that it was the sole responsibility of the Health Ministry’s Epidemiology unit to conduct research on C hronic Kidney Disease of unknown etiology (C KDu).
C KDu also called C hronic Renal Failure (C RF) has been reported in several areas of Sri Lanka, mostly in the North C entral Province (NC P). A large number from Badulla and Kurunegala districts are also affected by C KDu. The number of C KDu patients in registries from MOH offices in C KDu endemic areas by 2010 is 20336. Now this number is likely to be around 25,000.
The Ministry of Health (MOH) initiated a comprehensive research study in Oct. 2008 on C KDu to be carried out in collaboration with WHO, C olombo. Details are on the website http://www.whosrilanka.org/LinkFiles/WHO_Sri_Lanka_Home_Page_HL_Dec08_Insert_C KDu.pd f The study was conducted to find the causal factor/s of C KDu and other related issues. The study was to be completed by Sept. 2010. However, the findings of this study were unofficially released only in 2013 by the Ministry of Health. The report is titled ‘investigation and Evaluation of C hronic Kidney Disease of Uncertain Aetiology in Sri Lanka’.
Details are in
http://dh-eb.org/place.names/posts/WHO-final-C KDU.pdf) ‎.
Twenty eight coordinators, mostly medical doctors from the Ministry of Health were in volved in the study. After almost 5 years and spending Rs. 100 million. (it is assumed that the amount allocated was spent fully) the researchers were unable to come to any conclusion.
This report has many shortcomings. For example, the report indicates that postmortem tissues of kidney, liver and bone taken from 26 C KDu patients and 16 accident victims aged between 40 -60 years from the North C entral Province were sent for analysis at an international reference laboratory. The data from this study would be very useful to determine the factor/s of C KDu. However, the results of this study reported in the final report does not indicate the analytical data of the tissues obtained from accident victims.
The findings of the research study are also reported as a research article in BMC Nephrology 2013,14:180 (http://biomedcentral.com/1471-2369/14/180) It is interesting to note that out of the four main authors of this paper, three are medical administrators. According to the paper, the contribution of the main author and the third author was only co-chairing national C KDu research project committee on behalf of the Ministry of Health. As in the final report indicated above, there are no definite conclusions.
A number of seminars and symposia related to C KDu, have been conducted in the recent past. The most recent one is the symposium organized by National Academy of Sciences of Sri Lanka held on 10th Dec. 2013. Results of studies carried out by a number of Sri Lankan scientists were presented at these seminars and symposia, and C KDu was attributed to a toxic element/s or compound/s in drinking water. Among these are aluminium, arsenic, cadmium, fluoride, toxins released by Blue Green Algae, pesticides etc.
C KDu is affecting the social and economic life of a large number of people in the NC P and NWP. The families of those who are affected by this disease are in a desperate situation. It is necessary that causal factor/factors which cause C KDu are determined early so that appropriate action could be taken to control this disease. In this regard a multidisciplinary study, needs to be conducted. The most appropriate organization to conduct such a study is National Science Foundation which is responsible for the promotion of research and development in Sri Lanka.
Dr. C . S. Weeraratna
csweera@sltnet.lk
http://www.island.lk/index.php?page_cat=article-details&page=article-details&code_title=95422