JAMAICANS with kidney disease can expect to get no assistance from the National Health Fund (NHF) anytime soon, because the disease is still not considered a ‘priority’ for coverage on its list of “most chronic” illnesses.

The government agency established to assist people with chronic illnesses said its four-year-old survey had not identified kidney disease as being among the more prevalent diseases affecting Jamaicans.

In fact, the NHF said kidney disease was not a priority when the list of chronic ailments was decided on at the formation of the fund in 2003, and is not a priority now.

“We did a survey of the most chronic illnesses and that was not one of them at that time,” Rosemarie Lee, NHF public information officer said.

But according to studies done by Professor of medicine and nephrology at University of the West Indies (UWI), Dr Everard Barton, the number of people suffering from renal disease in Jamaica has reached disturbing proportions, with a prevalence of 320 out of every million people with chronic renal failure.

“That means we would have to treat approximately 900 patients per year with kidney failure” Dr Charmaine Watson Brown, consultant nephrologist at the Kingston Public Hospital (KPH), told the Sunday Observer..

Meanwhile Lee said doctors and patients had, in the past, raised concerns about the absence of kidney disease from the NHF’s list, and that the issue was referred to the fund’s medical review panel without any change to date.

She explained that the treatment of kidney disease was way down on the list of priority diseases at the NHF.

“The selection is done on the prevalence of the disease and kidney disease is way down on the list. There are a lot of more prevalent diseases,” Lee said.

But some critics have argued that kidney patients should be covered under the NHF especially since people suffering from illnesses such as diabetes and hypertension – which medical professionals say can result in renal failure – are assisted under the fund.

The cost to sustain the treatment of renal failure also appears to be a concern for the NHF.

“Kidney treatment is a very costly procedure, and once it is on the list you can’t take it off. We have to look at what it will cost the NHF,” Lee said.

Assistance from the NHF takes the form of a fixed payment towards the price of drugs approved by the NHF, with the beneficiary required to pay the difference. The NHF list of 15 chronic diseases also include prostate cancer, glaucoma, arthritis, epilepsy, asthma and depression.

Meanwhile, kidney disease sufferers are left to fend for themselves though corporate and other donations with the monthly cost for dialysis running anywhere between $20,000 and $50,000, excluding medication.

In addition to the cost, there is also a lack of treatment facilities for renal failure.

The KPH and University Hospital in Kingston and Cornwall Regional in Montego Bay are the only public hospitals with dialysis units, and treatment at either costs approximately $5,500 per week.

The three public hospitals have the capacity to treat about 220 patients.

Another 100 patients may be accommodated in the seven private dialysis units – four in Kingston, another in Montego Bay and two in Mandeville, however, at a higher cost per treatment.

In total, the health sector can offer dialysis treatment to only about a third of the estimated 900 cases of kidney failure each year.

“We need to offer more in terms of dialysis and transplants to satisfy the emerging population, and the numbers are rising,” Watson Brown said in reference to the prevalence of Jamaicans diagnosed with kidney failure annually.

Against a background of the inadequate information and treatment of kidney disease in the island, Watson Brown called for a public education programme to sensitise people about renal disease and kidney transplants.

“We should ideally have a larger cadaver transplant pool, but the public is not educated about it. It would have to be government policy driving it,” she said.

Watson Brown added that unless there was public education, cultural beliefs and fears about donating a kidney would continue to work against creating an organ pool.

“We don’t have that many donors, and that is directly related to education, she said, emphasing that “one can live a normal life with one kidney”.