16 May 2004	Sunday	25 Rabi-ul-Awwal 1425

It is rural India that turned the tables on Vajpayee. Competent political maneuvering and GDP growth above 7 per cent failed to impress the poor or meet their need for basic amenities. The landscape here is almost the same.

Pakistan spends under 2 per cent of its GDP on education and less than 1 per cent on healthcare. Economic managers may boast of fattening forex reserves, soaring stock markets and 6 per cent growth rate. But of what use are these when the benefits have hardly trickled down to the common citizen? People ask for education, health, sanitation and clean drinking water. Economic managers have to answer one simple question:

In this special report the business desk of Dawn has attempted to seek views of randomly selected, varying income individuals on the quality of their lives over the years. An effort has also been made to get feedback from key economic players to find out if they see some linkage between sustainable progress and development of the social sector.

KARACHI: Many celebrated economists affirm that between 1950-1997, Pakistan had posted GDP growth at the annual compound rate of 5.2 per cent, which compared favourably with other countries in South Asia. But that is history. The finance minister has proudly proclaimed that the growth this year shall be a sustainable six per cent.

The country, said to be graduating from the IMF programme in November, can make a showing of a long list of positive economic indicators (booming capital market, robust manufacturing sector, exceptionally good export figures, comfortable foreign exchange reserves and so on).

But for all that, our policy makers have neglected to invest in the country's greatest asset__its people, whose welfare over the years has received the scantiest attention. And the consequences have been heart-breaking. Sadly enough, the United Nations Development Programme (UNDP) has placed Pakistan at a low 144th place out of 175 countries in terms of the Human Development Index.

Pakistan's social indicators are all but dismal. Poverty, illiteracy and drug addiction are eating into the social fibre. More than a third of the country's population of 140 million people live below the absolute poverty line; 55 million people have no access to safe drinking water or primary health care services; 100 million are deprived of any sanitation services; 44 million (two out of every three) adults are illiterate and over 10 million children under five are severely malnourished and the list goes on and on.

Only three days ago, the Indian poor gave a clear enough verdict. They rose above pseudo nationalism and rejected the party that projected the image of 'India shining' but ignored them and their needs. They reminded their policy-makers, and those of other nations, that the policy of exclusion cannot carry them far. The gains of development must be shared equitably for the process of growth to continue uninterrupted.

In Pakistan too the development process is anything but equitable. The wedge between the rich and the poor is widening. Even the middle 60 per cent of population is finding it hard to live a reasonably comfortable life. Aurangzeb, Suraiya Bibi, Aaazam Khan, Khizer Hayat Bhutta, Gulzar Ahmed, people interviewed by Dawn in Peshawar, Karachi, Quetta, Multan and Lahore respectively are all low-to-middle income people by Pakistani standards.

They all earn a regular monthly income of Rs 7,000 to Rs 12,000. Still they find it difficult to make ends meet. These typical Pakistanis do not ask for the moon, but some semblance of humaneness: decent education for their children, medicine for their loved ones when they fall ill, and a house with water and sanitation.

Is this really too much to ask for when the bread-earner is toiling from dawn to dusk and his country is posting good economic progress? The major reason for the present dismal social scenario is surely the low allocation of resources. Historically, Pakistan has been spending just about three per cent of GNP ($3 per capita) on social sectors while debt servicing consumed six per cent and defence still larger 7.7 per cent of GNP ($27 per capita).

But it is not just insufficient allocation for the social sector that has been at fault. Whatever is available is unevenly distributed and generally favour the urban areas. The rural sector, which is home to more than 65 per cent of the country's population, is all too often neglected.

It is just as important to incorporate women into Pakistan's development agenda and to revolutionize the prevailing patriarchal views on women's place in society. The gender gap is most pronounced in education with 77 per cent illiteracy among women as compared to 51 per cent among men. Our policy-makers have failed to realize that female education is the most effective means to advance socially and economically as well as to reduce the population growth rate which is alarming, about 2 per cent a year.

In 1992-93, the government launched the SAP and the donors joined a year later but a great many people maintain that the colossal sum of Rs 150 billion spent over five years on SAP-I was able to ameliorate the lot of the people. It thus emerges that adequate funding, though essential, is not enough; equally important it is to streamline the service delivery system in the social sector. The basic questions of transparency and accountability in service delivery have to be addressed. Steps need to be taken to initiate a process of institutional and organizational reforms and to provide good governance.

Instead of focusing on a project here, a project there and all too often leaving them all half completed, emphasis in planning should shift from construction of new facilities to consolidation of the existing ones and improving the quality of service delivery. Fewer well-built, well-equipped and fully staffed facilities provide much better service than a large number of poorly built and inadequately staffed facilities.

To the people of Pakistan, education and health are not altogether denied. But they come at a tremendous cost. And yet the quality is suspect. There was a time when those who couldn't afford private education sent their wards to schools run by the government. Even at that time, there were'nt enough schools to accommodate all children of school going age. The standard of education in government schools has forever remained poor. But now it is poorer still.

And there are ghost schools, schools without buildings, pupils without tutors and the sorry tale goes on. An average English-medium school now charges no less than Rs 1,000 per month per child. Gone are the days when imparting education was considered a mission; it is now just one of the most lucrative business options with tax-free income for the private sector.

The situation in the health sector is probably worse. The sector provides fertile ground for enterprising health practitioners who leave no stone unturned in minting money at the cost of the sick. For all their crocodile tears of mounting cost of production, pharmaceutical firms are reaping rich dividends from the sale of medicines at exorbitant prices, compared with prices for matching drugs in neighbouring countries.

Public hospitals are far and few. lf a family is fortunate and can afford and manage to reach a government hospital on time, the sad story hardly ends there. In a number of cases it starts at that point. Right from lining up to get a 'parchi' (a slip) to the next line in front of doctor's room to the crowd gathered to get medicines it is a tale of wonders that sometimes ends in tragedy. It often takes a full day to be able to extract some service from a government hospital.

Not everyone can afford to miss a day's work to get treated for flu. Thus, mostly only the very sick reach these hospitals and that also because it is hard for the family to bear the torture of watching their loved ones suffer. Otherwise understaffed, dirty, crowded government hospitals offer little hope to the sick. But of course, if the patient is willing to part with a portion of his fortune, he can rent a hospital room and afford the doctor's costly visits.

The state of potable clean drinking water or sanitation services is no different. The cover of public services is, doubtless, shrinking and it's quality depleting. It is not just that the supply of social cover has failed to keep pace with increasing demand because of resource constraints and flawed delivery mechanism. A glance at the budgets of the last several years reflects the low place that the provision of social services occupy on the priority list of governments in power.

But is the government really to blame for the sorry mess in the social sectors? It is a pity that the government does not appear to care. In its zeal to promote privatization and market economy it has crossed all barriers of reason and fairness. It is difficult to argue with the notion that it is not the business of the government to do business. But taking its hands off and leaving everything to the private sector makes little sense.

The government must consider that left to itself, the private sector would be far more interested in minting more money than delivery of quality service. It is easy to see the conflict of interest here. If it makes better business sense to set up educational institutions in large cities, why would it bother to open schools in rural Pakistan, no matter how vital it may be in terms of improvement in social sectors.

The issue of access to social services by the majority cannot be pushed aside as of little consequence. First, they have a claim over government resources because they contribute to these through indirect taxes. In fact they pay more as a proportion of their earnings than their richer counterparts. This is so not because the poor are more duty conscious but because they consume almost all their income and they end up paying tax on each and every item they consume.

All consumer items have in-built taxes in their prices. So every time they buy wheat flour, salt and sugar, oil, tea, etc., they chip in their bit in the resource pool of the government. (Indirect taxes include sales tax, central excise duty and custom duty makes up 70 per cent of government revenues).

Yet some people argue that it cannot be left to the government to solve all of life's problems; nor can progress be donor-driven. If we want to move fast on the social sector reform agenda, we need to garner strong support of the local community, the private sector, the NGOs and parliamentarians.

The government, nonetheless, cannot absolve itself of its responsibility. It cannot just sit back and relax. It is hardly enough to make proper noises now and then and form committees. Even if the government cannot assume the role of sole provider of services at this point in time, it must act as facilitator and provide technical assistance, social guidance and financial support to people in addressing the basic social sector issues.

Universal literacy, access to clean potable water, sanitation and a minimum health cover for all are an inalienable right of the citizens in any society. In this country despite repeated claims of governments to being committed to the people's cause, allocations to social sectors in successive budgets have all but added to the miseries of the people.

If we want to prepare the nation for the technological challenges ahead, the state should devote more of its energies and resources to the social sector, the allocation for which must, most experts agree, be doubled to 10 per cent of GNP. Without higher allocation and good governance, the grand targets of education, healthcare, sanitation and clean drinking water for all will remain distant dreams.

The conclusion that this study by Dawn of the social sectors in Pakistan draws is that the economic momentum of growth cannot be sustained without investment in people. An illiterate work-force with poor health can hardly be expected to speed up Pakistan's industrial growth that is so dear to the heart of its rulers.