There is time for everything

BY a strange quirk of fate, India and Pakistan haven’t ever been sensible together at the same time. They like to be sensible, but separately and at different times. Astrologers would be hard put to figure out a heavenly configuration that could trigger sense and sensibility all over the subcontinent at the same time.

But the improbable seems to be happening now. Not only that the two prime ministers have shown seriousness of purpose, but the general sentiment is also one of hope and of desire to finally move purposefully towards a resolution of the disputes, particularly the dispute over Kashmir. There are some indications, hopefully not wishful, that the public opinion both in India and in Pakistan for reconciliation has now reached a critical mass in favour of an idea whose time has come.

It is self-evident that failure to resolve the Kashmir dispute will retrogressively affect, the future of more than a billion South Asians at a very critical moment in human history. In the battle for the political and economic independence, and for a better life for their peoples, the developing countries are engaged in a race against time. Things are moving so fast in the West that a delay of 10 years in putting our act together now may mean increasing the distance between us and the West by one more century.

Now, let us look at the importance of the developing scenario from a Pakistani point of view. It needs not be argued at length that most of the ills that we are victims of can be traced back to the enmity between India and Pakistan. To mention the major ills: religious militancy; supremacy of the army; slow economic growth; accumulation of huge internal and external debt; political instability; obsession with ‘strategic depth’ and its consequences; and the partition of Pakistan in 1971. One can draw an equally long list, or even longer, of the ills that the Indians have to grapple with in consequence of their half a century-long confrontation with Pakistan.

Now that there is a flicker of light at end of the proverbial tunnel, and now that there is an air of hope, we in Pakistan have chosen to move swiftly towards internal chaos. Now that the Indian leadership has shown some desire to rid the subcontinent of the unending Indo-Pakistan conflict, we have chosen to create a situation where it may not be easy to locate the locus of leadership in Pakistan for a meaningful and decisive dialogue. Maybe the heavenly configuration is not quite right yet, for there is not a single good reason for us to do what we are doing.

Considering that the debate about ‘constitutional government,’ ‘rule of law,’ ‘supremacy of the parliament,’ ‘good governance’ ‘will of the people,’ has never been quite meaningful in Pakistan, and considering that in the absence of a democratic culture none of those ideals are likely to be honestly and vigorously pursued any time soon, one may ask: What are we quarrelling about? And why now?

We are told that the quarrel between the government and the opposition is about a fundamental principle: Can the amendments to the Constitution made by an administration run by the army be accepted as valid and legal? This debate should now be concluded as the opposition has already accepted most of the amendments introduced through the Legal Framework Order. The opposition has, thus, accepted in principle the legality of the LFO. The debate is not about the legality of all the amendments, but the desirability of some of the amendments.

Behind this apparently bitter conflict over the LFO is the haggling over presidency. Since in our political culture persons are more important than principles, one can assume that the conflict over presidency is more important and divisive. It is the contention of the opposition that they are not against the present incumbent in person, but against the idea of the president being the Army Chief of Staff also. A more recent development in the line of opposition’s reasoning is that they would accept the present incumbent even in uniform for sometime if he were to enforce shariat.

This is rather strange logic because the people who do not quite accept the legislative acts of the president when the parliament was not in existence, want him to legislate now when the parliament is in existence. Further, if the opposition is willing to accept a president in uniform for two years, or for whatever period, then, again, it is not a question of principle but a matter of expediency. Now, if it is a matter of expediency, then, one would like to ask: What is appropriate or beneficial for the people of Pakistan, indeed for the peoples of South Asia, at a time when historic decision could possibly be taken to resolve the most lethal and long-standing conflict in South Asia?

In the long history of Indo-Pakistan conflict the situation that has emerged now, because of fortuitous circumstances, is most favourable for a final resolution. The situation is most favourable at the moment because of three elements that did happen separately before, but never together. These are: one, an Indian prime minister, heading a BJP-led coalition, who sincerely desires peace in the subcontinent; two, an American administration that is actively engaged in the process of Indo-Pakistan reconciliation; three, a political set-up in Pakistan that is just what is needed at the moment for resolving problems with India. The so far elusive heavenly configuration is in place, but one element, the set-up in Pakistan, needs some elaboration.

The political set-up in Pakistan has been alternating from civil to military and from constitutional to extra-constitutional since 1958 in a visible manner, but the military has always exercised influence directly or indirectly even since before the imposition of the first martial law in 1958. Over the years military has come to acquire a decisive role in the affairs of the state, especially in relation to India. This is a fact that is no more a state secret. In fact, we do not even make an effort to keep it a secret. This has come to be accepted as a given fact that cannot be wished away. Such being the case, can a purely military government, or a purely civilian government come to terms with its Indian counterpart?

To answer the question posed above: an agreement with India reached by a military government without the support of an elected parliament cannot be durable, while an agreement reached by a civilian government, even if elected, without an open association of the military will not be credible. Thus, the political set-up in Pakistan, the third element of the fortuitous circumstances for the Indo-Pakistan reconciliation, is the kind of set-up that alone can ensure conclusive dialogue with India. The Indians know it too. The president must, therefore, remain Chief of Army Staff to ensure that the process of reconciliation with India is not undermined.

Some of my friends may find these views rather unexpected of me. I offer for their consideration a thought: Can the role and influence of the army in the affairs of the state of Pakistan cease while India and Pakistan remain in a state of confrontation? And can there be a rapprochement with India without the visible support and association of the army?

In concluding let me share the thought that there is time for everything: a time to struggle for democracy and a time to fight for the rule of law; a time to uphold the sanctity of the Constitution, and a time to oppose what is unlawful. But now is not the time for any of these. At this moment nothing is more important for us than the future of a billion and a quarter South Asians.

E-mail: tvo@isb.comsats.net.pk

The Myth of Sisyphus

ON ceremonial occasions like the fourteenth of August and the twenty-third of March, columnists feel a certain compulsion to produce a balance sheet of national successes and failures.

And though successive governments have often come in for a bit of editorial drubbing, the analyses invariably ended on a note of optimism.

One can guess what their comments will be on the next anniversary of independence, for while matters appear to be under control on the economic front, politically things have never been as bad as they are today, and there doesn’t appear to be a workable solution in sight, short of dissolving the assemblies..

Can there have ever been a more bizarre scenario? In the Frontier the men of the cloth are straying further and further away from the ideals of the founder of the nation and have now clashed with the centre which is still trying to uphold some semblance of normality. The MPAs of that blighted region, representing seething swathes of ethnic and religious discontent, fomented by the American attack on Afghanistan, already have an abiding grip on the popular imagination, and are now enlisting the help of elements on the fringe of society in a bid to stamp out every vestige of secularism.

Their rancour against everything western is buried deep in the closet of the collective unconscious, and it is not at all clear how the government is going to wriggle out of this one. Mr Jamali has already locked horns with Maulana Noorani over the issue of the Shariat Bill, and a conscientious citizen, Dr Aslam Khaki, has filed a constitutional petition in the Supreme Court under Article 184(3) of the Constitution, which carries the request that the NWFP assembly be restrained from passing any law in the name of Islam, as the assembly is not competent to enact any law “which is in derogation of the Constitution.” The government advocates are certainly going to have their hands full. Politically, this is a big one, which the western democracies are watching very closely.

In Punjab, where the people haven’t had a leader since Maharaja Ranjit Singh, and patriotism is defined by the degree to which a politician defects to the other side, the voices of dissent are being throttled in an attempt to stamp out opposition to the Controversial LFO which a beleaguered prime minister maintains is an integral part of the Constitution. How he could have possibly arrived at such a conclusion, after massive protests by not only members of two opposition parties who were recently turfed out of the assembly, and who have recently hardened their resistance, but also small battalions of lawyers is quite astonishing.

The advocates are still clinging to the vain hope that some day this country might have a real democracy, unalloyed by constitutional articles and clauses that place a stranglehold on the elected representatives of the people, led by men in battle fatigues who have informally occupied the third chamber in parliament.

In Sindh, where the government enjoys a thin majority, there hasn’t been a single worthwhile debate during the seven months that have elapsed since the elections. On the rare occasions that the members have met, there has been the odd discussion, but the MPAs appear to possess a rare gift for getting diverted into channels that have little relevance to what is happening in the province, and for avoiding issues that matter and are of real concern to the people.

Whenever the issue of constructing that elusive Kalabagh Dam comes up in the assembly, the house erupts into a seething, rambling burst of anger, as if a few unscrupulous elements in the north were trying to hatch a sinister plot to deprive the people of Sindh of their share of water. The point is, nobody seems to be concerned about the fact that after 56 years, Karachi, the largest city of Pakistan and the nerve centre of the country, still doesn’t have a proper water distribution system or an uninterrupted supply of electricity. Water, often unfit for human consumption, is supplied by a variety of vendors, including the Rangers, whose basic assignment, it is generally believed, is to provide a back-up to the regular law enforcement agencies in the matter of peace and public order.

Nobody also appears to be concerned with the transport problem and the dreadful pollution being caused by the 14,854 intra-city and 513 inter-city buses, 13,613 taxis and 23,337 rickshaws plying the streets, not to mention the thousands of cars of various vintage and engine power and motorcycles that clog up the traffic.

In spite of regular presentations and feasibility studies by Chinese engineers, and assurances from the governor and the chief minister that the administration was going ahead with the Circular Railway project, it appears that the scheme has been finally put on the back burner. The other project, which envisaged the construction of a number of railway corridors, which was being favoured by the city Nazim, also appears to have hit a hidden reef. Apparently, the president, in his infinite wisdom, diverted what meagre financial resources there were to the Lyari Expressway project.

Nobody also appears to be too concerned about the practice of hastening the temporal existence of women suspected of indulging in immoral behaviour. A lawyer friend from Mirpur Mathelo, who regularly scours the Sindhi press for news of honour killings, did point out that in the recent past there appeared to have been a drop in the number of cases of karo kari. It is not clear, however, if the crime graph has actually fallen, because of the publicity that such cases have attracted, or if the cases have just not come to the notice of newspaper reporters. It would be nice if the former were the case, for it would at least represent an advance in moral and social rectitude.

The scene in Balochistan also reflects the uncertainty and lack of direction that exists in Sindh, and one wonders if the Sardars will repeat the tableau of the past where on one occasion every member of the provincial assembly but one became a minister, and the poor chap who probably pulled the shortest straw, nevertheless enjoyed the unique distinction of being the sole non-ministerial member in the assembly.

And what about the federal capital? The prime minister has categorically stated that the question of whether or not the president keeps or takes off his uniform will be decided by the army and not the parliament. This is probably the most astonishing statement that a politician in a democracy could ever make, and is carrying obsequiousness a bit too far. It is a tacit admission that irrespective of the kind of government that functions in the country, the army will always have a major role to play in the formation as well as the running of future governments in Pakistan. Democracy in Pakistan, is rather like the Myth of Sisyphus, where the Greek mortal rolled a rock up the hill, only to watch it roll down before he repeated the process.

Hopeful vs hopeless

THE opposite of hopeful is surely hopeless. Is it fair to suggest that only the hopeless are hopeless? No. Those without hope, particularly on a subject as difficult and contentious as India-Pakistan relations, pride themselves on realism.

We must establish a distinction here. We must not confuse those who are hopeless with those who are hateful. The haters are a separate category, in both India and Pakistan, whose minds are driven by a single, obvious passion devoid of logic or humanity. They will always be with us. We can do little about them except pray that they remain confined to the margins. If circumstances, or mistakes, bring them to centre stage havoc will hover over our lives.

The hopeless may be driven towards pessimism by the evidence. Which two nations could have a worse record of warfare by any means than India and Pakistan?

Strangely — and this may sound very odd — the same evidence makes me hopeful. India and Pakistan have exhausted all the possible ways in which a relationship can fail. Isn’t that good news?

War has been a continual reality on the subcontinent, either in the form of a direct confrontation between the respective defence forces, or as a proxy duel. War as a policy has failed. Neither country can be defeated anymore. There cannot be another surrender at Dhaka and there will not be any surrender at Srinagar. These are obvious facts, which all sensible people must recognize. The last doubts were eliminated when the two nations went nuclear. Nor is India going to be defeated by any war of attrition, whether on the level of Kargil or the sporadic hits scored by terrorists.

There are equally important lessons from the dialogue process, particularly in the post-nuclear dispensation. Prime Minister Atal Behari Vajpayee, who took the last step on the nuclear road, understood at once that the bomb could become a weapon for peace since there was no better guarantor of national security. Lahore followed. Lahore failed because Prime Minister Nawaz Sharif did not take his armed forces into confidence. The failure of Agra was more complex but, in retrospect, more educative.

It is already clear that the two countries have learnt what they need to from Agra. You must address core issues, however unpleasant, during the preparation phase, and come to an agreement on the nature of the finesse, since they are not amenable to immediate resolution. A range of people-to-people relationship, including travel and trade, must back political understanding. The immigration counters at the border crossing point at Attari are being got ready again: that sustains hope. India and Pakistan need to rebuild constituencies in each other’s territory. Concentrate on what you can achieve: magic wands were always an illusion. And no summits please until the mountaineers have found sufficient supplies of oxygen for a long haul. It is far more sensible to make haste slowly.

But experience is only one of the reasons for hope.

One of the qualities of a great leader is to recognize something that has been staring at everyone in the face, but no one has seen; something so obvious that it has escaped attention. Twentyfour hours before Atal Behari Vajpayee extended his hand of friendship for a third time across the border, no one would have believed that such a breakthrough was possible. The mood was contaminated with cynicism, and there had been serious political investment in conflict and gloom. Cross-border terrorism was unremitting, in spite of a visible change in the atmosphere of the Kashmir valley. The BJP had won a vital, life-saving election in Gujarat by focusing, acidly, on ‘Mian Musharraf’.

But Vajpayee recognized a basic fact that escaped the political class: that despite Lahore, Kargil, Agra and intermittent terrorism, the people of this subcontinent still wanted a resolution to a problem that had drained their lives for half a century. He did not romanticize this fact. He does not believe that a candle can displace darkness, or indeed that a candle should be confused with dawn. He knows that Indians will not accept peace that does not come with security. But he also understood, deep in his mind and heart, that the peace is the only real security there is. A state of war meant living life on the edge of an abyss, with no guarantees about when one’s foothold would slip.

As Mr Vajpayee put it, one can change one’s friends but one cannot change one’s neighbours. What option does anyone in his senses have except to search for understanding and goodwill? He also had the will to lead, without which nothing would have happened. He surprised his own party, both its hawks and its doves. The only person not surprised was deputy prime minister Lal Krishna Advani; the prime minister and he had discussed the options and Mr Advani accepted the prime minister’s perception.

The prime minister also stunned the opposition, which had not expected such a bold move in an election year. The Opposition was trapped in conventional wisdom. It believed that the BJP had more votes to gain from confrontation than from negotiations. But the prime minister has always believed that while you can win an election by beating the drums of war, you can sweep the polls by offering the peace dividend. There is both emotional and financial prosperity in this dividend. To its great credit, the opposition has put aside politics and responded enthusiastically to the prime minister’s initiative. The warmth with which a parliamentary delegation from Pakistan has been received by all sections of the political spectrum is proof of the unity in India behind the idea of a new beginning that makes the past as obscure as possible. What is there to remember from the past except war, terror, destroyed homes and broken dreams?

This is a fundamental reason for hope: that this time around there is no visible partisan politics in the effort for peace. There is instead the thrill of anticipation, laced of course with the dread that it might fail again. There is no shortage of saboteurs, and they are lurking in the shadows, ready to do their worst once again. Who knows which incident will occur this week, or the next, in another attempt to seal the barriers that have begun to thaw.

An important initiative must begin in the mind. It does not materialize from thin air. The most important reason for hope is that both India and Pakistan are being driven to a meeting point by cold self-interest.

The Americans, who are now officially in charge of the world, are, understandably, considered responsible for everything. Most people, if polled, would confidently agree that this building equation is also part of some American master plan. The happy news is that America is responsible, but not advertently. Their role is inadvertent. Mr Vajpayee and President Pervez Musharraf have both hinted, the former more explicitly than the latter, that they had learnt something significant from the Iraq war. It is, once again, an obvious lesson: never invite an elephant into your drawing room, even for a friendly chat. Even the friendliest elephant will leave that room in a mess. Moreover, the elephant, in an assertion of its weight, will soon dictate what friendship means. He will lay down the rules of behaviour. It is a prospect that must fill any intelligent householder with dread. Indeed, it is a prospect that should fill even an intelligent elephant with dread.

That Washington agrees with what has happened, and fully supports the process, takes nothing away from the above proposition. Of course the United States has a role to play. That is stating the obvious. Both India and Pakistan have sent key policy-makers to Washington to brief the Bush administration at the highest level. In a deliberate gesture of support President George Bush “dropped by” during a meeting between the prime minister’s trusted adviser, Mr Brajesh Mishra and Condoleezza Rice in the White House. Mr Mishra carries the prime minister’s assurance that India will participate fully in addressing Pakistan’s concerns if the Pakistan government stops its support to cross-border terrorism; it will not be a ruse through which Delhi finds other things to do once its problem has been addressed.

But that does not change the vital fact: that this process restarted not because Washington wanted Delhi and Islamabad to do so, but because India and Pakistan wanted to do so. The United States has been urging the two countries to do this forever; they have not listened in the past, and they would not have done so now if Vajpayee and Musharraf had not come, independently of George Bush and independently of each other, to the conclusion that a moment had arrived to find a different future.

Success is always a dangerous word, in part because no one can adequately define it. But everyone recognises a failure. Hope is best served by the recognition of limitations. If India and Pakistan agree not to fail, they will succeed.

The writer is editor-in-chief of Asian Age, New Delhi.

Lessons not learned?

SINCE the space shuttle Columbia broke apart over Texas four months ago, the commission investigating the accident has made progress that is at once remarkable and disturbing.

It is remarkable because investigators have managed to recover nearly 40 per cent of the shuttle and have come up with a working scenario of what happened to Columbia: that a piece of foam from an external tank hit the leading edge of the shuttle’s left wing 81 seconds after takeoff, most likely causing damage that allowed super-hot gases to burn through the wing on the craft’s re-entry 16 days later.

The investigation is impressive as well for the lofty aspirations of those in charge, who are focusing not simply on the cause of the Columbia disaster but also on broader issues of shuttle management.

The probe is disturbing because the results suggest that the National Aeronautics and Space Administration was not transformed by the explosion of the space shuttle Challenger 17 years ago.

The investigation suggests that NASA continued to tolerate risks in the shuttle, discounted safety concerns while it was in flight and, most troubling of all, suffers from systemic shortcomings that could result in another tragedy. In the days just after the Columbia disaster, NASA officials from administrator Sean O’Keefe on down touted the agency’s “culture of safety.”

But Harold W. Gehman Jr., the retired admiral who chairs the accident board, told the Senate Commerce Committee last month, “We find the safety organization is on paper perfect, but when you bore down a little deeper, you don’t find any there there.”

Despite — or perhaps because of — the fact that foam broke off and hit the shuttle on every previous flight, shuttle managers repeatedly discounted the risks posed by such strikes.

These seem to have been tolerated on the theory that previous missions managed to land safely — an approach reminiscent of the treatment of cracked O-rings before the Challenger explosion. “I’m hearing a little bit of an echo here,” said former astronaut Sally Ride, a member of both investigation boards. O’Keefe told the Commerce Committee, “There’s a lot of real soul search going on that says, ‘We rationalized based on historical evidence of what we thought was acceptable damage.’ Why would we think any level of damage would be deemed acceptable?”

Those difficulties were compounded after the shuttle was launched when engineers’ pleas for photography that might have shed light on the degree of

damage were turned aside by managers who seemed fixed in their conviction that the foam damage wasn’t important and were more concerned about following proper bureaucratic procedures than about the astronauts’ safety.— The Washington Post

Real threat to health care in Third World

WHILE media reports focus on numerous countries grappling with the outbreak of Sars, it by no means represents the principal threat for health care in the Third World. For all its menace, Sars pales in comparison with the much more dangerous threat that is posed by the increasing subjugation of our health-care systems to the greed of the international pharmaceutical and health management industry.

The rapid privatization of health care being undertaken by IMF’s clients is threatening to leave large numbers of people around the world vulnerable to various diseases as proper health care moves out of their reach. Medical journals boast of unprecedented advances in scientific knowledge of the human body, but millions of people around the world are dying of entirely treatable ailments such as tuberculosis and malaria.

While the world’s attention was focused on Iraq and the discrediting of the UN, the wilful undermining of another international body by the US has gone all but unnoticed. The WTO has, in the current unilateralist view of the Bush administration, outlived its usefulness, and the pharmaceutical industry’s lobby provided the impetus to make this break.

Admittedly, both the UN and the WTO are largely tools of US policy. They serve the useful purpose of legitimizing decisions made in corporate headquarters in New York or in Washington as the will of all the countries involved. However, by the very fact of having a membership wider than the World’s sole superpower, both the UN and the WTO are sometimes forced to reflect the tide of world opinion that is rising against wars and unfettered corporate globalization respectively. This is the sin for which they have been sidelined by the arrogant Bush administration.

In the case of the WTO, pressure building up since Seattle 1999, had forced it to ratify an agreement in Doha (2001) whereby poor countries could import generic drugs if there was a major public health concern like AIDS in Africa. There are 29.4m mostly very poor people currently afflicted with AIDS in sub-Saharan Africa. Many lives can be saved if they have recourse to generic drugs that are often many times cheaper than what the big pharmaceutical companies charge.

After initially agreeing to the Doha Declaration, which was the result of desperate pleas from afflicted countries as well as sustained activism by grassroots organizations, the US decided to unilaterally withdraw from it in February 2003. The $60 million donated by the pharmaceutical industry to Republican electoral victory has not been in vain. The influence of corporate interests in the White House is immense. The largest pharmaceutical company in the world is based in the US, and was one of the companies lobbying energetically against concessions over Doha.

What is at stake here? The pharmaceutical industry is one of the most profitable in the world, with profit margins at 18.5 per cent. Top pharmaceutical companies are among the biggest commercial enterprises in the world. For instance, with a stock market value of $180bn, Pfizer ranks fifth among the world’s biggest companies.

The pharmaceutical industry owes its wealth to extremely high barriers to entry into this field, including high expenditures and the patent system. Ostensibly, patents are granted to pharmaceutical companies to allow them to recoup the resources invested on R&D (research and development). For decades, pharmaceutical companies have justified the exorbitant prices of drugs by citing the hugeous resources that are required to finance their development.

However, it has been established over several years now that their R&D figures are bloated, and that they spend more on marketing than on R&D. Analysis of the industry’s tax information shows that in 2002 the industry overall spent 27 per cent on marketing and 11 per cent on R&D.

In fact, during the 1980s and 1990s management fad of focusing on core competencies, many pharmaceutical companies identified marketing and branding as their core competence rather than R&D or manufacturing. They were happy to outsource some R&D to subcontractors.

In addition, R&D is often subsidized by research done in universities or through government grants to the industry, which the industry includes in the total cost. For instance, the group Medicins Sans Frontiere (Doctors without Borders), an organization of volunteer doctors who work in the poorest countries, has suggested that while the pharmaceutical industry claims that it costs $800 million to develop a new drug, research by the Global TB Alliance puts it at around a maximum of $240m and an average of $40m.

Thus, when consumers around the world, but especially in developing countries like Pakistan, pay the exorbitant prices for patent-protected medicine, they are paying largely for the costly marketing that the pharmaceutical companies have done to promote those brands rather than for the research. This falsifies the fundamental justification for patent protection.

The Doha round allowed some, not all, poor countries to avoid bypass paying for patent protection. Looking at it from the pharmaceutical company perspective, one realizes that there is a real danger in this. In the short term this would have saved a few million lives in the Third World. But in the longer term it could have strengthened the demand for generic medicines and changes in patent protection, the source of these corporate giants’ wealth. The arithmetic maths just did not add up for the pharmaceutical companies and so they pulled the plug on the Doha agreement.

The move by this industry to protect their 18.5 per cent profit margins, at the cost of millions of lives in the developing world, is made only more grotesque when one looks at what the top executives are paid for formulating such policies. GlaxoSmithKline, the second largest company in the world after Pfizer, is proposing to pay its CEO 22 million pounds in severance pay. He was the highest paid executive in Britain in 2002.

These mega pharmaceutical companies are aided in their stratagem by other stalwarts of international health care who are eager to make similar profits at the expense of desperate patients. As the manufacturing sector’s potential for growth diminishes, it is in the service sectors, like health and education, around the globe that international capital is looking for openings.

A first step towards complete privatization has been taken in Britain for instance, in the form of Public Finance Initiatives (PFI), which legitimize the investment of private capital into the public sector. Although these initiatives have largely failed, the British government is strangely persisting against popular opinion.

In 2002, George Monbiot, a British journalist, pointed out that this seemingly irrational behaviour might be because PFIs are fast becoming a big export market for the UK. They need to be kept alive in some form in the UK in order to be sold overseas. He documents how since 1996 the British government has been sending delegations to convince the South African government that the private finance initiative was “maximizing efficiency” in hospitals, etc. One of the key selling features to other countries is the fact that “the full spectrum of techniques” has been “tried and tested in the UK”.

Soon after coming into office Tony Blair’s government sent the biggest UK health-care trade mission ever to South Africa to clinch the deal. In 2000 South Africa signed the first contract for PFI hospital schemes. Of course, companies that had “tried and tested” the model in Britain gained lucrative contracts.

And while it continues to support privatization of health care in developing countries, the UK government, under pressure as a result of the failures of PFIs at home, continues to explore other options. In 2000 the UK government dispatched a team to study the health-care sector in Cuba.

Cuba has a social welfare system under which health care is free to all and the overall quality of its system is among the best in the world. It is extremely cost-effective and patient-centric, precisely the results the UK British National Health Service is looking for. Health care costs #750 a head annually in the UK compared to seven pounds in Cuba. There is one family doctor per 500-700 people in Cuba, compared to one for 1,800-2,000 in the UK. The much smaller Cuba has 21 medical schools, whereas Britain has 12.

As we in Pakistan, allocate a meagre 2.8 per cent of our budget to health sector while a whopping 40 per cent goes to defence, we need to reassess these priorities. The government introduced boards of governors in teaching hospitals in Punjab, which marked the beginning of widespread and continuing agitation. The BoGs have huge discretionary powers especially relating to hiring and firing of staff and doctors, sale of all property and assets, and, significantly the hiring of any other body to perform any of the functions of a BOG.

The protesters claim that these BOGs are the first step in the privatization of public hospitals brought forward by the WTO deadline to Pakistan and other countries to declare whether our health-care sector is available for international investment.

In response to these protests the Punjab government set up a commission under Justice Mujaddid Mirza, which submitted its report to Punjab Chief Minister Chaudhry Pervaiz Elahi on Jan 31. It is widely believed that the commission recommended abolition of BOGs. The Punjab government has predictably held back the publication of this report so far.

If the formulation of BOGs in teaching hospitals in Pakistan is not motivated by international and local pressures to open up the health sector to private investment, the government has nothing to lose by publishing the commission’s report. If it believes that there is a viable case for privatization of hospitals, it should open the field for discussion on the issue.