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Special assistant identifies flaws in country’s healthcare sector

July 23, 2019

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Special Assistant to the Prime Minister on Health Dr Zafar Mirza speaks at the seminar on Monday.
Special Assistant to the Prime Minister on Health Dr Zafar Mirza speaks at the seminar on Monday.

ISLAMABAD: Special Assistant to the Prime Minister on Health Dr Zafar Mirza said on Monday that public sector hospital have become hunting grounds for private hospitals to take in wealthy patients.

Addressing a seminar on the ‘Health Vision of the Government of Pakistan’, he said: “Unfortunately, 70pc of healthcare is provided by the private sector and private sector hospitals and clinics neither pay tax nor give patients proper receipts.

There are mafias operating in the health sector, due to which we need to reform our institutions, including the Ministry of National Health Services (NHS) which is still being run according to the ways of the 20th century.”

The seminar was organised by the Sustainable Development Policy Institute (SDPI).

Dr Mirza said the healthcare system had become “a source of infection”, particularly when it comes to blood-borne diseases.

The sector suffers from lack of funding, disease-oriented policies

“People are infected at clinics and hospitals because of unhygienic conditions, the reuse of syringes and other [forms of] negligence. I have started reforms, and hopefully we will see positive results within a year,” he said.

He also said that the current funding in the health sector is unacceptable, and funds need to be allocated according to the requirements.

“I have served in the World Health Organisation’s Eastern Mediterranean Region and was shocked to know that the per person funding in Pakistan’s health sector was the lowest in the region, which has 22 countries.

“In Pakistan, 0.9pc of the GDP is spent on health and whenever an increase in funding is demanded it is increased by 10pcrather than considering the requirements,” he said.

Dr Mirza added that policies should be health-oriented rather than disease-oriented.

“As the lifespan has been increasing across the globe, the health of elderly people is also very important. Moreover, almost all issues are directly or indirectly related to health, such as one fourth of deaths in developing countries are due to environmental pollution,” he said.

He added that the Constitution does not guarantee the right to health, compared to education, which has been declared the right of every child.

“The 18th Amendment is usually blamed for the lack of health services, as now the provinces are responsible for the health sector, but that is not correct at all. There are still national level responsibilities, actually there are larger and specific responsibilities,” he said.

He gave the example of the United States, where states have more autonomy but the centre has established various organisations such as the US Food and Drug Administration, the Centre for Disease Surveillance and so on.

He said that the Ministry of Health was abolished in 2011, and the NHS ministry had to be established in 2014.

“We are responsible for irresponsibly dealing with national programmes such as HIV, tuberculosis and hepatitis etc. Because of this, those diseases are spreading across the country and there is no coordination between the centre and the provinces,” he said.

The increasing population is also an issue, he said. The population of Pakistan in 1947 was 32 million. Even though half of the country separated, he said, according to the 2017 census the population is now 208m.

“Every year, 9m pregnancies occur in Pakistan and of them 4m are unwanted. In 2030, Pakistan will become the fifth most-populous country and our population will be larger than the population of the US, Russia, Brazil and Indonesia,” he said.

He said that, unfortunately, more attention is given to hospitals rather than primary healthcare.

While discussing solutions, Dr Mirza said there should not be anything less than universal health coverage to address the issue and every individual should have a health card for free treatment.

NHS Parliamentary Secretary Dr Nousheen Hamid said a number of new laws were made on health-related issues, but problems and missing links remain.

“The implementation mechanism is also very weak. There are limitations after the 18th Amendment, as laws are now only made for the Islamabad Capital Territory administration and not for the whole country,” she said.

Published in Dawn, July 23rd, 2019