After the pandemic

05 Apr 2020


NO country could have been entirely prepared for a once-in-a-century event such as the coronavirus pandemic. Otherwise the disease would not have been wreaking such mayhem in some of the world’s richest nations. But in Pakistan, the crisis has in one fell swoop brought into sharp relief a shambolic healthcare system barely capable of meeting even baseline requirements of its burgeoning population, let alone rising to a formidable challenge. Decades of criminal neglect displayed by successive governments towards the well-being of this nation have left us particularly vulnerable in a situation where the worst is yet to come. Aside from the shortage of hospital beds, medical personnel, testing facilities etc, there are in the entire country only 2,200 ventilators — equipment that could mean the difference between life and death in severe cases of a respiratory disease like Covid-19. Consider that this ill-equipped health infrastructure is also simultaneously coping with the ‘regular’ burden on its resources.

Overall, our budgetary allocation for the health sector is far below the 6pc recommended by WHO. Instead of adopting prevention-centric strategies, provincial governments tend to deal with outbreaks of infection through firefighting. A haphazard, short-sighted approach results in a pattern of recurrent public health crises that incrementally adds to the disease burden and depresses our core health indicators. There was a rash of HIV infections in Sindh’s Ratodero district last summer on account of unsafe medical practices that affected around 1,000 people, most of them children. Around the same time, five districts in Punjab also showed an alarming spike in HIV-positive cases. Every year, seasonal outbreaks of ailments like dengue, malaria, Congo-Crimean haemorrhagic fever, etc affect thousands of people, many of whom find it difficult if not impossible to access affordable and timely medical help. Then there are the chronic diseases that plague the population, among them hepatitis, tuberculosis and, of course, polio. The sociocultural factors hampering Pakistan’s efforts to eradicate polio also illustrate that health must be seen in a more holistic context and addressed accordingly. The lack of a robust population planning programme exacerbates the health burden still further.

However, after the day of reckoning comes a time for reflection and an opportunity for redressal. Once the pandemic has passed, the government must accord the health sector the priority it deserves. That means not only a substantial boost in budget outlay, but a comprehensive assessment of the sector’s shortcomings with input from local stakeholders so that functional systems can be put in place. Moreover, in line with many other countries, the state should recognise health as a right to which all citizens must have access. If this comes to pass, we may one day be able to say that even a contagion threatening the world can have a silver lining.

Published in Dawn, April 5th, 2020