Healthcare lessons

11 May 2020


PARTS of the world are beginning to emerge from the worst of the coronavirus pandemic. Battered and bruised they understandably are, but in the long run what will sustain them and all the others who are still in the thick of the crisis are the lessons learnt from the horror they have lived through, and their willingness to act on them. On Wednesday, at a virtual briefing in Geneva, the World Health Organisation chief Tedros Ghebreyesus said as much when he urged countries to invest in their healthcare systems rather than scramble for solutions when the next pandemic arrives. “We cannot continue to rush to fund panic but let preparedness go by the wayside,” he observed. The world, he added, spends around $7.5tr annually on health — amounting to nearly 10pc of global GDP — but had for too long neglected investment in preparing for emerging pathogens.

Pakistan is far from out of the woods, and the next few weeks could be critical. All eyes are on the country’s creaky health infrastructure as it comes under increasing, unbearable strain. The pandemic has been a rude wake-up call for the country’s leadership and its skewed priorities that have always placed security concerns above all else. Health is chronically underfunded, far below 6pc of GDP recommended by WHO. Planning is shambolic: a substantial chunk of even the inadequate health budget often lapses by the end of the fiscal year. Several chronic medical conditions — exacerbated by cultural practices, lack of access to quality health services and often ineffectual public awareness campaigns — are endemic to the population. These ailments, among others, include hepatitis C (one of the highest prevalence rates in the world), tuberculosis and of course polio, where we stubbornly remain among the last two countries where the disease is yet to be eradicated. Sporadic, seasonal outbreaks of dengue, measles, Congo-Crimean haemorrhagic fever, etc add further to the disease burden and the toll on the economy through lost working days. Moreover, because Pakistan has been so remiss on the health front, challenges thrown up by the pandemic could make us fall behind still further. Reports suggest that the lockdown has adversely affected children’s routine immunisation as well. And two WHO reports indicate that disruption to health services because of the contagion could cause a 20pc increase in TB incidence over the next five years.

After the coronavirus storm finally passes, it should not be business as usual. Pakistan’s ramshackle public health sector must get the funding and the priority it deserves. Instead of a fragmented approach that leans towards firefighting, there must be holistic, multi-sectoral preventive health programmes engaging a wide range of stakeholders. It is also time to kick-start the country’s moribund population planning programme. This once-in-a-century pandemic should be accompanied by the realisation that health must be treated not as a privilege, but as a right.

Published in Dawn, May 11th, 2020