PESHAWAR: The health department’s public health section has taken some flak from experts over what they called poor performance, which, they insist, has led to the province’s inability to put up an appropriate response to Covid-19 epidemic.

According to them, the public health section is an important component of the health department as it is required to make strategies to tackle emergency situations but it has been in the hands of the same people for more than a decade, who haven’t developed a proper mechanism for emergency response.

Experts in the health department told Dawn said that the response to novel coronavirus (Covid-19) was the domain of the public health section but it had failed to develop an automated system to help actively report cases, analyse data, carry out contact tracing, and make other kinds of responses.

They said it was not a difficult task to do as the health department had dozens of people trained in disease surveillance and response.

Experts insist no mechanism developed to respond to emergencies

The experts said it wasn’t the first time that the department faced a public health issue as the province had an earthquake in 2005, floods in 2010, dengue outbreak in 2017, 2018 and 2019 besides polio, measles and leishmaniasis outbreaks.

They said there should have been a befitting response to Covid-19 epidemic but it appeared as if the department was still building up things from the scratch.

The experts said it wasn’t that the department never had an opportunity to build a system or take over a system.

They added that the World Health Organisation had successfully run the Disease Early Warning System from 2005 to 2014, which was later phased out with the commitment that it will be taken over by the department and pledge from the WHO to provide technical and logistic support.

The experts said that was an excellent opportunity to adopt the disease surveillance and response system but due to personal grudge and benefits involved, the transition didn’t happen resulting in the absence of any system in place to date.

They said under the WHO’s International Health Regulation (IHR 2005) to which Pakistan was a signatory, the provincial governments were bound to implement the Integrated Disease Surveillance and Response System that was designed as a project in Khyber Pakhtunkhwa but its concept or design was absolutely flawed.

The experts said it didn’t have a public health surveillance and response system in place neither they intended to develop one otherwise that was an excellent opportunity to strengthen and streamline the IDSRS when finances were not an issue as the government had invoked the law under which the departments were exempted from pursuing a long process for purchase and procurements.

They said the role of public health section was to provide oversight and to lead the Covid-19 response but a war fought with few lone warriors always led to failure.

The experts said the public health section was being run by two chronic officers, who weren’t letting their colleagues be part of this response despite having a team of deputy directors (public health), no one was taken aboard and shared responsibilities.

According to a document available with Dawn, a high-level inquiry found both officers to be guilty of embezzlement of funds three years ago but they continue to lead the Covid-19 response.

The insiders told Dawn that the health department’s failure to build communication links with the medical teaching institutions that were receiving big caseload, so it was struggling to get updates and data from one of the most important institution, Lady Reading Hospital.

They said the LRH administration was also reluctant to share any data with the department and even the government wasn’t interested to find out why mortality rate in patients admitted to the LRH was so high.

The sources said the World Bank had started purchasing equipment on the recommendation of health department using $3m grant.

They said the bank had nothing to do with procurement process and only paid the amount to the firms from where the purchases were finalised by the health department.

The sources claimed that hospitals in the province had a lot of issues with machines supplied to them but they kept silent for fear of reprisals.

They said the focus was on the purchase of protective gear and other items from the money allocated by the government.

The sources said the district administration, relief and home departments, PDMA, border control agencies, airport authorities were playing part in Covid-19 response but the health department struggled as expectations from it were quite high.

They said the public health section led by a BPS-17 dentist with BPS-20 and BPS-19 doctors working under him had also failed to guide the minister on technical business, which ‘ruined’ the Covid-19 response.

“Public health deserves great attention by the government. Everybody has to play a role to keep others safe but this can’t happen unless a sophisticated public health system is in place and build strong communication channels with other sectors as health is a multidimensional subject,” an official said.

He said public health shouldn’t work as a section under director-general health services (DGHS) and instead, it should be an independent authority, like in developed countries, to take appropriate actions to prevent the spread of diseases and safeguard the people’s health.

Published in Dawn, May 17th, 2020