Our chance to reset

23 May 2020


The writer is country director, Population Council, Islamabad.
The writer is country director, Population Council, Islamabad.

FATE has struck the world a cruel blow. A deadly virus that knows no borders has struck across class, clans and religion. Overnight, the rich and mighty are facing economic woes. They have become poor by their own very lavish and exorbitant standards, losing millions with stock market crashes and fall in demand of oil prices. What had the greatest value has become valueless: the boom in the travel industry, which epitomised the benefits of globalisation and connectedness, is likely to be wiped out.

Rather than treating this period as a mere nightmare, the world has an opportunity for a major reset of priorities — starting from human relationships to our socioeconomic system — if we want to ensure never to be caught in a similar pandemic dilemma again. Especially stark is the avaricious and callous relationship between the elites and the poorest excluded populations.

History post Covid-19 will distinguish between countries and nations on the basis of whether they considered this just a pause or reassessed the society they want to live in. The choice is between a society driven by money and more money for a few, or health and decent life for all, where every life counts. Ideal country leaders will gain the moral high ground and do the right thing, no matter how high its costs. In hindsight, the world will reward empathy, effort and transparency during the crisis. Exemplary is the leadership of New Zealand, Finland and Taiwan that brought their populations out of this crisis, by putting the value of lives above any economic gains and point-scoring.

Pakistan’s leadership has a unique chance to reject the current abnormal to capture a new normal.

In Pakistan, our leadership has a unique chance to reject the current abnormal to capture a new normal. It simply means that the levels of sickness and food shortage as we have today are not acceptable. Some 55 million living in hunger is not acceptable; 20m children out of school is not acceptable and 40 per cent of children being stunted is cruel and hugely abnormal.

There is a chance to reset ourselves as a society where there is no tolerance for inequalities in at least three areas: access to healthcare, access to education and incomes of less than two dollars a day. To do this the rich will have to pay their dues in taxes and contribute to the welfare of the majority. Enough talk about how little we spend on health budgets. National health accounts show that the burden of paying for health expenditures is being borne by the Pakistani people. The same applies for education, except while health is seen by the poor as a necessity, education is considered a luxury to be put off for the next generation. The delivery of basic health and education services has been abdicated by the state.

The signs of such a reset are missing right now.

Allowing full relaxation of the shutdown is meant to allow the poor to eke out a living. But this is being done at the potential cost of thousands more unnecessarily getting infected and thousands of needless deaths. The hard-to-swallow reality is that the value of the lives of 55m Pakistanis have basically not mattered to us. They are mere numbers, and will continue to be seen as voiceless, faceless, bodies that must venture outside their homes even when they should be inside instead of putting their lives at huge risk. This is where our public health community is crying itself hoarse to say that there is no evidence that anyone will die of hunger, but they will die of acute illness.

Economists knows that the death of a main earner of a poor family sends them into dire poverty and distress, so much so that they cannot recover for a full generation! But this does not factor in the Yale and other economic models being used to weigh economic gains against deaths. Giving billions of rupees in cash handouts might be a noble gesture, with politically huge benefits. But those advising it know very well it is just a temporary mechanism for income-smoothing; it is not a cure for poverty. When we jump up with new figures showing declines in poverty, we should ask what sort of state allowed millions to be totally without health coverage, education and any earnings. Above all, the lives of the poor are likely to get much worse due to spiralling exponential population growth. Paltry economic growth will be outstripped by our population growth about which we remain unconcerned.

It should not be a surprise when Unicef states that 5m new babies will be born in the next nine months — that is more or less the usual number. Babies bring joy and hope, but in Pakistan we have solid proof that almost half of the pregnancies are unwanted, and the poor bear the brunt of these due to lack of family planning services. The only news during Covid-19 is that even the few who do use contraception may be denied access to family planning services. The poorest with need for services do not have access to begin with, so why the concern?

If Pakistani elites decide on a lockdown based on science and worldwide data, they will redeem themselves. If they lift it, they are merely returning to their own original ways of not really caring about what really threatens the masses as long as their own lives are intact. After all, the elites are merely inconvenienced by the length of the lockdown. It is the wretched of the earth who clean toilets, streets, cook and drive for them whose lives will get needlessly worse.

Just saying that we care for the poor is mere words; we have to put in place jobs, social safety nets and basic essential services to make sure that people live a decent life. This is not just the language of the SDGs, but an ask for resetting to basic standards of humanity. Not doing so is selfish, tribal and divisive and truly self-destructive.

The writer is country director, Population Council, Islamabad.

Published in Dawn, May 23rd, 2020