PAKISTAN confronts an existential crisis far more critical than its economic troubles. The threat stems from what World Bank country director Najy Benhassine has described as the “persistently low quality of basic services for human development”, which is both the cause and effect of the economy’s frequent boost-and-bust cycles.

The decline in human development indicators is reflected in the stunted growth of 40pc of our under-five population. Nearly 7pc of our children do not even make it to their fifth birthday. A majority of citizens have little access to clean water, waste and sanitation services, basic healthcare or proper nutrition and education — both in remote regions and major cities.

An average Pakistani receives only eight years of schooling. We have the highest infant mortality rate in South Asia and the lowest life expectancy. With six beds per 10,000 people and one doctor for every 1,300 individuals, we face a severe health crisis.

Pakistan is ranked in the ‘low human development category’ at 161 out of 192 countries listed on the Human Development Index for 2021-2022 due to its poor education, health and income indicators. India currently ranks 132 on the HDI. Bangladesh is doing even better with a ranking of 129, while Sri Lanka is placed at 73rd position.

As the years go by, Pakistan’s human development indicators continue to worsen and its position on the index keeps slipping. This is evidence for Mr Benhassine that Pakistan’s current economic model is not working. He recently wrote in a UNDP publication that Pakistan had “fallen behind its peers, significant progress with poverty reduction has now started to reverse, and the benefits of growth have accrued to a narrow elite”.

He indicated the country could emerge from its crisis, like Indonesia, Thailand, India, Vietnam and others, “through deep and sustained policy shifts in key areas”, boosting growth and improving living standards.

He also listed the required reforms ranging from improving basic services to closing the human development gap, strengthening fiscal management, securing the economic and business environment and reforming agriculture and energy.

However, the real question is “whether those with power and influence will take the opportunity arising from the current crisis to do what is needed”. The World Bank executive has rightly pointed out that there is a broad consensus that action is needed to change policies which have plagued development, benefited only a few, and led to highly volatile and low growth.

The problem is that the elites are not a part of this consensus; and it is not likely that they ever will be. No policy shift is possible without breaking the institutionalised hold of these elites on Pakistan’s power structure. And in the current political milieu, that will not happen anytime soon.

Published in Dawn, December 29th, 2023