TO many it will appear as nothing more than another low rank achieved in an index measuring how dismal life can be for the poor in Pakistan. But behind the number is a story so big it holds the destiny of this country in its orbit. Start with the simplest point: Pakistan ranked 149 out of 188 countries in a study released at the UN General Assembly in New York and with the rather bland title of Measuring the Health-Related Sustainable Development Goals in 188 Countries. But dig a little deeper into what the study is trying to tell us, and we discover something that upends the foundations of our entire policy framework, which is built around the pursuit of growth in output and the development of infrastructure, with outcomes like health and education left as byproducts.

There is one statistic that hauntingly sums up the dismal state of our population’s health. More than 44pc of Pakistan’s children under the age of five years are stunted. Compare that to the global average of 25pc in 2011. Here is how Unicef put this number into perspective: “This is the third highest percentage of stunted children in the world and means that more than 9.6 million Pakistani children have experienced chronic nutrition deprivation in utero and/or during early childhood.” This has to be amongst the saddest realities prevailing in our society today. Stunting is an illustrative aspect to focus on because it is linked to so many other indicators: sanitation, literacy, nutrition and political will. If we see any improvement in early childhood stunting, we can assume that it is accompanied by improvements in many other areas too.

The sad part is that we have seen no improvements in this area since the 1960s, when figures first began to be kept. The simple reason is that improving the state of education and health has never been a priority for us, the results of which can be seen in a wide array of social indicators that place us nearly at the bottom of most rankings. We found our place down there once again at the UN General Assembly recently, a fact that passed us by while all attention was focused on the prime minister’s speech. Our priorities have been focused on visible infrastructure and growth in output all along. What good is growth and infrastructure if they cannot provide proper nutrition to our children when they most need it? When we have one of the world’s highest proportions of out-of-school children? Clearly, growth is not trickling down because our social indicators show little movement upwards. And even more importantly, what good is this growth and infrastructure if their pursuit means a generation of stunted children growing up with damaged cognitive abilities, reduced immunity and elevated susceptibility to diseases?

Published in Dawn September 24th, 2016