Priorities and public health – (28 June 2016)

Priorities and public health – (28 June 2016)

Priorities and public health

Published in Dawn, June 28th, 2016

IN recent years, polio has taken centre stage on the health landscape in Pakistan. To some extent, given the international dimensions of the issue, that is justifiable.

And while it is encouraging that the outlook on polio appears to have improved considerably, a number of recent reports illustrate that general access to health remains deeply problematic, beset by institutional apathy and corruption.

An inquiry committee investigating the health infrastructure in some Khyber Agency tehsils has discovered that 19 out of 20 community health centres and dispensaries in those areas have been non-functional since 2003-04.

To add insult to injury, the Fata Secretariat has been regularly shelling out funds for rent as well as for the salaries of 120 absentee employees.

The situation in some other tribal agencies is believed to be the same. Meanwhile, appallingly, there are only two chest surgeons in Karachi’s public sector which caters to patients from both Sindh itself and Balochistan.

Long delays in surgery are thus inevitable, and 200 patients are currently on the waiting list.
In an important sense, a nation’s standing in the world is gauged by how its people’s basic needs are being met. Much like education, health has received no more than lip service in Pakistan, which spends merely 0.9pc of its GDP on healthcare.

Misplaced priorities mean that emphasis tends to be on big ticket, high-visibility items rolled out with much fanfare and which are useful for propaganda purposes.

Consider this: federal funding for the Khyber Institute of Child Health and a burns hospital, both in Peshawar, has not been forthcoming; instead it has been diverted, it is reported, to Islamabad’s metro bus project.

Health is not a constitutional right per se in Pakistan, although it stands to reason that like education it too should be included through an amendment. Nevertheless, the principles of policy set out in the Constitution enjoin the state to promote the “social and economic well-being of the people”, which cannot be achieved without providing access to quality public healthcare.

Unlike the situation not only in many developing countries but also the West, the majority of Pakistanis seek recourse to private healthcare because public health facilities are either absent or substandard.
These out-of-pocket expenses force them to cut corners in other spheres of life, such as nutrition or education, which then further compromises their social and economic well-being. But this vicious cycle cannot be de-linked from the overall state of the nation.

Despite the outbreaks of communicable diseases in the country — measles in Sindh being among the more recent — non-communicable diseases are an increasing concern.

It is estimated that approximately 50pc of Pakistan’s population suffer from one or more chronic NCDs, and that the economic burden associated with deaths from these conditions will reach $296m by 2025. Health and education for all is the very bedrock of development.

Published in Dawn, June 28th, 2016

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