NationalVOLUME 16 ISSUE # 01

Life after coronavirus

Normalcy has started returning to Pakistan after it lifted nearly all coronavirus-related lockdowns following a sharp decline in new cases and deaths in July. The government may have justifications for lifting the restrictions but it could have come up with a better strategy to rectify flaws in the routine life of the people.

The pandemic could have been used as an intervention to reset the economy and the lifestyle of the people. It provided an opportunity to the government to change habits and norms of society. It was an ideal time to make laws, forcing businesses and markets to open between 8am and 7pm. Most people, who have experienced life in the West, believe staying out in the markets and roaming around till midnight for no reason needed some intervention, but the government wasted a great opportunity. Slowly lifting the lockdown with such restrictions could have been enough to reset our lazy behaviour. All developed nations observe the routine, which not only saves electricity but also allows families to spend more time together. There is no harm in opening wedding halls but we have missed an opportunity here as well. A limit of 100 to 150 guests at most could have saved so much food, fuel cost, travelling time and fatigue. Laws could also have been made for better traffic management and pollution control, which is one of major challenges facing the country.

The Pakistan government pats itself for devising “smart” lockdowns, which not decreased the number of the infections in the country sharply but also saved the economy from massive losses. One believes natural causes played a more major role in bringing down the cases, than the government efforts. The international media and experts are also impressed with Pakistan’s performance after almost 92pc of patients have recovered in the country. The new cases have reduced to 500 and deaths to 10 in a day, a decline of almost 82pc from a peak of close to 7,000 new cases a day a few months ago.

The international media and experts attribute the low numbers to the underreporting of cases and deaths and low testing. A top international rating agency, Fitch Solutions, has appreciated Pakistan’s efforts but also pointed out flaws in Pakistan’s healthcare system. It said the government was making efforts to improve the healthcare system in Pakistan and had undertaken several reforms which would take time to deliver gains. “However, like many of its neighbouring emerging Asian markets, Pakistan is striving to achieve universal healthcare access to quality essential health services, with a specific focus on vulnerable groups.” In its assessment, it warned that opportunities for multinational drugmakers would be marred by fundamental issues which exist in the healthcare system and underperformance of the public sector healthcare system will drive the growth of private healthcare. “Pakistan Vision 2025 reflects the government’s commitment to investing in the social sector including health as a top priority and the National Health Vision (NHV) 2025 provides a single, shared vision for universal health care, especially for women and children in the country,” it said.

It identified that one of the key actions under the NHV is the formulation of the Pakistan Human Resources for Health Vision 2018-2030 to address the health workforce challenges. Despite the increasing political will in Pakistan to develop the healthcare sector, given the government’s poor track record of implementing planned healthcare sector reforms, there is a possibility that the implementation of such improvements will be delayed. There are numerous weaknesses which will affect the sector’s development, including poor governance, lack of access and unequal resources, poor health information management systems, corruption in the health system, a lack of monitoring in health policy and health planning, and a lack of trained staff, the agency elaborated.

The country’s healthcare system remains significantly underfunded which inhibits the provision of high-quality care and hence limiting the chances for high-value medicine sales. Healthcare standards in Pakistan remain poor by global standards, with 78pc of the population paying for healthcare expenditure out-of-pocket. According to a study, Pakistan ranked 154th among 195 countries in terms of quality and accessibility of healthcare lagging behind Bangladesh, India and Sri Lanka, it observed. Pakistan has one of the lowest densities of health workers in the region and globally, with a doctor to patient ratio of 1:1300, doctor to nurse ratio is 1:2.7. With such low levels of staffing, Pakistan is listed as one of 57 countries with a critical health workforce deficiency.

The impact of the weaknesses has been perpetuated by the Covid-19 crisis, which reinforces the need to ensure effective crisis management and fast-track progress toward universal healthcare. On the upside, the underperformance of the public sector healthcare system in Pakistan has created a room for the private sector to grow, which has become popular in health service delivery. Moreover, pressures on public health institutions from a rapidly growing population have allowed the private sector to service the gap created by an ever-increasing demand and limited public health facilities, the report added.

Despite loopholes in the healthcare system, Pakistan’s Covid-19 situation is better than its neighbours. The positivity rate in Pakistan is around three whereas it is 9.4 in Iran and 9.8 in India. The positivity rate in Bangladesh is 24. If deaths are compared over the last few weeks, according to the population, Iran has reported 20 times the number of deaths in Pakistan, while India recorded around four to five times the number of fatalities.

The situation has given a new lease of life to Prime Minister Imran Khan and his government. The opposition was expecting a large number of deaths in the country, which could pave the way for the ouster of Prime Minister Imran Khan, if not his government. The low number of deaths has not only saved his government, but also the national economy of huge losses. He will emerge a stronger leader after the pandemic.