COVID-19 & Pakistan Health Crisis
When the third wave of Covid-19 rages, it may sound premature to speak of ‘afterward.’ It’s not too early, however. How countries counter to health emergencies depends directly on the way they were prepared for the crisis. In fact, “health emergency” may be a pure health problem, like a pandemic, or a corollary to other disasters, including earthquakes, floods and famines, at local or national level.
We were less ready to face a health tragedy, as demonstrated in the Covid- 19 incident. Although Pakistan is vulnerable to disasters, we have not constantly invested in disaster preparedness relating to health and, consequently, our hazardous response. There are a variety of policies and operations that cover our lack of preparedness for healthiness emergencies.
WHO supported an independent assessment of our “core capacities” in Pakistan in 2016 to prevention, detection and reaction to health threats? In the context of the International Health Regulations (2005), a main team of international experts has been around for weeks to assess, including the position of pandemic preparation, 19 technical areas in detail. The appraisal team produced an extensive report containing detailed recommendations for the improvement of the national infrastructure and operation for emergencies, but it did not employ.
Pakistan currently lacks the legal base to announce an emergency in terms of national health. Health ministries are less ready to react on their own to a health crisis. During national emergencies the 18th amendment further destabilized and complicated national coordination.
There is not even close operational management of the National Disaster Management Authority with its counterparts. There would not be any need to set up a National Command Operation Center if there were a rational national disaster management institutional network. Also, at 19 entry points (airports, etc) in a country that is a vital function in the event of a pandemic like Covid-19, a weak, ill-controlled organization, under the federal Ministry for National Health, Regulation and Coordination is responsible for screening and Quarantining. This organization must be thoroughly revised.
We also require a strong and trustworthy national disease monitoring system and an imaginative, fast response team led by a field epidemiologist in each district. The ICU beds and critical care specialists in Pakistan are also intensely lacking. Our system is starting to shudder as the number of critical patients increases. In this respect, a vigorous ramp-up plan is desirable. Pakistan currently lacks the officially authorized base to state an emergency in terms of national health.
There are many inequities around the world, including in the health sector. As shown by Covid-19, high-income health systems are also not sheltered from the overall effects of the pandemic. In the current vaccine struggle the inequalities between rich and poor countries were also exposed.
In high-income countries at low-risk adult populations are vaccinated, while high risk front-line health workers and co-morbidity elderly people await their vaccines. Similarly, in poor countries the haves and have-nots get privately vaccines from the rich, whereas in the public sector the old and frail and the poor wait for their turns.
Covid-19 has universally exposed health systems. Just as the global community learned its teachings after World War II and said ‘never again,’ the global health care plan now calls for a similar degree of response.
Countries need to reorganize their health systems’ vision to a universal primary healthcare coverage. The case for healthcare investments is strong and their positive externalities affect not only health but national productivity, human development and growth as well.
Health workers must be taught to meet national health needs and priority. Everyone should have access to necessary medicines and technology and provide chains should be fitted, clear and efficient. Health services should go beyond patient therapy and cover preventive, encouragement, rehabilitation and palliative care.
Important functions of public health, such as sickness monitoring, disease control and health sector directive, must be strengthened. Disaster preparedness and response as part of healthcare must be considered. Health is an interdisciplinary fact and requires a government-wide and social approach.
It is not only the responsibility of health ministries, e.g. water, poverty, education and risky behaviors have many significant determinants for health. Intensification primary healthcare should be a key priority. The majority of economic health services can and should be provided here.
There are terrible indicators of health in Pakistan. Health of mother and child is in dismay. The incidence of communicable diseases is out of control and dangerously high. Our healthcare system is built-up and hospital based, dominated and least regulated by the private division.
The functions of public health were never strong but now, following the 18th amendment, are extremely disjointed. Pakistan has low health spending, in spite of its low income countries, and after Covid-19’s financial impact, fiscal space has declined even further. However, our healthcare system needs to be given more grim and sustained care than ever before.
Covid 19 tremble us. As the pandemic falls, before another disaster strikes us we have to put our healthcare on warfare. We should set up a nation-wide health committee that should conduct an early review and recommend boldly and in-deathly so that we can deliver decent and necessary healthcare and prepare ourselves for major health challenges, including emergencies in the future. Health care spending should not be seen as a social overhead, but as an investment.