State of Healthcare in Pakistan – Part 1 – Asrar Qureshi’s Blog Post #784

State of Healthcare in Pakistan – Part 1 – Asrar Qureshi’s Blog Post #784

Dear Colleagues!  This is Asrar Qureshi’s Blog Post #784 for Pharma Veterans. Pharma Veterans welcome sharing of knowledge and wisdom by Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on  WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

Photo Credit: Karolina Grabowska

Photo Credit: Laura James

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Pakistan is the sixth most populous country in the world, with a population of over 220 million, a figure which is likely to increase after the current census gets done. We still prefer to call ourselves ‘a developing country, though we have fast degraded as an ‘underdeveloped’ state. Our economy has nosedived, our governance is at its worst ever, our politics is at it dirtiest, and our people, businesses, workers, officers, decision makers, law enforcers, and reformers are at their most corrupt level. We are standing with a bleak future, with no light at the end of the tunnel apparently. With this rather dismal preamble, I start discussion about the state of healthcare in Pakistan. 

Basic Premises

Healthcare sits among the top items for any government in any country. It is because healthcare is an essential component of any country’s development and growth. It is important for a country to have a healthy population to ensure that the economy is productive and that the country can grow and develop. Healthcare also plays a crucial role in reducing poverty and inequality by providing access to affordable healthcare services to all citizens. Additionally, healthcare is important for the prevention and control of diseases, which have a significant impact on the quality of life of individuals and communities, and on the country’s economy.

The government plays a critical role in healthcare by providing funding and resources to ensure that citizens have access to affordable healthcare services. Governments also regulate the healthcare industry to ensure that healthcare providers meet certain standards of quality and safety. Additionally, governments are responsible for developing and implementing public health policies and programs to promote healthy behaviors and prevent the spread of diseases. Finally, governments are responsible for ensuring that healthcare services are accessible to all citizens, regardless of their ability to pay.

The private sector also plays an important role in healthcare by providing healthcare services and products to consumers. Private healthcare providers often offer more specialized and advanced services than public healthcare providers, and they may be more efficient and effective at delivering healthcare services. Additionally, the private sector is responsible for developing and producing new drugs and medical technologies that can improve health outcomes for patients. However, the private sector is also driven by profit motives, which can often lead to higher costs for consumers and reduced access to healthcare services for low-income individuals.

Healthcare systems in LMICs – Lower and Middle Income countries face a number of challenges, including limited funding and resources, inadequate infrastructure and equipment, and shortages of healthcare workers. Additionally, many developing countries struggle with high rates of infectious diseases such as HIV/AIDS, malaria, and tuberculosis, which can place a significant burden on healthcare system. Moreover, many developing countries lack the political will and commitment to invest in healthcare systems and make the necessary reforms to improve health outcomes for their citizens.

Pakistan faces similar healthcare challenges, including limited funding and resources, inadequate infrastructure and equipment, and shortages of healthcare workers. Additionally, Pakistan has high rates of infectious diseases such as tuberculosis and hepatitis, as well as non-communicable diseases such as diabetes and cardiovascular disease. Finally, Pakistan’s healthcare system is fragmented and poorly coordinated, which can make it difficult for patients to access the care they need.

WHO released top 10, most urgent healthcare challenges to tackle in 2020s, which are listed below. Each one of them applies to Pakistan also. 

1. Elevating health in the climate debate – climate is now among the biggest threats to the planet earth and its inhabitants. Emissions kill around 7 million people every year through causing a number of serious diseases. In addition, extreme events like floods and droughts increase malnutrition and infectious diseases like malaria, dengue, typhoid etc.

2. Delivering health in conflict and crisis – attacks on polio teams are common in Pakistan. Security situation, sectarian violence, political uprising makes it dangerous for healthcare professionals to deliver healthcare. IDPs – internally displaced people are usually without appropriate healthcare.

3. Making healthcare fairer – the gap between wealthy and poor is growing wider in terms of access to healthcare also; people in wealthy nations can expect to liver 18 years longer than their poorer neighbors. Lack of adequate public healthcare forces people to spend from their own pockets thus making them even poorer. 

4. Expanding access to medicines – medicines and vaccines are still not an option for a large number of people in Pakistan. While people living in cities and large towns have easy access to drugs, the same is not true for those living in remote areas. To further complicate the issue, medicines available in such areas are not of the right quality.

5. Stopping infectious diseases – we are very familiar with infectious diseases. Malaria, dengue, typhoid, tuberculosis, and hepatitis are common across the country, with some hotspots where these are endemic. Scores of lives are lost, and valuable days of work are lost every year due to infectious diseases. 

6. Preparing for epidemics – gastroenteritis epidemic is a regular visitor every year, so are respiratory problems. COVID19 like epidemics can also be expected any time. Epidemics’ control requires immunization with vaccines, and we do not have a single unit for manufacture of vaccines. Dengue came as an epidemic but was fortunately controlled rather efficiently.

7. Protecting people from dangerous products – the US and Europe have put severe restrictions on smoking and vaping. Pakistan allows to sell all brands of cigarettes freely and vape is a fashion here. Spurious drugs are selling in many parts, and unhealthy foods have become part of culture. This is a fast rising health challenge.

8. Investing in people who defend our health – Pakistan is already facing shortage of quality healthcare staff. Medical colleges have become abundant thanks to private sector, but paramedical staff and healthcare technicians are in short supply. New medical equipments need highly skilled workers to operate these which are hard to come by. Constant, large investment is needed in this sector.

9. Keeping adolescents safe – our adolescents are dying or becoming incapacitated due to road accidents, domestic violence, sexual abuse, harsh child labor, drug addiction, and diseases. We take pride in being a young population, but we must protect our adolescents.

10. Earning public trust – no government has succeeded in gaining public trust on account of polio drops administration to children up to five years of age. Same is true for family planning and vaccinations. It takes consistent effort and public-private partnerships to gain confidence, but it is lacking.

I repeat that though these are global challenges covering all countries of the world, each one of these is applicable to Pakistan.

Healthcare stands on three pillars: Healthcare related policies; Public and private health infrastructure; and availability of diagnostic and treatment tools, the last one also includes easy access to drugs. We shall review each of these in some detail to understand the entire healthcare landscape. 

To be Concluded……

Disclaimer: Most pictures in these blogs are taken from Google Images and Pexels. Credit is given where known; some do not show copyright ownership. However, if a claim is lodged at any stage, we shall either mention the ownership clearly, or remove the picture with suitable regrets.

References.

9789290222651-eng.pdf (who.int)

Pakistan's Healthcare Budget Is Set To Decrease, Placing Further Pressure On An Already Underperforming Healthcare System (fitchsolutions.com)

BUDGET 2022-23: Health ministry’s allocation gets a massive cut - Pakistan - DAWN.COM

WHO's 10 most urgent health challenges for the 2020s | World Economic Forum (weforum.org)