Pakistan at health care crossroads

In early April, social media in Pakistan went abuzz with news and videos of police manhandling doctors in front of Chief Minister’s Secretariat in Balochistan province. The protesting members of the Young Doctors’ Association (YDA) were beaten and dragged away before being shoved into jail.

To demand much-needed personal protective equipment (PPE) for fighting Covid-19, the doctors had marched to the CM Secretariat to demonstrate, and the baton charge by the police was the result. The confrontation ended after the chief minister assured the doctors that they would be provided with all needed equipment to fight against the Covid-19 outbreak that has infected paramedical staff.

The event exposed the flaws in the province’s health-care system.

In Pakistan as a whole, the “reactive” measures across the country have been effective, particularly the lockdown, which has helped to curtail the contagion. However, a consistent increase in communicable diseases across the country indicates serious problems with the national health-care system.

On April 25, 2019, news about an outbreak of the human immunodeficiency virus (HIV) in Ratodero, a city in Larkana district, Sindh, caught the attention of national and international media. With the assistance of the World Health Organization (WHO), local and provincial health departments initiated screening for HIV cases in the area.

From April 25 to June 28, 2019, almost 30,132 people were screened, of whom 876 tested positive. The crisis put another dent in the reputation of the health-care system. It was a sudden prick in the bubble of claims that communicable diseases had been controlled in Pakistan.

In addition, for monitoring and early diagnosis of communicable viral diseases, the Pakistani government launched a Disease Early Warning System (DEWS) in 2005. However, the sudden rise in HIV cases in Sindh in 2019, the prevalence of hepatitis C virus (HCV) in the country and the onset of multi- and extensively drug-resistant tuberculosis (MDR/XDR TB) have raised concerns about the efficiency of DEWS.

The Covid-19 outbreak has affected the entire world. It will force health-care systems to adopt more proactive rather than reactive measures in future.