Are we ready?

It has been slightly less than two years since the World Health Organisation (WHO) ended the Public Health Emergency of International Concern for the Covid-19 pandemic back in March, 2023. Over an estimated 30,000 Pakistanis died in that pandemic, which was arguably the greatest public health crisis of our time. And while the country’s fatality rate was far lower than that of many advanced nations, with Pakistan only having the world’s 29th highest Covid death toll despite being the fifth most populous country, this is no excuse for the country’s policymakers to rest on their laurels. When the next pandemic arrives, and yes it is a matter of ‘when’ and not ‘if’, the country needs to be better prepared. Since today marks the International Day of Epidemic Preparedness, there is no better time for those in charge of the country’s health policy, and other relevant domains, to reflect on Pakistan’s readiness to handle the next global or national public health emergency. One of the most alarming trends during the Covid days was the inability of developing countries like Pakistan to afford essential equipment like masks, ventilators and vaccines in the quantity that was needed. Many households were also unable to bear the financial costs that came with a prolonged lockdown, even if locking down made the most sense from a public health perspective it was economically unsustainable for the majority. The country’s lack of a proper welfare system was sorely felt at this point.

In this regard, it has been reported that the Pandemic Preparedness and Response (PPR) through Operationalising One Health Approach Programme in Pakistan will be funded by the World Bank and implemented in coordination with the Asian Development Bank, WHO and the UN’s Food and Agriculture Organisation. The Pandemic Fund’s governing board reportedly approved $418 million for 40 countries this October. The money will reportedly be used to strengthen disease surveillance and early warning systems, upgrade labs, and build a health workforce. While this money is a start, less than half a billion dollars spread across 40 poor countries is not exactly adequate. And while the Pandemic Fund is mobilising an additional $6 billion to bolster healthcare programmes in 75 countries, there are unmistakable echoes here of the rich world once again not doing enough to support healthcare and development initiatives in the Global South. This is quite risky in a globalised world where health crises in any one country can quickly go global.

Looking to our own authorities does not provide one with much more comfort. Around half of all Pakistanis still lack access to basic health services despite a 13 per cent improvement in the country’s universal health coverage index between 2015 and 2022. An environment where so many people lack any kind of healthcare is fertile ground for both national and global health emergencies. Public spending on healthcare is still well below the 6.0 per cent of GDP recommended by experts, depriving Pakistan of the strongest shield against future epidemics: a strong, well-functioning local healthcare system. As such, the country remains overly dependent on foreign donors for its pandemic preparedness policy.