Pakistan’s capacity to fight disease outbreaks


Dr M Ahmed Abdullah

OVER the past few months, the whole world is being haunted by the imminent threat of a global pandemic. The novel Corona Virus 2019 or COVID 19 as it is being called has swiftly overtaken major media headlines around the world.
We collectively as human kind have a very short memory span, as every time we are faced with a new infectious disease we start weighing the situation in the context of some sort of divine intervention. We easily ignore history and in our arrogance we fail to learn lessons from the great pandemics of the past. Not too long ago; 102 years ago to be precise, people were dying in droves during the 1918 Spanish flu epidemic. We also need to develop a clear understanding of the fact that diseases affect people disproportionately, based on their socio-economic status and lifestyles.
In this regard it has already been clearly stated by the World Health Organization that disease outbreaks have the worst impact on the weakest health systems. Pakistan has one of the weakest health systems in the world, with poor health indicators, a predominantly reactive approach towards problems and a persistently increasing lack of resources in terms of manpower, money and material. There have been no confirmed cases of COVID 19 until now in Pakistan, however a major reason for this fortunate happening is the lack of preparedness and diagnostic capacity that we have had for dealing with any kind of disease outbreak; in simpler words how would we know if we have it.
There is a major deficiency of coordination between the various components of the health system, no formal mechanisms for contact tracing, distant private and public sectors in health care delivery, and a huge proportion of people who receive healthcare from unregulated and untrained individuals who practise medicine across the country and who clearly outnumber all health professionals. In the modern world, reliable data is essential for evidence-based decision making; however our complete lack of it is a serious problem. There are no formal mechanisms and entities in place that can swiftly respond to a health problem, as our approach depends on responding to the problem once it is upon us. The discussion would be incomplete with talking about tangible solutions. In the first phase of response the government needs to focus on delivering robust and mandatory trainings on infectious disease control and prevention to health workforce performing their duties in various capacities in the health system, including the private sector. Mass media health promotion should be initiated to educate the masses on preventive techniques. Provision of resources such as personal protective equipment and diagnostic facilities should be done on war footings.
We live in a very short sighted environment and hence we need to open up more to the world for sharing of new and innovative ideas from other parts of the world. Unfortunately we have been drawing most of our worldly inspiration from developed countries, where as more experience sharing should be carried out with other countries that share our problem of scarcity of resources. Even though these solutions are all possible but unfortunately we are far behind in our struggle to develop a more efficient, responsive and proactive health system.
—The writer is Assistant Professor Public Health, Islamabad Medical and Dental College.