With the current course of population growth, Pakistan is set to add another 100 million people to its population by 2050. In a country already ravaged by a plethora of issues concerned with economy, politics, governance and national security, overpopulation may prove to be fatal. Pakistan is currently fighting its battle with an existential crisis.
It has been suffering from perpetual political instability, economic downfall, security crisis and social degradation. The sense of normalcy in the country has become a distant dream and the confidence of the citizenry in the state is spiralling downward exponentially. The social, economic and political insecurities are growing and the state is finding no way to bring stability.
It is fighting its own war with its own key elements. But that’s another story for another day. With the issue of rampant population growth, the most significant issue that needs to be addressed is that of public health. A calamity of insurmountable consequences and yet so neglected in our country. Hence shows the inherent traits of being a Third-World nation.
Pakistan is showing an alarming escalation in its health problems. This, coupled with structural issues, that is, a poor healthcare infrastructure, is a huge concern. Almost 60 million people live in poverty. Thus access to quality healthcare is negligible and healthcare disparity is of huge proportions. Poverty is deemed to rise further as a result of faster population growth and perpetuating economic instability. And thus the public health crisis will worsen.
Pakistan has also been facing a precarious situation, a climate change crisis. The recent example is of calamitous floods that hit the country this monsoon and brought unprecedented destruction. There was huge infrastructural damage across the country as well as large population displacement. The perilous situation of health of the people who suffered from floods is unimaginable. According to the WHO, multiple disease outbreaks happened across the affected areas, including cholera, malaria, dengue and other communicable diseases.
In addition to that, women suffered tremendously from maternal health issues related to reproductive health. There have been childbirths in completely unsafe situations resulting in huge risks for both mother and newborn. Furthermore, the issue of non-communicable diseases has ramped up as well. Overall,the public health crisis coupled with the climate change crisis is hugely consequential for Pakistan, already in a deplorable condition.
Pakistan is facing a double burden of disease (BoD), with the endemicity of hepatitis B and C with 8.6 percent affected individuals; the fifth highest tuberculosis burden in the world, and focal geographical area of malaria endemic.
The overall HIV prevalence is 23.0 percent, although 77 percent of those who inject drugs are using sterile injecting equipment. Estimated antiretroviral therapy coverage is 9.8 percent. In addition, the country has high rates of unscreened blood transfusions, a leading cause of disease transmission in Pakistan. Drug-resistant tuberculosis is estimated at 5.3 percent among new cases and 20 percent among previously treated cases. Vaccine-preventable diseases and new emerging infections call for strengthening disease surveillance and response systems.
The way forward to mitigate this important issue includes a universal healthcare policy, increased budgetary allocation, a systemized system of clinical healthcare and community healthcare, enhanced coordination among federal and provincial health ministries, adequate facilities for healthcare staff especially doctors, more collaboration with WHO and other concerned international agencies, widely scoped public awareness programmes and a comprehensive, sustainable national healthcare policy. In order to achieve these objectives, and the state must act to bring socioeconomic and political stability and good governance in the country. Lastly, Pakistan is the only country along two other countries in the world that is still fighting against Polio. And if significant steps are not taken soon, the morass of public health crisis will further deepen.
The healthcare system is burdened while allocation of funds from annual budgets is very low. Since healthcare functions under provincial governments, there has been a huge interregional disparity as well. There is a dearth of policies related to healthcare as well as debilitated healthcare infrastructure.
In case of non-communicable disease burden, the picture is not different either. Pakistan tops the charts when it comes to proportion of population suffering from diabetes type II, cardiovascular diseases, kidney diseases and malignancies.
Furthermore, due to constant economic instability, Pakistan has been suffering from food insecurity too. As a result, a lack of adequate nutrition is resulting in a dilemma of severe malnutrition. For children it contributes to the high number of child and maternal deaths. Approximately 40 percent of children under the age of five are underweight and more than half are affected by stunting. The body’s natural defence mechanisms are also weakened as a result of poor diet. Thus, nutritional deficiency is another public health issue causing increased morbidity and mortality.
Moreover, issues like smog and water pollution are causing addition of toxic substances into food chains, resulting in decrease in average life expectancies across the country. According to a report, 90 percent of drinking water in Lahore contains toxic amounts of arsenic which is a carcinogenic substance. Overall, the picture of public health is dismal in every aspect and the consequences are far greater than being anticipated by the authorities and successive governments.
Furthermore, the healthcare infrastructure has also been in a debilitatrf condition. There are inadequate healthcare facilities across the country. Due to negligence of governments and low allocation of budgets, the situation is becoming even poorer. Healthcare staff, especially doctors, are fleeing the country due to inadequate facilities, service structure issues and lower salaries. This has been adding more issues to the quagmire of the healthcare system of the country. And thus, its fight against the rampage of public health issues is falling short.
The way forward to mitigate this important issue includes a universal healthcare policy, increased budgetary allocation, a systemized system of clinical healthcare and community healthcare, enhanced coordination among federal and provincial health ministries, adequate facilities for healthcare staff especially doctors, more collaboration with WHO and other concerned international agencies, widely scoped public awareness programmes and a comprehensive, sustainable national healthcare policy. In order to achieve these objectives, and the state must act to bring socioeconomic and political stability and good governance in the country. Lastly, Pakistan is the only country along two other countries in the world that is still fighting against Polio. And if significant steps are not taken soon, the morass of public health crisis will further deepen.
