Over 90 countries globally regard access to healthcare a basic human right, enshrining in their respective constitutions laws and policies aimed at ensuring the provision of such services to all their citizens. More than 75 years since its formation, however, Pakistan has yet to regard healthcare a fundamental right, implicitly suggesting it is not an essential necessity for life.
Pakistan’s lax view toward healthcare is reflected in its World Health Organization ranking of overall health, placing it 124 of 169 states under consideration. At home, a “Health of the Nation” report compiled by the Pakistan Medical Association (PMA) has echoed these concerns, highlighting successive governments’ failure to address the health and safety issues plaguing the citizenry, particularly their quality of life.
According to the report, approximately 30.8% of the population, 71 million citizens, are diabetic, suggesting roughly 1 in 3 people require insulin to survive. Similarly, the country must reckon with a myriad of communicable diseases, especially in far-flung rural areas. In 2022, the country was estimated to have more than 600,000 cases of tuberculosis, including roughly 16,000 drug-resistant cases. Pakistan is also one of only two countries, with Afghanistan, where the poliovirus remains endemic. UNICEF has also reported the country’s unenviable infant mortality rate, 55.777 deaths per 1,000 live births, compared to 26.619 deaths per 1,000 live births in neighboring India. Tackling these diseases requires the provision of adequate resources and unrestricted access to medicine; however, recent steps undertaken by the government make the latter a difficult prospect.
Last year, amidst pressure from industry groups, the government increased the prices of over 80,000 drugs, including 146 essential medicines, rendering a majority of them unaffordable for a population already burdened by high taxes, utility bills and rampant inflation. This is especially troubling considering World Bank data showing roughly 95 million Pakistanis live below the poverty line, barely able to afford basic sustenance and shelter, much less medicine.
Rather than tackling the problem through greater budgetary allocations for healthcare, recommended at 5% for developing nations by the World Health Organization, the country allocated a mere 0.95% of its GDP to healthcare in fiscal year 2023-24. These limited funds tend to disproportionately benefit urban centers, sidelining rural areas with crumbling infrastructure and poor doctor-to-patient ratios. Following the 2022 floods, such areas have also seen a spike in waterborne illnesses, with few efforts undertaken to counter them.
Unfortunately, the federal government’s ambivalence toward the healthcare sector has not been corrected by the provinces, as envisaged under the 18th Amendment, which called for effective and region-specific actions to tackle prevailing disparities. Attempts to correct these discrepancies, as through the PTI-led government’s health card program, have their own issues, with critics noting such measures risk endangering the public health sector by subsidizing the cost of treatment at privately-run facilities rather than fixing the inherent problems that plague state-run centers.
What is clear to all is that Pakistan’s historical lack of seriousness and concern regarding healthcare has enabled a dire situation for the country’s poorest segments, who continue to face difficulties in accessing healthcare. Correcting course requires systemic changes spanning years, if not decades, to see lasting improvements in lifespan and median health statistics. A key first step would be to declare access to affordable healthcare a constitutional right and boost government funding, even if it means reducing finances for security or the Public Sector Development Program. Healthy nations require healthy families; hoping to achieve the former without focusing on the latter is a recipe for disaster.