The future of healthcare: reflections from a WEF session

On Sept 9, 2015, I moderated a World Economic Forum panel discussion on the future of healthcare in Dalian, China. The panel drew on a wide range of expertise. With Minister Subramarian from Malaysia, Daljit Singh from the corporate world…

Summit on the Global Agenda 2014

For the last seven years, every November, around 800 thought leaders from around the world convene in the United Arab Emirates for the World Economic Forum’s Summit on the Global Agenda. Knitted as a global knowledge network of around 80…

Sania Nishtar’s Comments on the Round table on post 2015 at the International Conference on Nutrition, Rome, Italy November 19, 2014

Non-communicable disease is a collective name for four major diseases, CVD, diabetes, some cancers and chronic lung conditions These 4 diseases, are linked by 4 lifestyle and four biological risks. Diet is one of them This afternoon, I would like…

Reflections from the UN NCD’s review

My visit to the United Nations’ headquarters during the UN review on non-communicable diseases (NCDs) on Friday, July 11, as speaker and moderator for two events, respectively, made me go down the memory lane for some reasons. As a young medical intern working in…

The public health challenge of this century

A forty-five year old man at the prime of his life in Pakistan struggles with heart disease. He has been told that three of his major coronary arteries are critically blocked. His wife, at age 43 suffers from type 2…

The World Health Organization Is Fighting Childhood Obesity

Earlier last week, the Director General of WHO announced the establishment of the WHO Commission on Ending Childhood Obesity to strengthen the scientific evidence base for action, to engage all stakeholders and to create awareness and build momentum for action…

Grandmother’s eggs

Last month, a high powered technical Symposium on maternal and child health concluded at the flooded Oxford University Egrove Park with a message that can be captured in just one Cartoon. Projected as the last slide of Stephen Kennedy, the opening…

Governance — Going granular

At the end of each year, analysts tend to review past performance of governments and sectors and whip forecasts and recommendations for the future. In doing so, they generally view things with a technical analytical lens where performance metrics, indicators…

World Cancer Day: A sobering reminder

Our senior verifier Farkhanda broke down into tears as she narrated the story to me. I noted that she had been very sad all day yesterday, after having reviewed a child’s funding application. Nine year old SN knew she was…

Lessons from Sabir’s story: Why we aim for development and humanitarian objectives at Heartfile

Sabir was not on his bed when I entered the ward, which gave me an opportunity to go through the case notes. He suffered from a heart disease called infective (bacterial) endocarditis, a condition in which an infection ‘somewhere’ in…

Governance in 2014

Part – I However, assessing governance effectiveness is a challenging task from an empirical standpoint and often information has its limitations in conveying the real impact of poor governance at the granular level – a level that can indicate the…

Butchers galore

Lying in a surgical unit of the Khyber Teaching Hospital in Peshawar is an elderly woman with half her abdominal wall practically eaten away by infection – the outcome of a surgery carried out in a district hospital, which was…

Pakistan’s Polio Priorities

When Pakistan’s new government is sworn in on Wednesday it has a historic opportunity. The new administration under the leadership of Nawaz Sharif could be the government to eradicate polio from Pakistan, one of three countries where the crippling disease…

The boy with the bruised lip

Ali seemed very shy. He didn’t make eye contact with the Heartfile verifier—or perhaps it was his swollen and badly bruised lip, which made him conscious. Throughout the conversation between our verifier and his mother, his gaze remained lowered, as…

Let’s stop ignoring this needless suffering

In most populations, more than 40% of adults aged 25 and over suffer from high blood pressure, a disease which, if left untreated, has unparalleled potential to kill and disable, inflict enormous suffering and significantly undermine quality of life. Millions…

High Level Dialogue on Health in the Post 2015 Development Agenda

It was as if the High-Level Dialogue on Health in the post-2015 Development Agenda was convened in Botswana to make a point—a country, which uses diamonds for development. Through consistent economic policies, the country has developed its mining sector, which has generated the fiscal…

Pakistan’s Polio Tipping Point

Early this month, tragedy struck Pakistan’s polio eradication campaign once again with the killing of two more polio workers and a policeman on patrol with the vaccination teams. The latest murders in Pakistan preceded the killing of nine polio workers…

World Cancer Day—some personal reflections on NCDs

World Cancer Day is another occasion to recall the interconnectedness of risks, which provide an opportunity to tackle the world’s biggest killer—Non-Communicable Diseases (NCDs), a collective name given to ‘four diseases’ linked by ‘four lifestyle’ and ‘four biological’ risk factors….

Mega misnomers

Pakistan’s national and human security challenges have never been so pervasive. A war along the northern borders and relentless insurgency threatens the writ of the state, pitting law-enforcement agencies against people. Vested-interest groups exploit and deepen existing polarisation on ethnic,…

Visits: Heartfile Financing (Oct 22)

I saw four patients during my visit to the hospital today. Each one of them has a story which reflects blatant policy inattention, which undermines the core prerequisites of human security. First, there was a young woman who had attempted suicide…

Polio and Pakistan: Great Trepidations

The brutal assassination of nine grass roots level health workers in Pakistan, who were involved in a door-to-door immunization campaign in an attempt to secure children from crippling polio, adds an unprecedentedly grave dimension to the ongoing carnage in Pakistan….

DRA: a case for hope

The bill creating a much-needed federal drug regulatory authority – Drug Regulatory Authority of Pakistan – was enacted into law recently. The World Trade Organisation (WTO) agreements have made it binding on all countries to have independent drug regulatory authorities,…

The New Wings of Development

The concept of development, through which governments view social policy in environments where capitalism is the mode of social organization, may be up for a major rethink, globally. This year, policy signals at agenda-setting global convening and major publications seem…

14th August: great trepidations

Great trepidations shadow Independence Day. With the country’s increasing isolation in the arena of international politics, poor state performance, and a polarized society, Pakistan survives today primarily on the resilience of its people. This is a time to reflect on…

Pakistan’s drug deaths

The deaths of over 125 people in Lahore from contaminated drugs are a stark illustration of the inherent institutional and policy weaknesses in our health systems. Our articles and statements in the media and in other academic journals on this…

18th constitutional amendment and health

In April 2010, the Pakistan National Assembly passed the 18th Constitutional Amendment which abolished the health ministry and devolved its portfolio to the provinces. Our articles and statements in the media and in other academic journals on this issue can…

Polio update

Despite massive investment and high level political commitment, Pakistan still risks being the last remaining reservoir of polio virus transmission in the world. Our articles and statements in the media and in other academic journals on this issue can be…

Pakistan and Polio

At the recent meeting of heads of Commonwealth states, Australia put polio squarely on the table with a 54 million dollar promise. This adds to the existing pledges towards the disease eradication goal, which has collectively received more resources than…

Devolving health

Pakistan’s Ministry of Health was abolished on the 30th of June and a number of federal health responsibilities were placed under the jurisdiction of seven other government ministries/divisions. The dynamics of this change and the questions emerging as a result…

Independence Day resolution: embracing five attributes

In this rapidly changing globalized and inter-connected world, some recent events are compelling us to redefine existing norms and practices. Burgeoning tensions earlier in the Middle East highlighted the need to accord higher priority to mainstreaming democracy. Recent riots in…

Devolving health—a way forward

On June 28, a notification of the Government of Pakistan articulated a plan for completing the process of devolving many subjects, including health, as part of the final stages of implementing the 18th Constitutional Amendment. As a consequence, the Ministry…

Drug regulation and beyond

The establishment of a drug regulatory authority is once again on the policy agenda, this time round as part of implementation of the 18th Amendment-relevant devolution of health. In principle this is a step in the right direction. Whilst the…

Trivializing hope

The events of May 2nd and 21st have left the nation embarrassed and demoralized. The challenges arising as a result thereof may compound Pakistan’s existing problems. Many find it difficult to search for beacons of hope within the myriad of…

Regulation and 18th Amendment

As one of the key instruments of governance, regulatory functions have increasingly been in the spotlight, subsequent to the 18th Constitutional Amendment. Regulation can take many forms but in the current context it refer to interventions initiated by the government…

Soliciting inputs—Health and the 18th amendment

The Implementation Commission of the 18th Constitutional Amendment, in its recent session, has taken the final decision to devolve the Ministry of Education. The next round of deliberations will decide the modalities of devolving another set of ministries, including the…

Doctors’ movement

Young doctors in the largest province of the country are on strike for the 17th day running. With revolutionary fervor from the lawyers’ movement and the Middle Eastern revolutions shaping our societal political culture, it seems that the movement is…

Non-communicable diseases: evidence-policy disconnect

World Bank’s report ‘Tackling Non-communicable Diseases in South Asia’ made headlines in Pakistan, yesterday. This is an important subject and its significance should be appreciated by policymakers. The report highlights the magnitude of burden attributable to a set of diseases,…

Operation polio

The drive to eradicate polio in Pakistan has recently been marked by four positive developments. First, acknowledgement by the government that the country now runs the risk of becoming the last remaining reservoir of endemic poliovirus transmission in the world….

Agenda setting

The government and opposition factions appear to be converging on a ten-point Agenda focused on eliminating some of the currently prevailing governance distortions in Pakistan. Articulated as a set of “Demands” by one particular opposition party, the points have been…

2011—risks and resilience

At the recent meeting of the Global Agenda Council of the World Economic Forum in Dubai some of the top issues in the global risk landscape and their possible mitigates were highlights. Ironically, a few of us from Pakistan could…

Case of the vanishing ministry

The Implementation Commission of the 18th Constitutional Amendment is due to present its final recommendations to the Parliament for approval next week. Statements issued in the run up to that have already indicated that subsequent to abolishing the Concurrent Legislative…

The PDF premise

Pakistan Development Forum (PDF) 2010 was convened at a time of unparalleled challenges—with several macroeconomic issues, a grinding fiscal crunch, competing priorities for resource allocations, an energy crisis, ongoing war, relentless insurgency, and an unprecedented need for resources in the…

Dengue: misplaced fears

The recent outbreak of Dengue, which is commanding widespread attention, is an important insight into several health and overarching governance issues. Before those are alluded to, a brief comment is offered on the current situation. It is indeed a sign…

The budget process

Drawing attention to the budget process during the month of October may appear a little out of step specially when there are so many other governance-related storms whipping. A closer look however indicates otherwise. The budget process for a fiscal…

Flood and Disaster Observatory

In the last eight weeks, ‘coordination’ has come to be viewed as the epitome of flood relief, and the lack thereof, a major failure of stewardship agencies. The emphasis on coordination in the given context is not without reason. The…

Flood Financing and innovative means

Financial constraints, which parallel the unprecedented need for financing to rebuild and rehabilitate in the aftermath of the recent floods are calling for efforts to mobilize resources to bridge a huge gap. Currently, several conventional channels are being utilized and…

Disaster governance

Disasters are a true litmus test of governance. Many attributes of governance interplay in disasters, before, during and after a situation. This comment flags five governance lessons, evidenced by the response to the recent catastrophic floods.   The first attribute…

Child protection legislation

The Khyber Pakhtunkwa Child Protection and Welfare Ordinance 2010  is due to be presented to the Provincial Assembly any time now. The Ordinance is meant to be an improvement on the previous legislative enactments. However, a recent review circulated on…

Friends, dialogues, poverty and pragmatism

Some of the statements in wake of the recent meeting of Friends of Democratic Pakistan and strategic dialogues aimed at defining areas of priority for the use of incoming bilateral assistance from Untied States have been positive and encouraging, including…

Parliamentary Empirics

The 18th Amendment to the Constitution is being hailed on a two-fold premise: one, that it will proclaim and empower the Parliament as supreme; and two, that it will fundamentally redress the basic anomaly of Pakistan’s parliamentary system of government,…

Population denominator

July 11, World Population Day, holds special significance for Pakistan, the sixth most populous country in the world where the importance of Population as the denominator for planning and development must be clearly appreciated. In a country where food, water,…

The budget’s ‘social footprint’

There was a misplaced euphoria in some social sector circles last year over the expansionary fiscal policy evidenced in Budget 2009/10 and the increase in allocations for the social sectors indicated therein. However, as months unfolded, budgetary cutbacks became apparent…

The problem with BISP health insurance

This comment is a review of the health sector policy decision signaled in the June 5 budget speech as part of which a new health insurance scheme will be launched for the poor under the rubric of the federal government’s…

Politics of health reform – Part 3

Pakistanis faced with many unprecedented challenges. Ongoing acts of terrorism, the executive-judiciary confrontation, threats of environmental disasters looming with the Hunza lake bursting at its seams and a storm whipping up in theArabian sea, a relentless energy crisis, a tough…

Politics of health reform – Part 2

It is said that “in order to judge the character of a nation, look no further than its health system”. This yardstick unfortunately doesn’t project a positive image of Pakistan’s national character as the country fares poorly with respect to…

Politics of health reform

Ever since the enactment of major health reforms in theUnited States, global interest in the subject has burgeoned. ForPakistan, health reform should be an imperative for reasons that have been glaringly apparent. Cases of alleged malpractice by the private sector…

Sanitizing the constitution

The 18th Amendment Bill is being widely hailed for repealing some of the distortions introduced in the Constitution in previous years under military rule and for returning the parliamentary form of democracy closer to its truer shade inPakistan. A multi-partisan…

National Security Policy

prevailing situation should lend impetus to strategic thinking about a holistic vision for a National Security Policy. The imperative to do so is two-fold: one, the contemporary understanding of security within the context of a nation state has broadened from…

National Health Policy 2010

The Ministry of Health has stepped up efforts to enunciate the National Health Policy 2010 and bring the process, which commenced with the initiation of a Health Policy Task Force in 2008 to fruition since the availability of donor resources…

Federal Bureau of statistics and the draft bill

The evidence generating institutional arrangements of a state qualify to be its fourth pillar, since evidence constitutes the basis of decisions in every state domain. Within this context, the draft bill to make the Federal Bureau of Statistics (FBS) an…

Women: through the governance lens

Although effective governance—or the lack thereof—has an impact on every aspect of our societal, social and economic lives, nowhere is its imprint more vivid than in determining the status of women in a society. This comment uses the International Women’s…

Civil service reform revisited

The International Crisis Group’s Report on Civil Service Reform has sparked conversations around the need and potential avenues for restructuring Pakistan’s civil service. This, however, is not the first time that a report on the subject has been made public….

Separation of powers

The potential standoff between government and judiciary has finally been averted. Process-related concerns notwithstanding, the saga’s culmination appears to be a product of sound technical advice, heed to provisions of the constitution and a process of consultation. These attributes of…

The taxonomy within FoDP

Members of the forum of Friends of Democratic Pakistan (FoDP) have been convened for the fourth time since the announcement, which led to the creation of the forum in September 2008 on the sidelines of the UN General Assembly. Whilst…

A poor man’s woes

The poor man is under tremendous stress as a result of numerous economic hardships including high unemployment, inflation, scarcity of essential commodities, and limited ability of the state to target welfare services. These hardships often prompt those who hold welfare…

Road to anti-corruption reform

In a landmark decision on December 16, the Supreme Court has ruled on the legal validity of the National Reconciliation Order (NRO) and has termed it void ab initio for being ultra vires of the Constitution. In layman’s terms, the…

Beyond the NFC Award

The National Finance Commission (NFC) will be announced by the Prime Minister in Gawadar today. Felicitations are due not only for the amicable coming to fruition of a process fraught with long-drawn disputes, but also for the innovations which have…

The federation and provincial autonomy

The Balochistan package, the implementation of which the Prime Minister envisages finalizing by December 15, has been received with views on both extremes of a spectrum. The ruling stakeholders term it as a significant milestone whereas the Baloch nationalists have…

Amending the constitution

The Special Committee on Constitutional Reform, which was constituted to frame recommendations with regard to the construct of the 18th Amendment to the Constitution of Pakistan, is likely to come up with its recommendations soon. The focus of attention of…

The way forward—post NRO

The emotional turmoil, which the nation was going through over the fate of ethical standards in accountability norms and the threat of the widening gulf between justice and law appear to be easing with indications and pronouncements by the government…

Is it feasible to merge ministries?

 A id conditionality appears to be a subject of recent controversy—not all conditionalities are controversial though. Some—as pointed out by the writer in these columns on October 22—particularly those related to governance reform may be useful for a country, if…

Aid empirics

The recent discussions regarding the Kerry Lugar Bill and the debate about the value of aid in general on its sidelines, brings to the fore the understanding that both sides—donors as well as Pakistan—have very high expectations of aid in…

Freedom of information—oxygen of democracy

A number of civil society organisations have drawn attention to the need for strengthening Pakistan’s existing Freedom of Information (FOI) legislative framework on September 28 —the Right to Know Day. FOI is not to be confused with media freedom. FOI…

Is aid the answer?

The meeting of Friends of Democratic Pakistan (FoDP), convened on the sidelines of the United Nations General Assembly in New York, concluded yesterday by signaling unprecedented support to Pakistan. This was evidenced in both the representation at the meeting as…

Constitutional amendments

The Special Committee on Constitutional Reform is currently deliberating on the nature of constitutional amendments to be introduced through the 18th Amendment. Achieving balance of power should be an important outcome of this exercise. In addition, however, the potential within…

Governance—through the sugar crisis lens

The heartbreaking scene of 18 women succumbing to stampede whilst striving to get a bag of free sugar brings to attention the gravity of the ongoing commodity crisis.  Such crises provide an insight into the regulatory capacity of governments and…

Nuancing national security

Reaffirming the commitment to national security can be a befitting commemoration of the country’s 62nd Independence Day. National security is defined as “the requirement to maintain the survival of the nation-state through the use of economic, military and political power…

Anti-corruption reform

The release of Transparency International’s National Corruption Perception Survey, 2009, which assessed citizens’ perceptions as to the level of corruption in the four provinces ofPakistan, has sparked a debate about the prevalence of corruption in the country and the inter-provincial…

Devolution reform

The fate of the devolution initiative is likely to be decided by the end of this year, regardless of the presidential sanction to the provincial draft proposal—currently in the pipeline—given that the Local Government Ordinance will stand omitted from the…

Judicialisation of rights

The Petroleum Development Levy (Amendment) Ordinance, 2009, which offset the Supreme Court’s suspension of the imposition of the carbon surcharge was challenged on the basis of the Constitution’s Articles 2A, 4, 5, 8, 9, 25, 37, 38(d), 77 and 89….

Equity, social justice and the social sector

The Finance Bill 2009, which gives effect to the financial proposals of the federal government for a year, is the government’s key instrument of fiscal policy and in many ways, a reflection of its policy stance to achieve stated endpoints…

The IDP-governance link

There is hardly any problem in the country, which cannot be tracked back to challenges and weaknesses at the level of governance—the crisis of the internally displaced persons (IDPs) is certainly no exception. Both the technocratic and political aspects of…

Budget 2009-10 and the health sector

The health sector was marked by six policy highlights in the expansionary fiscal policy of the government in the federal budget for 2009/10. These policy dimensions center on the following: scale up of the existing budget; pronouncement of a health…

The forthcoming budget and the public-private mantra

The government has decided to increase spending in the development sector in the current year as is evidenced by the expansionary fiscal policy adopted in the forthcoming budget for the year 2009-10. Approval of the highest ever Public Sector Development…

Institutionalizing Accountability?

The Holders of Public Offices (Accountability) Act 2009, which currently exists as a Bill and is to be introduced in the National Assembly, will perhaps be one of the most vital instruments of governance inPakistan, over the coming years; its…

A Marshall Plan?

 The donor’s conference in Tokyo and the meeting convened by the Friends of Democratic Pakistan on its sidelines concluded on April 17 with a 5.28 Billion US$ pledge in economic assistance to Pakistan, congressional approvals permitting. A number of references…

The White Paper and the question of aid effectiveness

T he White House has recently released a White Paper onU.S.policy toAfghanistanandPakistan, articulating a number of geo-political and development imperatives for the region. This comment will focus only on the dimension related to development assistance within the contemporary realm of…

The fight against spurious drugs

The issue of spurious drugs has been in the spotlight for some time now beginning with the suo moto action by the Supreme Court in 2007 and the subsequent regulatory actions by the then government to the more recent creation…

Restructuring and reforming NAB

The government is on its way to revamping the country’s accountability infrastructure and statutes. It is evident from a review of news postings in early January, that the National Accountability Bureau (NAB) will be replaced with an Independent Accountability Commission…

Financial crisis, social unrest and reform

The December 22, 2008 issue of Newsweek featured an article on the downside of Chinese state reform. Entitled ‘Why China is too scared to spend’, the article drew attention to the weaknesses created in the Chinese health system with the…

Global crises—imperatives for a just social order

There is an apprehension within the development circles that the economic impact emanating from the crisis in international commodity markets and the affects of the global financial downturn coupled with constrained fiscal space in the country as a result of…

A new war – against polio

Pakistan’s security situation and the war on terror has become a top priority for the government. While the need to prioritize issues is understandable, attention to some other matters of the state on a war footing is also warranted. In…

NAB and related governance issues

The government has decided to repeal the National Accountability Ordinance 1999, and has drafted a bill to legislate for an alternative accountability mechanism; with the promulgation of these statutes, the National Accountability Bureau (NAB),Pakistan’s apex agency mandated in an anti-corruption…

Democracy and governance – upstream determinants

With the conclusion of presidential elections, the power configuration within the state has been defined. ‘Majority rule’ or ‘a few ruling with the consent of many’, described by the Greeks centuries ago, as a characteristic feature of democracy has been…

Governance Empirics

Between the government and their critics, opinions relating to the government’s hundred-day performance are at the extreme ends of a spectrum. Unfortunately as a nation, we are not in the habit of being impartial in performance evaluation. The objective of…

Independence Day – an ode to governance

14th of August is as august as a day can get, both for Pakistanis who have witnessed the perils of partition and experienced the anguish of being in a subservient role as well as those of us born after independence;…

National trade policy 2008/09 – the trade-health interface

It is conventional for the commercial sector to assess and comment on the potential impact of a trade policy as was evidenced by the plethora of commentaries on the media subsequent to the enunciation ofPakistan’s National Trade Policy 2008/09, on…

Health Policy – chinks in the armor

In the midst of all the overarching challenges the country faces, sectoral policy and strategy appears to be relegated to the background; the latter cannot be mainstreamed in any case without sound institutional governance, which is also a determinant of…

Romancing health insurance

With all the four provincial budgets for the fiscal year 2008/09 tabled, the annual provincial development programs for the next year have been unveiled. Provincial development budgets range from 22.12-41.13% of the total outlays withPunjabspending the highest and Balochistan the…

Budget – five points under the health lens

Had it been conventional to place the budget in the public domain to solicit inputs of the civil society on the directions proposed therein, suggestions such as the one articulated in this opinion could have been more timely in terms…

Pakistan’s Covert Cartels

With economic, food and energy crises looming, criticism can be the most convenient past time. Such situations however, are also the litmus test for patriotism, given that a true commitment to the country warrants a look into the present and…

Honing the 100-day agenda

Perceived as an effort aimed at planning strategically the Prime Minister’s 100 day agenda is a step in the right direction. The points articulated therein are substantively valid if implemented in their true spirit. Their contents however, are a mix…

Political party manifestos – a sectoral insight

The pre-election political party debates relating to their positions on various sectoral processes ofthe state on national television, has prompted many ofus to review party manifestos with the view to exploring strengths and weaknesses in an attempt to determine the…

The Social Sector – telling evidence

In its report entitled “The State of the World’s Children, 2008” UNICEF’s reiteration of Pakistan’s stalling position to meet the targets stipulated in the Millennium Declaration particularly with reference to MDG 4 and 5 adds yet another set of predicaments…

The new government’s option

With the elections of 2008 forthcoming, and a change ofhands on the governments reigns envisaged shortly, it is evident that any new government in Pakistan will have many issues to grapple with – from terrorism and conflict to the energy…

Corruption: the need-greed equation

Pakistan’s ranking on the 7th position in the recently released Global Corruption Barometer by Transparency International should lend a serious impetus to address an issue, which is deeply ingrained in the institutional processes of the country, both in the public…

Does corruption lurk in the health sector of Pakistan?

T ransparency International’s World Corruption Report of 2007 with its focus on corruption in the judicial system is of contemporaneous relevance toPakistan with respect to the spotlight on the judiciary. However, its findings have also opened a debate in many…

Health and the budget 2007 – How “healthy” is our budget?

T he federal budget for 2007 will be presented on June the 9th, subsequent to which a special parliamentary session will be convened to debate the budget. Within this context, this article focuses on budgetary allocations for the health sector…

What is the role of the state in health?

T he recent divide of opinion about the construction of the medical tower in Islamabad, the indication that another is in the pipeline for Karachi, signaling of investments underway in high-tech equipment, the organ transplantation bill and concerns expressed subsequent…

Social Policy Reform – raison d’etre

S ocial policy is central to politics and one of the major responsibilities of governments. In many developed countries the entire political debate is structured around social guarantees that representative political contenders can offer to their electorate and subsequently, sustained…

The world’s first legally binding agreement on global health security, the International Health Regulations, 2005 came into force this week on June 15, 2007. Pakistan has responsibilities as a signatory to this agreement, which it must fulfill.

F or most of us, disease pandemics are forgone history; plague killed 12 million people in 1855, but we think of it just as a setting in Jean Plaidy’s novels. Influenza claimed 25 million lives in 1918, but it is…

A new paradigm for regulating drugs and pharmaceuticals

P olicy issues relating to drugs and pharmaceuticals have increasingly been in the spotlight in 2006; the impetus to this came from the saga of the sale of spurious drugs and the consequent suo moto action by the Supreme Court….

Dengue and its likes – long term context

  D engue is making headlines with widespread public attention and political response. True that Dengue and its potentially lethal complication, Dengue Hemorrhagic fever should be a national public health concern – as they are. By way of contextualizing however,…

Opening the insurance market – the health perspective

T he Economic Coordination Committee of the Cabinet on Wednesday the 27th decided to allow foreign companies to invest in the insurance business in Pakistan on the premise that this would help attract Foreign Direct Investment (FDI). There can be…

“Playing” Social Protection with a new stack of cards!

We have a history of starting things denovo in this country. Individually and institutionally, we must scrap past initiatives, create silos, never build on efforts underway and whenever the adage “we have never learnt from the past” is referred to…

Health in Executive Committee of the National Economic Council (ECNEC)

    T he configuration of the four health projects presented to August the 23rd’s Executive Committee of the National Economic Council (ECNEC) meeting raise some broader issues that need to be the substrate of contemporaneous conceptual thinking with reference…

The health and technology nexus in Pakistan – hope or hype

Why does technology get spotlighted in the discourse over health outcomes and the discussion on health sector reform? For the simple reason that health and technology have shared agendas. It is well established that in addition to serving as a…

Tools for treatment – Scope for using technology in reforming and improving the health sector is immense

W hy does technology get spotlighted in the discourse over health outcomes and the discussion on health sector reform? For the simple reason that health and technology have shared agendas. It is well established that in addition to serving as…

Rahim Yar Khan’ health initiative – revisited

Perhaps no other health policy intervention in recent times has been the substrate of a greater controversy compared with restructuring the mode of primary health care service delivery in Rahim Yar Khan (RYK) as part of which the management of…

‘Playing health’ with a new stack of cards

T he planet earth’s environmental and ecological transformation is a subject of much ado as are the contemporary concerns around the power dynamics, which will determine the global epicenter economically, militarily and politically over next two to three decades. This…

Budget 2006-07 – an ode to health

Flagging a 21.3% increase in the budgetary allocation for health as part of the unprecedented increase in the development expenditure in the fiscal budget of 2006-07, the recital of June 5, 2006 made a reference to health as being a…

The Health Budget 2006 – the policy context

Budget 2006 is just around the corner with an indication that there would, both, be aggregate as well as program-specific enhanced allocations for health. This raises the question of whether these can translate into improved health outcomes over the short…

The Public-private interface: more than ‘a driver of economic growth’

 C hanges in public-private roles are interlinked with broader changes in the macro-economy. Limitations of centrally planned economies, the resultant privatization of State-owned enterprise accentuated by fiscal constraints and donor conditionalities have continued to promote a package of measures in…

Civil Service Reforms – the move from hype-to-hope

 Civil service reforms need to be an integral part of social sector reform processes if sustainable solutions to currently existing issues within the ambit social sector service delivery are envisaged. Within this context, there seems to be some justification for…

Avian Flu – the short and long term contexts

G iven that diseases such as the Plague, SARS, HIV/AIDs and Avian Flu do not respect national boundaries, the news of Avian Flu in our immediate neighborhood, left a slim choice between treading the prevent-prepare-control options a week ago. However…

Restructuring Basic Health Units – mandatory safeguards

R ecently, a national strategy has been approved for revamping the ‘Primary Health Care System’ with structural changes envisaged at the District level based upon the results of a pilot experience inPunjab. The strategy aims to restructure the first tier…

Pakistan Medical and Dental Council – strategic imperatives

R ecent controversies around the Pakistan Medical and Dental Council (PMDC), the efforts presently underway to break the resulting stalemate and more topically offered solutions now favoring a major overhaul highlight an opportunity to flag some fundamental questions about the…