Health Security For Pakistan: Are We Going To Learn Anything From 2020?

The year 2020 is coming to a close. To date, we have been shamelessly spending less than 0.8 percent of our GDP on healthcare; and despite the pandemic not much has changed.

We are experiencing an unprecedented pressure on our healthcare system with covid running amok in a second wave and we had barely recovered from the first.

We have experienced shocking  tragedies such as in Peshawar when oxygen storage tanks were not appropriately filled in time because there was no local supply source readily available.

Initially we were running out of personal protective equipment and hazmat protective suits and several frontline healthcare workers lost their lives.

Then we were well short of ventilators till the NCOC had them urgently shipped in and some efforts were made at indiginization of this key critical care armamentarium.

There is obviously an inadequate supply of continuous renal replacement therapy and extra corporeal membrane oxygenation (ECMO) which critically ill patients with severe hemodynamic abnormalities and acute kidney injury and extra ordinary oxygenation requirements respectively require.

Another major issue noted is absence of highly skilled critical care physicians, nursing and respiratory care technicians barring a few centers of excellence. Infectious disease expertise is not widely available either.

These healthcare system failures were seen in different ways worldwide but then we had  a somewhat younger population to deal with and not the very elderly vulnerable ones that overwhelmed Italy, USA and UK for instance.

Now we are struggling to obtain vaccines from various sources and have simply failed to have an indigenized program despite our much vaunted higher education phD programs and overstaffed  basic science faculty in major universities since nearly two decades. Expecting our scientists to thus  develop covid vaccines with inadequacies in infrastructure and funding was never going to be realistic.

Most of our clinical faculty simply are incapable of designing clinical trials with strong internal and external validity because of lack of training and prioritization at undergraduate and postgraduate levels.

A need for a total and urgent rethink of our national priorities is in order to realign our healthcare financing with a complete planning, structural , governance and procedural overhaul of this decaying and outdated healthcare system.

This is a question of survival and health security for Pakistan. Are the policy makers ready for the challenge?

Are we going to learn anything from 2020?