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Corruption And Healthcare: Is This The Right Moment For The PM To Open A New Ideological Front?

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There is almost no disagreement across the political spectrum that Pakistan’s health sector is broken – or in fact, it is in tatters. The point of disagreement between different ideological positions is what exactly caused the Pakistani health sector to deteriorate to such a bad condition.

Broadly speaking there are two ideological positions, waging a relentless contest on this crucial question of practical utility.

The first position, which has at its back the whole propaganda machinery of the Pakistan state, says that it is because of the financial corruption of the leading political families that the state failed to build an efficient health sector in the country. These families, runs the argument, gobbled up money allocated for the health sector.

The second position, which could be described as an orphan in the field of propaganda in the rich and glittering world of media, says that Pakistan’s health allocations are tiny as compared to defense allocations. This position says that it is because of our misplaced priorities, we have more fighter aircraft and tanks than we have ventilators in the public hospitals. While we are the 11th largest importers of arms in the world, our health practitioners don’t have protective gear to treat Coronavirus patients in our public hospitals, argues this position.

The country’s Prime Minister and the whole coercive machinery of the state waste no time in pushing and arguing on behalf of the first position. “The Sharifs go to London hospitals for medical treatment and yet they haven’t built hospitals in Pakistan while they were in power.” This propaganda goes on and on with power centers pushing this theme round the clock, as if their whole edifice of power structures depends on this propaganda. The second position is championed by a few wayward left-oriented intellectuals with no propaganda tools or funds available to them to make an effective case in support of their ideological position.

The first position was the main campaign slogan of present ruling party, the Pakistan Tehrik-e-Insaf (PTI) during the campaign for the 2018 parliamentary elections. Allegations of financial corruption against the Sharif family and a broken health sector gelled well as a propaganda theme in the election campaign of ruling party.

After the PTI came to power, its lackluster performance left it with no option but to make criticism of previous government’s performance during the past five year the main propaganda theme of their media policy. The government allocated a major share of its information ministry and intelligence agencies’ funds for running a campaign to malign the political class.

Other power centers were no less interested in maligning the previous rulers. These power centers, especially the military, have an obvious interest in this debate as the second position held defence spending responsible for lopsided national budgets while leaving peanuts for the health sector. There was, thus, a convergence of interests between the military’s narrative and that of the ruling party on this point. Ironically the advocates of first position wanted to use the alleged financial corruption of a family to whitewash the totally irrational distribution of resources in the national budget. No rational person can justify the immense allocation of huge sums for tanks and aircraft—based on abstract threat perception of small group of unelected officials—while ignoring the health sector that deals with the day-to-day survival of millions of Pakistanis.

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In 2017, the World Bank carried out a survey of Pakistan’s health allocations since the year 2000 and found that the average value that each Pakistani got during this period was well below the average across the developing world, “For that indicator, The World Bank provides data for Pakistan from 2000 to 2016. The average value for Pakistan during that period was 2.69 percent with a minimum of 2.34 percent in 2011 and a maximum of 3.14 percent in 2007. The latest value from 2016 is 2.75 percent. For comparison, the world average in 2016 based on 182 countries is 6.65 percent” reads the World Bank Report. In comparison Pakistan dedicated 4.0 percent of the GDP to its budget, which is more than US $12 billion. The government proposed almost unchanged allocation of Rs1,152 billion for the defence budget for the fiscal year 2019-2020 as compared to a revised budgetary allocation of Rs1,137 billion for the financial year 2018-2019.

The situation where our health practitioners don’t have protective gear to treat COVID-19 patients in the public hospitals didn’t develop in a day. It took years of misallocation to reach this point. And now we are at a point where we have to borrow ventilators from friendly countries to treat our loved ones. No amount of propaganda can divert the attention from the fact that in Pakistan, health is an orphaned sector.

Two days ago Prime Minister Khan again came forward in support of the first position and maligned the political class for ignoring the health sector. While there is no corresponding equally powerful voice in support of the second ideological position, the Prime Minister’s vehement arguments in support of the first position can itself lead to friction in the political arena and thus could cause a weakening of political will to deal with the threat COVID-19 pandemic in our society. Any emergence of permanent political divisions would be a disaster at this point of time. Pakistan is a highly fractured society and ethnic, sectarian and political divisions are already all too visible. Any more friction in the political arena will be devastating for our ability to deal with the threat of COVID-19. This is probably not the right moment for an ideological contest – something which those in power in Pakistan right now must understand.

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It is ironic that the clarion call for an ideological contest is coming from Prime Minister Imran Khan, who should be most worried about any political divisions in society at this moment of crisis – which could be rightly described as posing an existential threat to the existence of both Pakistani society and state. Only a person who is not familiar with all the dimensions of the threat that this crisis poses to the continued viability of the Pakistani state and society can indulge in such petty political pointing scoring. We refer here to what Prime Minister Khan did in his press talk with anchorpersons and journalists at the Prime Minister House two days back.

What exactly led Prime Minister Khan to indulge in petty political pointing scoring on the question of a broken health sector? Is he aware of all the dimensions of this crisis, especially the security and stability aspects? Does the fact that he indulged in petty political point scoring and accusations against his opponents indicate that he is desperate and doesn’t see any possibility of himself leading the fight against COVID-19? Is he anticipating some kind of political change in case the crisis worsens and therefore wants to stick with his niche of sole campaigner against financial corruption? The next few weeks will answer all of these questions.

But I want to highlight my own impression of the lack of knowledge and understanding on the part of Prime Minister Khan after listening to his last press talk.

My impression is that he is unaware or uninformed about two things:

a) that Pakistani is heading towards an economic collapse if some wealthy friendly country doesn’t come to its rescue in the next six months. In such a situation of economic collapse violence will take place and it can become rampant,

b) that there is no culture in Pakistan of discussing the security dimension of any actual crisis that we face in the country. But it is high time that we wake up see how our security capabilities will be affected by spread of COVID-19 virus in our society.

Prime Minister Imran Khan’s petty political point scoring and the ease with which he just went through it made a very strong impression of a person who is either not aware of all these dimensions of the crisis or is not thinking about them. Petty issues of one family’s financial corruption should not be the preoccupation of those leading us through this uncertain and perilous time.

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Naya Daur