Daily Times

“Health is a political choice and politics is a continuous struggle for equity in health.” – Margaret Chan, former Director-General of the World Health Organization (WHO)

As the global political landscape undergoes significant transformations, the implications for health policy are far-reaching. Countries increasingly use global health architecture as a tool to exert influence worldwide, impacting funding priorities and international health standards. For Pakistan, understanding these shifts is crucial for navigating the complexities of global health governance and enhancing its healthcare system.

The recent rise of a Labour government in the United Kingdom has placed a strong emphasis on health, with NHS spending reaching £185 billion for 2022/23 and further increases proposed. This shift towards preventive measures, including vaccination programs and mental health initiatives, presents new opportunities for Pakistan. The transition from conservative to leftist governance in the UK reflects a broader global trend, which may lead to increased contributions to global health institutions like the WHO, the Global Fund, and the GAVI Alliance. A leftist government may prioritize global health initiatives more heavily, offering enhanced support and resources to developing countries. By engaging with the UK, Pakistan could benefit from innovative health policies and funding avenues, helping to improve healthcare access and equity.

In the United States, political approaches range from neoliberal and liberal to protectionist and isolationist. The Democratic administration’s expansion of the Affordable Care Act (ACA) and allocation of $12.3 billion for global health in FY 2024 offer Pakistan potential funding and technical support. Conversely, a Republican administration might focus on sovereignty and countering China, possibly reducing contributions to the WHO, Global Fund, and GAVI Alliance, impacting global health support for developing countries.

The evolving global political landscape, characterized by the rise of right-wing politics in the US and France and leftist movements in the UK, offers both opportunities and challenges for Pakistan’s healthcare system.

A Republican government could also revisit policies like Roe v. Wade, leading to stricter abortion laws and influencing global reproductive rights and population control discussions. This shift might reduce support for family planning and contraceptive access in Pakistan. Additionally, policies like the Global Gag Rule could limit US funding for international reproductive health services, affecting women’s health and broader public health outcomes. As a major global player, a conservative shift in the US could influence similar movements in other countries, including Pakistan, potentially leading to stricter reproductive health policies and reduced support for population control measures.

The European Union’s collective health policy, exemplified by the EU4Health program, focuses on strengthening health systems, digital health, and pandemic preparedness. With a budget of Eur 5.1 billion for 2021-2027, this program offers Pakistan valuable opportunities to engage in collaborative projects, enhancing its healthcare infrastructure. The EU’s significant investments in health research and innovation under Horizon Europe (Eur 5.5 billion) also provide an avenue for Pakistani researchers and institutions to participate in cutting-edge health innovations.

China’s centralized health policy allows for swift implementation of large-scale public health campaigns. This capability was evident during the COVID-19 pandemic, where China constructed hospitals within days and conducted mass testing. The BRI, which includes healthcare infrastructure projects, represents a significant investment opportunity for Pakistan. By 2020, China had invested over $200 billion in BRI projects, including healthcare facilities. Partnering with China under the BRI could significantly enhance Pakistan’s healthcare infrastructure, providing new hospitals, clinics, and medical technologies.

India’s Ayushman Bharat program, which aims to extend health insurance to over 500 million people, presents a compelling model for Pakistan. This initiative could inspire similar efforts in Pakistan, where expanding healthcare access remains a critical challenge. Collaborating on digital health solutions and telemedicine, part of India’s National Digital Health Mission, could particularly benefit rural and underserved areas in Pakistan, enhancing healthcare delivery and data management.

The ongoing war in the Middle East has significant implications for Pakistan. This regional instability affects Pakistan through several channels: Middle East plays a crucial role in global energy markets. Ongoing conflicts and sanctions can disrupt oil supplies, impacting global oil prices and, subsequently, Pakistan’s energy costs.

This economic strain can limit Pakistan’s ability to allocate resources to its healthcare sector. Any escalation in conflict can lead to economic downturns in these countries, reducing remittance flows to Pakistan. These remittances are vital for Pakistan’s economy, including funding healthcare services. Increased geopolitical tensions can lead to security threats, including terrorism, which can directly impact public health through injuries and increased demand on emergency medical services. Additionally, regional instability can lead to refugee movements, straining healthcare resources and infrastructure in Pakistan. Pakistan’s foreign policy, which often navigates complex relationships in the Middle East, including ties with Iran and Saudi Arabia, affects its stance in global health diplomacy.

To reduce dependency on foreign aid, Pakistan must develop sustainable health financing mechanisms. This includes increasing domestic investment in healthcare and ensuring political stability for consistent policy implementation. Diversifying partnerships, including with the Labour-led UK, EU and China, can provide access to advanced health technologies and infrastructure development. Further, building capacity within Pakistan’s healthcare system is crucial, and targeted training programs in countries with robust public health systems can play a vital role.

The evolving global political landscape, characterized by the rise of right-wing politics in the US and France and leftist movements in the UK, offers both opportunities and challenges for Pakistan’s healthcare system. The shifting contributions to global health institutions like the WHO, Global Fund, and GAVI Alliance, influenced by these political changes, will significantly impact funding and support for developing countries. However, this complex landscape also presents a silver lining: Pakistan can mobilize maximum expertise and resources from both the G-7 and BRICS blocks. Leveraging the expertise and resources of both neoliberal G-7 countries and the BRICS nations can help Pakistan address the dual challenges of climate change and pandemics.

The G-7’s financial resources and knowledge, combined with the production capabilities of the BRICS, offer a balanced approach to developing a robust healthcare system. By strategically engaging with these diverse global players, Pakistan can improve health outcomes, build resilient healthcare infrastructure, and address global challenges.

The writer is a medical practitioner.