Daily Times

Having said that, the healthcare system of any country is based on four main stakeholders; individuals, health professionals, private markets and state. If anyone falls behind or doesn’t participate in its betterment, the system will cease to exist. So, it’s the joint responsibility of all stakeholders to commit themselves to the betterment of the healthcare system for the greater good of humanity and themselves.

Firstly, prevention starts at the individual level because government and health professionals alone cannot fix our health problems. Change begins at home, we must change our lifestyles to combat communicable and non-communicable diseases. We should prefer long term benefits that maximize our health rather than short-term pleasures that destroy it. For example, smoking is a short-term enjoyment but in the long run its detrimental to our lungs. Similarly, people in our society prefer to go to a buffet dinner every time but abhor going for early morning walks in the park that are highly beneficial to control Diabetes without medicine. Lastly, if we reduce salt intake in our diets, we can prevent the silent-killer that is Hypertension but from our childhood salt and spices are considered major ingredients in the food we take. Our society has been structured to do so, we as individuals should change these cognitive structures for the amelioration of our health.

Secondly, health professionals have also contributed to the failure of the healthcare system in Pakistan. It is a common principle, “A patient cured is a customer lost”. Moreover, they spent huge amounts on buying advanced equipment and costly medicine, but they seldom invest on preventive care, diagnoses and control diseases before their occurrence. Additionally, its very sad to say that Pakistan witnessed the world’s first outbreak of Drug Resistance Typhoid Fever; it is because of the overuse of antibiotics by the hands of healthcare professionals and private healthcare markets. Even, I witnessed the prescription of third generation antibiotics for minor illnesses like seasonal flu in rural areas of Pakistan as General Practitioner. However, here in the UK, NHS forbids the frequent use of antibiotics due to the fear of drug resistance and even GPs are frightened to prescribe antibiotics even for a major illness.

Additionally, its very sad to say that Pakistan witnessed the world’s first outbreak of Drug Resistance Typhoid Fever; it is because of the overuse of antibiotics by the hands of healthcare professionals and private healthcare markets

Thirdly, private healthcare pharmaceutical market share a major responsibility for the deterioration of the health system. They have been sponsoring healthcare professional’s luxurious lifestyles and luring them to use their products in lieu of monetary gains. Their actions have led us to the misery of Antibiotic Resistance, resultantly many infections and minor injuries are untreated, that might kill us in the future. Multidrug resistant Tuberculosis and Typhoid are the best examples. Private Markets should work for prevention not for destruction. Pharmaceutical, Equipment, Artificial Intelligence, Insurers, Healthy Food and the fitness industries should place better healthcare at the center of their business plans.

Fourth and the foremost player in shaping health system is the state; it has performed much better than it did in the previous years, but still it has a long way to go. Therefore, the top cadre of health policymakers and technocrats should strengthen healthcare systems, improve institutional effectiveness, and devise healthcare policies that Pakistan needs today in order to nip the diseases in the bud at the primary level of occurrence.

Similarly, in order to reduce non-communicable diseases the government should implement high taxes on smoking cigarettes, carbonated drinks and sugar consumption. It should also introduce e-smoking that is less harmful than tobacco products. Moreover, citizens should be provided with public parks and Gymnasium for health activities. Likewise, to contain communicable diseases early detection techniques, diagnosis, and preventive vaccination is of prime importance. Unfortunately, Pakistan has the lowest EPI coverage, less than 56 percent, in spite of free availability of vaccination from international donors. For poliomyelitis, the problem that I have witnessed is of cold chain management at the union council level, which reduces the efficacy of vaccine; resulting in huge financial loss. So, equipment must be provided in villages to make vaccine useful. I would also suggest an Online Health Information System for data collection from hospitals. This data will be analyzed for disease burden, drug-resistance & co-infections. It will also help to formulate a ‘Risk Prediction Model’ for early diagnosis and prompt treatment. A Risk Prediction Model has been a success in many countries and has significantly reduced Hepatitis, HIV/AIDS, TB and different types of familial cancers. Lastly, as John Snow, the father of epidemiology, ended the cholera epidemic that killed hundreds of people in 1854, by merely warning people to remove the handles of wells. Similarly, through health education, we can control HIV/AIDS transmission from a pregnant woman to a child; only by the intervention of antiretroviral therapy which stops its vertical transmission. And, the cheap use of Penicillin can reduce infant mortality in Pakistan by streptococcal infections. Additionally, Malaria, Hepatitis, Poliomyelitis & Tuberculosis also have entirely preventable causes. Therefore, the right health interventions for the right population are pertinent to decrease Pakistan’s disease burden.

Our government spends 95 percent budget on cure and treatment and less than 5 percent on prevention. It needs to place disease prevention, health promotion and health education at the core of the healthcare system in Pakistan. Moreover, innovations in health systems are necessary to decrease disease burden; new diagnostics, cure and vaccines need to be introduced, and delivered urgently to eradicate infectious and non-infectious diseases. Also, it’s the only way to attain Sustainable Development Goals. So, let’s unite together to make a sustainable and affordable healthcare system in 2019.

The writer is a Chevening Scholar with an MSc Global Health in London School of Hygiene and Tropical Medicine

Published in Daily Times, January 14^th 2019.