The COVID-19 pandemic was declared as a pandemic by the World Health Organization (WHO) on March 11. At the time of declaration there were 118,000 confirmed cases in 114 countries with 4,291 lives lost and even today we are no way near to winning it.
In the midst of any such crisis, the importance of the quality of governance, decision making and competence of the leaders comes to the fore. Naturally, there is no such thing as a one-size-fits-all approach, especially when there is a stark difference between the developing and developed world and hence their approach to the management of the pandemic.
As rightly pointed by Director General of the WHO Dr Tedros Adhanom, some standard operating procedures (SOPs) implemented in high-income countries might not be practical for low-income and highly populated countries. The health systems of the developing world might not be as robust as that of the developed world and will rely on proactive prevention and containment measures. However, most developed countries appear to be on their way to containing the virus and minimizing its economic impact, whereas the developing world’s biggest worry at the moment is hunger and poverty.
Therefore, in cases of lock down, the low-income countries are to bear the burden of spiraling food prices, rising unemployment, economic instability followed by social and political unrest. This calls for good governance to efficiently deal with the situation by raising funds and providing the needy/ daily wage workers of the nation with the essentials of life while observing strict lockdown in the country.
The lack of consensus between the federal and the provincial governments is also a constraint which is why the fair distribution of international aid amongst the hard-hit provinces requires attention
The widespread outbreak of the virus has re-emphasized the significance of good and efficient governance. Governments across the globe have directed their efforts to construct effective governance mechanisms and rapid response to the virus. However, there are diverse challenges for states, other than pandemic management.
The four challenges that governments are equipped with are: a public health emergency including identifying and treating infected populations, widespread food and livelihood insecurity, disruption of food supplies, and adoption of emergency powers to address crises and maintain public safety.
Iran spends 6% of its GDP on its health system while Pakistan only spends 2% which is why Pakistan lacks many elements of a full-fledged national health system, which is a foremost consideration in managing a pandemic.
The shortage of resources fundamentally disadvantaged Pakistan’s early response, even as the WHO was appealing to all countries to take urgent early steps. A significant local shortcoming was in community mobilization and sensitization activities, and so lockdown maneuvers early on failed to contain the spread.
The lack of consensus between the federal and the provincial governments is also a constraint which is why the fair distribution of international aid amongst the hard-hit provinces requires attention.
There remains a need to develop transparent channels to disperse the aid timely and effectively. While a number of provincial governments have already complained about the lack of support in fighting COVID-19, negligence to effective disbursement of international aid can be used as political ammunition in inter-provincial relations.
Confirmation of COVID-19 cases is another challenge. There are 41 laboratories across Pakistan with limited capacity to confirm COVID-19 cases. The daily testing capacity observed at the start of the pandemic was only 575 t/d. This figure peaked up to 31,681 t/d by mid of June which was a sign of good surveillance for confirmation of the new cases.
However the testing capacity has now declined to only 22,418 till todate. The subsequent decline in new cases reported to date could be due to this drop in surveillance. Test positivity overall is still 16% which needs to be reduced below 10%. There is an urgent need to strengthen all aspects of disease surveillance.
Beyond this, the management of the informal sector that was previously ignored is posing a grave challenge for the government in the COVID-19 context. Informal settlements present all the conditions for rapid spread with high population, scant access to water and sanitation, widespread poverty and inadequate health infrastructure and is not covered by any social protection.
In the current situation they are sidelined as food and medical aid distribution has been limited to areas near major cities, depriving those living in rural areas. Moreover, Pakistan is in the danger zone in terms of food security. Pakistan stands at 55th position in the list of countries projected to face acute food insecurity as a result of the global pandemic.
The outbreak of COVID-19 should be a wakeup call for the policy makers, bureaucracy, public health practitioners, urban planners, and the public itself, to take charge of the situation. The Pakistan government must start by giving attention to human security during COVID-19 by addressing the most vulnerable segments of the society by ensuring means of their livelihoods and easy access to basic facilities along with social protection mechanisms.
They must ensure that people of Pakistan are able to withstand the catastrophic weight of the current conditions. To ensure this, the government must establish a coordination committee with equal representation from provincial/local governments, NGOs, community leaders and involve populations which have never been accounted for in previous planning efforts. Lastly, the center and the provinces must consider the dire need of greater devolution and fiscal discretion for local governments.
The writer is a research fellow at Centre for Aerospace and Security Studies (CASS)