With her outstanding contribution in the field of public health, Dr Sania Nishtar’s pioneering work through her public health NGO, Heartfile, has drawn international acclaim, most recently from the World Health Organisation where she was nominated for the role of Director General. This stands as testament to the impact of her work not just in Pakistan but across the world. Her book Choked Pipes is an essential study on the problems facing Pakistan’s healthcare system and solutions on how to ensure the delivery of health and medical facilities to the millions of people who at present have little or no access to the most basic of medical services. Her analysis is not only a blueprint for Pakistan’s health policy but also serves as a template for several countries struggling to provide healthcare with rapidly growing populations. Additionally, countries like the United Kingdom with well-developed healthcare systems have drawn from her seminal research in identifying bottlenecks and developing solutions for reform.An eye-opening documentary based on her book has been screened both in Pakistan and internationally including at the Royal Society of Medicine in London. Dr Nishtar explains how Pakistan’s health policy is inherently flawed in a system where the public-private mix has singularly failed to address the needs of a rapidly increasing population. In Pakistan, the public sector remains woefully underfunded while burgeoning unregulated private system malpractice is rife. Pakistan’s population of 200 million makes it the sixth most populous country in the world yet the subject of health has systematically floundered on the margins of government priorities. 73 percent of the population have no health coverage and often are forced to travel hundreds of miles to access any form of health facilities. The rural population in particular remain excluded from the adequate healthcare services. Living in Pakistan, Dr Nishtar understands the precariousness of life all too well. People living on the brink of poverty run the risk of financial ruin if confronted with a sudden medical problem. Excluded from basic healthcare, sudden illness can push families into financial catastrophe as precious assets are sold off to fund punitively expensive medical bills. This motivated her to set up Heartfile Health Financing, a platform for those facing a sudden healthcare emergency. Heartfile Health Financing has helped thousands of people receive treatment without facing financial adversity. Critical medical procedures are expedited within 72 hours, often saving patients from life threatening conditions.Through the use of its technology platform, Heartfile Health Financing is playing a critical role in health reform, ensuring effective delivery through the provision of a detailed information trail. The new model of transparency which this information trail provides can tackle endemic corruption not only in Pakistan but can serve as a benchmark for a multitude of countries facing similar health care challenges. People living on the brink of poverty run the risk of financial ruin if confronted with a sudden medical problem. Excluded from basic healthcare, such families have to sell precious assets to fund punitively expensive medical bills As a medical student in Peshawar, Dr Nishtar stood out for her academic excellence and went on to become a highly respected cardiologist. However, the plight faced by those without adequate healthcare made a lasting impact on her. This led her to set up her NGO, Heartfile, in 1999 which has now evolved into a leading institution for global public health issues. She has worked relentlessly as a champion for health reform, traveling across the country to visit patients, assess hospitals and medical clinics in the most deprived areas to shine a spotlight on the subject of health and her mission to achieve universal healthcare in a system where all citizens are served equally.During her tenure as Federal Minister for Health, Science and Technology and Higher Education in the 2013 interim government, Dr Nishtar brought unprecedented integrity into a department often tainted by rumours of corruption. Though her tenure was short, Dr Nishtar implemented far-reaching reform including the re-establishment of a national ministry for health. Considering Pakistan’s vast resources, the suffering of the people stands as a damning indictment in a country where healthcare is still not acknowledged as a fundamental human right. Pakistan is one of three countries where polio and tuberculosis still loom large. Though vested interests in countries like Pakistan continue to hinder reform, Dr Nishtar’s achievements in the fields of health, governance and social development are outstanding which is why her voice continues to resonate with a rare power and clarity. The writer is the founding editor of Blue Chip magazine. She tweets @MashaalGauhar
