KARACHI: Expressing concern over the state of healthcare in the country, the Pakistan Medical Association (PMA) stated on Tuesday that the year 2019 saw further deterioration in the health sector as there were major outbreaks of infectious diseases across the country, which reported 117 cases of polio.

“Polio remains endemic despite over 100 rounds of the vaccination being carried out in the past decade. Last year, the polio programme seemed to be on the brink of eradicating transmission of the wild poliovirus. In the year 2019, however, as many as 117 cases have been reported (Khyber Pakhtunkhwa 83, Sindh 19, Balochistan 9, Punjab 6) as compared to 12 cases in 2018.)

“This sorry state also attracted criticism from international monitoring bodies which observed that there is lack of political unity behind the polio programme,” says a PMA press release.

The association also shared concern on the dengue outbreak and described it as ‘vicious this year’.

‘The health budget, despite repeated pleas and reminders to the government, has remained less than one per cent’

“Around 50,000 cases have already been reported. This is almost double the number of people infected with the virus in the past decade. This shows the negligence of our rulers, they have done nothing to combat this disease,” it said.

The number of HIV/AIDS patients in Pakistan, according to the PMA, currently stands at 165,000 whereas 9,565 new cases had been detected in 2019.

During the outgoing year, Rato Dero, a small town in Larkana, alone reported 895 cases of AIDS. Of them, 754 were children and 141 adults.

“From April to November 30 this year, about 37,558 people have undergone HIV screening in Larkana, out of them 1,195 have reported with suspected presence of the virulent germs,” it says.

The outbreak of extremely drug resistant typhoid in Karachi and the interior of Sindh, the association says, affected people in thousands.

“It’s a serious water-borne infection caused by the bacterium Salmonella Typhi that spreads through contaminated food and water.”

In addition, there have been confirmed cases of Crimean-Congo Hemorrhagic Fever (CCHF) in Balochistan, Sindh, Khyber Pakhtunkhwa, and Punjab.

“CCHF is widely spreading in Pakistan. The deadly Congo [Crimean-Congo hemorrhagic] virus has ‘attacked’ Karachi, the largest city of Pakistan, killing at least 20 people this year,” it said.

It also highlighted the reasons leading to the fast spread of hepatitis in the country currently having 15 million infected people, calling for government focus on prevention, ensuring that infection control practices were in place at all healthcare facilities and eliminating quackery.

The association refers to the World Bank estimates according to which Pakistan’s annual burden of disease due to outdoor air pollution accounts for 22,000 premature adult deaths and 163,432 disability-adjusted life year lost, while that for indoor pollution accounts for 40 million cases of acute respiratory infections and 28,000 deaths/year.

“This is the worst situation due to air pollution but again no significant change has been observed. Even the Sindh High Court ordered thrice improvement in this respect but no serious initiative was seen on part of the government. The relevant laws have never been implemented, including the Prohibition of No Smoking Law 2002,” the association regrets.

It called upon the government to invest more on disease prevention, including provision of clean water and safe sanitation and sewerage systems.

“The WHHO recommends that the health budget of any country should at least be 6 per cent of its national Gross Domestic Product. In our case, the health budget, despite repeated PMA pleas and reminders to the government, has remained less than one per cent.

“The association believes that proper planning, political will, honesty, increase in health budget and its proper allocation and above all the consolidated preventive measures can improve the health delivery system in 2020,” it concludes.

Published in Dawn, January 1st, 2020