According to statistics, Pakistan had not been able to control the burden of communicable diseases like tuberculosis, malaria, dengue fever, typhoid, hepatitis, cholera and other infectious diseases. Malaria, dengue, polio, and tuberculosis, are among the top killers. Pakistan is ranked fifth on the list of high-burden TB countries, and worst of all; Pakistan is one of the three remaining countries where poliomyelitis, also called polio, is still endemic. An average of about one million lives claimed yearly by malaria (estimated 12% of the rural population is believed to carry malaria parasites in their blood) and anticipated mortality rate of 48 thousand deaths per year as a result of TB cases. Similarly, infectious diseases are the biggest killers of children in Pakistan, causing 60% of all child deaths under 5 years of age.
Pakistan does not have an effective infectious disease surveillance system and unfortunately, it is off track in meeting the Sustainable Development Goals (SDGs) of healthcare. However, an Electronic Disease Early Warning System (e-DEWS) was created in 2005 through the collaboration of World Health Organization (WHO) and the Federal Ministry of Health with the goal of early detection of infectious pathogens to reduce the morbidity and mortality rate, but regrettably it was not implemented at the grassroots level. Recent outbreaks of dengue, chikungunya and other infectious diseases across the country raise questions about the efficiency of e-DEWS.
Correspondingly, the structure and function of the current healthcare system in Pakistan are far below international standards and ranked at 122 out of 190 countries in terms of healthcare standards. Pakistan does not have an organized healthcare system; even health priorities are not properly defined by present government. Government of Pakistan needs to work out an extraordinary strategy for the challenges ahead, as it continued to witness the burden of infectious diseases since infectious diseases are a real public health threat, and outbreaks can have serious social, political, economic and national security consequences. Core health issues such as infectious disease outbreaks should be addressed to formulate a potential health policy that could be implemented at the grassroots level for efficient execution.
In a nut shell, Pakistan faces numerous challenges in healthcare, which can be broken down into social issues, technical constraints, lack of trained human resources, infrastructure, effective legislation and policy making, awareness and negligence. As a result, Pakistan faces many challenges in implementing the health-related SDGs. The lack of reliable and recent health data is another serious issue together with the weak institutional capacity, which has led to poor governance and policy incoherence. There is no evidence of strong political will, and inter-ministerial conflicts are rampant to cope with infectious disease outbreaks. In order to control healthcare issues, corruption must be stopped – one of the major causes of not being able to cope with infectious diseases outbreaks efficiently. Pakistan has been declared to be among the leading countries with a corrupt health system. Corruption is one the rise in every aspect of healthcare, including funds allocation (especially funds allocated to local NGOs), drug pricing and regulation, immunization programs etc. Unless these issues are properly addressed, the government of Pakistan may not contribute well to achieve the SDGs by 2030.