Pakistan, a population of approximately 251.27 million people, faces significant healthcare challenges, including a high rate of infectious and non-communicable diseases. According to data from WHO, Pakistan bears a significant portion of the regional burden of many communicable diseases, including HIV, Hepatitis B and C, Tuberculosis, and the burden of multidrug-resistant Tuberculosis
Disease prevention is a critical component of healthcare that can significantly reduce the overstretched healthcare system. By focusing on prevention Pakistan can reduce the incidence of diseases, minimize healthcare costs, and improve the quality of life of citizens.
The GDP of Pakistan is dependent upon the per capita income of a healthy segment of the population. The public health segment needs to be strengthened and broadened by a robust system of health care delivery through universal access coverage.
Communicable Diseases
Communicable diseases are those which are transmitted from one person to the other. These diseases are caused by bacteria, fungi, and viruses primarily through contact, airborne, droplet, and vector. Pakistan being a developing country has a poverty rate of almost 40% which is a major factor in the prevalence of communicable diseases in Pakistan. Communicable diseases are being taken care of through an expanded program on immunization (EPI). The majority of the communicable diseases are vaccine-preventable and vaccines are provided to newborns right from birth till the age of 5 years against 12 diseases (TB, Polio, Pertussis, Diphtheria, Tetanus, Measles, Rubella, Pneumonia, Meningitis, typhoid, Diarrhea) and to the pregnant mothers against tetanus during the pregnancy.
The rest of the communicable diseases emerging (new infection) or reemerging (recurrence of infection) are taken care of by a program called the Communicable Disease Control Program in Pakistan. CDC in Pakistan differs from the level of CDC Atlanta (Center for Disease Control and Prevention) where all (communicable and non-communicable) diseases are being taken care of by the US health system.
The main distinction between EPI and CDC is that the former is a global initiative by the World Health Organization (WHO) aimed to ensure that children have access to vaccines, regardless of their location or socioeconomic status. The latter is aimed to prevent or contain the spread of diseases.
Reasons For Disease Burden For Communicable Diseases
Lack of Health Education
The following are the major root causes in the case of health education:
- People don’t know the importance of vaccines.
- They also lack the knowledge of measures to be adopted for the prevention of these diseases.
- People don’t know the importance of eating healthy and have poor nutrition.
- People lack interest in regular checkups.
Misconceptions about vaccines persist, with some people believing they cause infertility or harm general health. This lack of understanding leads many mothers to decline vaccination for their children. A significant barrier to vaccination uptake is the inadequate communication between health programs and their target populations, resulting in a lack of awareness about existing initiatives.
Furthermore, even those aware of these programs often cannot access them due to poverty and extremely low socioeconomic status. Limited public involvement hinders community mobilization, exacerbating the issue. The struggle for survival in impoverished communities, characterized by low income and unemployment, makes regular health checkups a luxury few can afford.
Missed Opportunities
People approach the health care system to avail themselves of preventive facilities but fail due to the non-availability of commodities and the concerned staff. The scarcity of healthcare infrastructure, particularly in rural areas, forces millions to seek care from unqualified providers or forego essential services altogether. Additionally, insufficient investment in healthcare workforce development, research, and innovation has stifled progress in addressing pressing health concerns. Lack of interest shown by the healthcare staff especially due to their nipped benefits from the government side and additional responsibilities due to large numbers of vacant slots in preventive programs further aggravate the situation.
Non-Communicable Diseases
Unlike CDC Atlanta, the non-communicable diseases are being taken care of by another program called NCD, which currently extends support for diabetes and hypertension. The main reason for these diseases is unhealthy lifestyle and food. People avoid exercise or hard work, that’s why we see a significant amount of ischemic heart diseases in Pakistan. Unhealthy food from the market cooked in oil containing a high ratio of bad cholesterol leads to the narrowing of vessels throughout the body causing an increase in the incidence of brain hemorrhage, hemiplegia, kidney failure, fatty liver, diabetes, and obesity.
Health Hazards
Poor Sanitary Conditions
Pakistan is among the worst countries in the world for poor sanitation and hygiene. An estimated 70% of households still drink bacterially contaminated water. A report by Water Aid (2020-2021), suggested that 21 million people in Pakistan still don’t have clean water close to their homes. Every year there are 53000 Pakistani children under 5 who die from diarrhea due to poor water and sanitation. Children suffering from such diseases are expected to fall behind in school or drop out altogether aggravating the problem of illiteracy in Pakistan., which further stifles the economic growth of Pakistan.
Smog
The transport sector’s share in air pollution worldwide varies from 20% to 70% depending on countries, locations, and social status. In Lahore transport sector’s share in air pollution is reported to be 40% of the total. Recently, Lahore has been ranked as the most polluted city in the world. The air quality index has become hazardous, it was recorded at 1165 which later dropped to 1099. Residents across Lahore described the air as thick with a suffocating haze and there was growing frustration among them over lack of government measures. A study showed that the people living in Lahore will die 7 years earlier because of this environment. In small cities like Multan, the AQI was recorded to be 2000 which was alarming.
Adulteration in Edibles
Adulteration in edibles like milk, ghee, cooking, oil, yogurt, spices, flour, meat, and organic fruits leads to health problems. The reason for this adulteration is poor control by food authorities.
How Can We Improve this System and Promote Disease Prevention?
- A legal framework should devised for all the people responsible for adulteration. The DRAP (Drug Regulatory Authority of Pakistan) should take strict actions against firms and factories manufacturing spurious drugs, especially the life-saving ones that are injurious to the human body causing multiple reactions.
- In Pakistan, the sewerage lines go parallel with water supply lines increasing the chance of contamination of the water supply running through the low-quality pipes which may leak. These pipes should be at a distance from the sewerage supply.
- The transport authority should arrange for annual checkups of the vehicles and should set a healthy age limit for the vehicles to run in urban areas.
- The nutrition programs in all the provinces/areas running Every vertical program has an inbuilt component of social mobilization and public awareness which is not being implemented in the true spirit that’s why a comprehensive coordination plan by collaboration of all the concerned preventive programs should be chalked out and implemented with strict monitoring and evaluation.
- There must be uninterrupted supplies of commodities at health facilities and with the outreach teams.
- The vacant slots should be immediately filled in the programs to avoid additional responsibilities and to decrease the world load on individual health workers for better coverage.
- There should be a check and balance by food authorities of all the provinces and areas in Pakistan with the support of the World Bank and other development partners, being the part of IRMNCH (integrated reproductive maternal and newborn, child health and nutrition) program, should be redesigned to focus only on the clients with low socioeconomic status to provide them the commodities of the program.
By implementing these measures and fostering a culture of prevention, Pakistan can significantly reduce the burden of diseases and build a healthier future for its citizens.
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She is a student of International Relations with a passion for law, politics, and current affairs.