The Express Tribune Editorial 12 March 2020

Our quarantine centres

Tarpaulin camps set up in an open space with cotton mattresses laid out on unpaved mud floor: this is what makes up a coronavirus quarantine centre established at the border with Iran or on the outskirts of Quetta in Mianghundi. With no beds to lie on, virtually no doctors to attend to, and no proper testing facilities, these places are anything but quarantine zones. As if offenders, coronavirus suspects are literally detained inside the camps at these so-called isolation centres that leave much more to be desired. They are overcrowded and terribly lack basic bathroom and toilet facilities. Meals are not served properly either. For those having returned from abroad, passing a 14-day isolation period at these centres is akin to undergoing rigorous imprisonment.

Treatment facilities are a critical miss at these quarantine centres. When, according to reports, a boy tested positive for coronavirus at the Taftan quarantine centre on Tuesday, he was taken all the way to Quetta, some 600 kilometres away, at the risk of exposing whatever and whoever coming across in between. There are also reports of most doctors refusing to report for duty to the two quarantine centres, with the result that only a doctor or two are available at a time, along with a few paramedics, to take care of those under observation. Isolation centres set up in many other parts of the country, like in the interior of Sindh province, are nothing much to write home about either.

That speaks of our casual approach to dealing with a serious challenge — a challenge that can only be prevented, or contained, with precautions as an anti-virus is still a long way to come about. Without any further delay, the authorities concerned need to pay attention to the sorry state of our quarantine centres — besides, of course, putting up all other necessary preventive measures in place. All isolation centres need to be equipped with all necessary facilities. There is also the need to set up more isolation centres while taking a prior action. We are certainly not caught off-guard. We knew it was coming.

Utilisation of funds

Revelations made in a report in this newspaper about non-utilisation of funds and delay in their release by the Sindh government, have not come as much of a surprise. The report covers the first two quarters of FY2019-20. The trend shows that things will likely not be much different at the end of the current fiscal, if the experience of recent years is anything to go by. Crumbling state of civic infrastructure and increasing lack of civic facilities in various parts of the province too lead many to believe so. The report says funds allocated for many development schemes for health, education, transport, roads, irrigation, agriculture and wildlife have not been released altogether. Not a single rupee has been spent on funds released for several uplift projects for environment, climate change and coastal development.

A total of Rs319 million have been allocated mostly for projects aimed at improvement of environment, but none of these funds have been utilised showing lack of interest on the part of relevant officials in implementing the plans. An identical situation exists in the provincial energy department. An amount of Rs1.308 billion has been allocated for energy projects this fiscal. Only Rs153 million have been disbursed, and the entire amount remains unspent. The budget allocation under the head of energy is primarily aimed at filling up the gap in power supply to rural areas through solar energy. This is a serious lapse in view of the approaching summer months when temperatures soar.

An amount of Rs23 billion has been earmarked for development projects in the education sector, but here too things are unsatisfactory: out of the Rs6.53 billion that have been released only Rs2.47 billion have been spent. The story is much the same across various departments. Reports from other developing countries might explain the delay in release of funds and the slow pace of their utilisation. When the year nears its close, there is a sudden spurt in spending.

AIDS ‘cure’

Amid global anxiety caused by coronavirus, there was some heartening news relating to another incurable virus that we have become all too familiar with. A second patient has been cured of HIV after undergoing an experimental stem cell transplant treatment. Doctors in London said they could find no trace of infection in his body, more than 30 months after he stopped undergoing traditional anti-retroviral treatment. His recovery has been documented in a study published by the prestigious medical journal, The Lancet. Adam Castillejo, 40, was diagnosed with HIV in 2003. Later, he was diagnosed with Hodgkin’s Lymphoma. In 2016, as part of a bone marrow transplant to treat the blood cancer, he received stem cells from donors with a genetic mutation that prevents HIV from taking hold. The only other case of such treatment curing HIV was in 2011 when American Timothy Brown was treated in Berlin.

Unfortunately, with the good news was a caveat: researchers cautioned this is probably not a generalised cure for HIV, which causes a million deaths every year. The treatment was only done as a “last resort” because of the deadly blood cancer. The procedure had a 10% mortality rate, but given that the patient would have certainly died without the related cancer treatment, that risk became irrelevant. Also, “several other” patients who had undergone similar treatment, while responsive, had shown less heartening results. But doctors were still confident that the other patients might continue to improve. Meanwhile, there will be much debate over whether the process of offering stem cell transplants to a broader range of patients suffering from drug-resistant forms of HIV should be considered an option. Some researchers not involved with the study also highlighted the importance of remaining prudent, with a “wait-and-see” attitude towards whether the patient remains HIV-free before suggesting broader application. Still, it looks like we have cured the incurable, and that is always a win.