TB prevention
IF Pakistan is to achieve the target of effectively ending the tuberculosis epidemic in the country by 2035, as stated by the National TB Control Programme in its mission statement, sustained efforts are required to eliminate this communicable disease. And as we mark World TB Day today, it is a good opportunity to reaffirm the national commitment to ensuring a TB-free Pakistan. Despite advances in the field of public health, TB remains a matter of concern globally. According to the WHO, in 2021 around 10.6m people fell ill with the disease, while the number of TB-related deaths in the same year was 1.6m. The stark fact is that the highest incidence of the disease is in the Global South, with over 80pc of cases and deaths reported from low- and middle-income countries. Many of these cases are reported from South Asian states, including Pakistan, India and Bangladesh. In fact, Pakistan has the fifth highest burden of disease in the world. As per the National TB Control Programme’s statistics, 573,000 people fell ill with TB in 2020, while 46,000 died during the same year. The rise of multidrug-resistant TB presents an additional challenge where battling the disease is concerned.
Certainly, the best way to eradicate TB is early diagnosis and full treatment. As the WHO notes, amongst the reasons for the rise in multidrug-resistant TB is “delays in diagnosis, unsupervised, inappropriate and inadequate drug regimens [and] poor follow-up”. The UN’s health body adds that drug resistance can emerge because of the poor quality of medicines, as well as the fact that patients stop treatment prematurely. Health experts need to urgently address these gaps in order to prevent the spread of more virulent strains of TB. In particular, the quality of drugs needs to be assured, while patients and their families should be counselled to complete treatment. With commitment and sustained focus, Pakistan can address this public health crisis and come closer to eradicating TB.
Published in Dawn, March 24th, 2023
Targeted killings
DISTURBING echoes of a violent past have re-emerged in Karachi, and experience tells us that swift action is necessary to nip this pattern in the bud. On Sunday, three individuals in different parts of the city fell victim to targeted killing. On Tuesday morning, a cleric associated with the Sunni Ulema Council was walking down the street when he was approached by two unidentified men on a motorbike and slain with a single gunshot to the head. Wednesday saw yet another similar crime in which a factory owner associated with the banned sectarian group Ahle Sunnat Wal Jamaat was gunned down in the New Karachi area by four armed assailants on two motorbikes. Just short of a month ago, an educationist also fell victim to a targeted killing in the city. Police have yet to ascertain the motives behind these murders, but in a city where street crime has risen exponentially over the past year or two, robbery was clearly not the objective.
The police have yet to put forward any theory about what lies behind this spate of targeted killings, or indeed whether any of the murders are connected at all. However, the back-to-back assassination of two individuals associated with religious organisations warrants a close consideration of the sectarian conflicts, with their political dimensions, that have in the past caused much bloodshed in Karachi. Some elements may also be trying to stir panic and create a law-and-order situation to serve some other agenda. The city’s crime graph has fluctuated considerably over the past several years. In 2010, there were 1,233 targeted killings in the metropolis — more than the total number of people who lost their lives in suicide bombings in the entire country that year. The Rangers-led Karachi Operation that began in late 2013, when the city was a cauldron of ethnic, political and sectarian violence, managed to bring down the rate of what are categorised as ‘major crimes’— targeted killing, kidnapping for ransom and bank robberies. In the last couple of years, it is street crime that has been the bane of the residents’ existence. There were over 60,000 incidents of street crime in Karachi in the first nine months of 2022, but virtually no targeted killings. The police must get to the root of the recent murders; there is far too much lawlessness already in the city.
Published in Dawn, March 24th, 2023
Delayed polls
Among the many disappointments of this past week has been Sikandar Sultan Raja’s meek surrender of his constitutional office to elements who clearly wished to see the democratic process in the country suspended. There were many who had continued to believe he would remain committed to a higher standard of conduct. They would have been most disappointed that the chief election commissioner has seemingly become party to a perverse project to subvert the Constitution.
By caving to the security establishment and government pressure to postpone elections well beyond what the law stipulates, Mr Raja has imperilled his legacy. Considering the ramifications of his biggest decision in recent months — unilaterally postponing the Punjab polls after a date had already been announced — there are genuine concerns regarding the ECP’s ability to hold any elections in a free and fair environment.
It is impossible to view the decision with any charity. It is nothing less than a tragic betrayal of the people by the ECP, the present government and each department of state that has refused to facilitate the electoral exercise.
The excuse presented to the country as the delay was being announced was as flimsy as what we had first heard when it became apparent that those in power were not interested in holding polls in Khyber Pakhtunkhwa and Punjab on time. ‘Pakistan is not safe enough to hold an electoral exercise’, the ECP repeated on Wednesday night; ‘no one is available to provide security for the conduct of polls’.
The fact that there was no question of ‘choice’ in this matter was glossed over: the state would have been bound to provide the ECP with all the support and security it needed for the conduct of elections, yet it seems it had no interest in pushing for it.
So, what will it take for Pakistan to once again be ‘safe enough’ for democracy to prevail? Who will make that call? Will it be the same people who, at the moment, are refusing to provide security to the poll exercise? When did this country make decision-making regarding the electoral process officially dependent on the whims of the security establishment? What happens if, come October, they once again refuse to ‘greenlight’ the poll exercise?
The PDM government, as its present behaviour suggests, would have few qualms about intervening in such a scenario. Imran Khan or no Imran Khan, it has fumbled on a scale so spectacular that it is highly unlikely to want to turn to the public even six months from now. These questions should give any democratically inclined mind pause about the path this country is being forced onto. If the ECP does not reverse its decision, the precedents being set are going to damage Pakistani democracy, perhaps irrevocably so.
Published in Dawn, March 24th, 2023