Saving lives
WORLD Immunisation Week, which ends today, is a poignant annual reminder of how much remains to be done to protect millions of children globally against vaccine-preventable diseases. Aptly themed ‘the big catch-up’ for this year, the aim is to focus on children who have missed out on routine vaccinations during the long period of Covid-19 and to try and restore immunisation to at least pre-pandemic levels. Pakistan, too, is making an effort in this direction but Covid-19 has aggravated the situation, and added thousands to the existing number of unvaccinated or partially vaccinated children. Routine immunisation in the country has presented a mixed picture. For instance, figures for Punjab, from a couple of years ago, show almost 90pc vaccination coverage in the province, but the story is grimmer in Balochistan where only 37pc of the eligible group has reportedly been vaccinated. Globally, the national average places Pakistan in the category of countries with the largest numbers of unvaccinated children — this despite the fact that the Expanded Programme on Immunisation has been in place since 1978. As a result, we frequently see outbreaks of illnesses like measles, while polio, despite the decreasing number of cases, has yet to be eradicated.
The reasons for the inadequate level of vaccination are well-known, and involve misconceptions — sometimes even triggered by GPs themselves — and a general mistrust of government initiatives among parents, besides a lack of awareness and education. Perhaps the solution lies in greater direct engagement with communities to explain to parents that vaccines save lives and that their side effects are temporary. Here, the services of Lady Health Workers, who are already doing a commendable job, can prove invaluable. Their role can be enhanced with regular training in conveying greater information on childhood diseases to parents. Making vaccination centres more accessible and ensuring that all communication is in local languages can help clear up the fears parents harbour about vaccination for their children.
Published in Dawn, April 30th, 2023
Drug pricing
MORE than a simple regulatory matter, drug pricing in Pakistan has become a political issue. Hence, we have seen governments postpone or reject any demand from drug manufacturers to raise the rates of their products for fear of a public backlash. It should be appreciated, then, that the coalition government has finally approved an increase of up to 20pc in the retail prices of non-essential medicines while capping the rise for essential drugs at 14pc — even if the decision has been made after a long wait and frenzied lobbying by a pharma industry teetering on the edge. The increase in retail drug prices falls far short of the industry’s demand for an across-the-board price adjustment of 39pc to offset the impact of price inflation, currency devaluation, increased energy rates and the global commodity boom on input costs over the last one year. Nevertheless, the decision will help save pharmaceutical firms from total collapse and bankruptcy, as well as prove an incentive for resuming full production to end shortages in the country — at least for the next few months. In fact, the current increase is a win-win situation for all stakeholders — the government, industry and the public, considering the highly inflationary environment.
The dispute between the government and the pharmaceutical companies, local and foreign, over excessive official control on drug pricing and its ‘flawed’ mechanism is not new. Recently, the fever-reducing Panadol had practically vanished from the market for some months due to the refusal of the industry regulator, Drap, to increase its price, in spite of the massive surge in the cost of its production. There have been numerous such examples in the past where drug-makers have been forced to suspend production of essential and non-essential drugs because the retail prices have been far below their production costs. Many foreign drug-makers have exited the Pakistani market due to the pricing dispute. Such a situation should not continue, especially given the high inflation. Some mechanism will have to be evolved to allow manufacturers to recover their input costs and make a reasonable profit for future investment in new technologies and quality control. Otherwise, patients will continue to face periodic shortages of essential drugs and pay a lot more for smuggled alternatives. Such a situation would provide an opportunity to unscrupulous elements to flood the market with substandard and spurious products.
Published in Dawn, April 30th, 2023
Politics of vengeance
SAME tactics, different faces. Governments may come and go, but a destructive politics of vengeance continues to poison the atmosphere.
On Friday night, a raiding party of Anti-Corruption Establishment and Punjab police officials used an armoured vehicle to break open the main gate of PTI president Chaudhry Parvez Elahi’s residence in Lahore in an effort to arrest him. Upon entering the house, riot police set upon the occupants with batons and later took 12 people into custody.
Despite Mr Elahi’s lawyers saying that a court had granted him pre-arrest bail in a corruption case, the ACE team insisted that the former Punjab chief minister was wanted in a new case and they would not leave without him. The operation, which continued until 2am, was unable to locate Mr Elahi despite a thorough search of his residence. Not content with this unwarranted show of brute force, the police yesterday booked the PTI president on terror charges, claiming that its personnel were “attacked with stones, batons and petrol” during the raid.
No longer is there even a pretence of the rule of law in the government’s conduct vis-à-vis the opposition. Last month, the police used heavy machinery to break into Imran Khan’s residence in Lahore while he was on his way to Islamabad to attend a hearing in the Toshakhana case, and his wife and sister were present in the house.
Arrests of PTI leaders, allied politicians, and critics of the PDM on flimsy pretexts — including ‘spreading hatred’ — have gathered steam. At least two PTI social media activists went ‘missing’ for a time. Such tactics should be familiar to the parties that comprise the incumbent coalition government which were at the receiving end of the PTI government’s high-handedness. Politicians in the opposition at the time were detained for months by NAB without evidence; and anyone critical of Mr Khan’s government, including journalists, was hounded through the courts on various charges, including one as serious as sedition.
But instead of demonstrating maturity and bringing some civility to the political environment, the coalition government has embarked on a wholesale witch-hunt of the opposition without an iota of shame. Last month, Interior Minister Rana Sanaullah bluntly cast the tussle in existential terms. “Now either [Mr Khan] will be eliminated from the political arena or us.” This is not the language of leaders that are looking to consolidate the country’s future; this is selfish, bare-knuckle revenge politics.
While Mr Khan may well be responsible for resurrecting a style of politics that in the 1990s had played into the establishment’s hands and contributed to the downfall of several elected governments, the PML-N could have refused the temptation of paying the PTI back in the same coin. Instead, it has chosen a path that will guarantee perpetual instability.
Published in Dawn, April 30th, 2023