Climate change and new threats: Pakistan’s crumbling health sector
https://arab.news/pb854
Climate and human health-- both these entities are an ancient struggle and the idea that health and diseases are linked to climate probably predates written history. In fact, the ancient Greek physician Hippocrates related the spread of epidemics to seasonal weather changes.
For centuries, humans have known that climatic conditions affect epidemic infections, well before the basic notion of infectious agents was understood. The Roman aristocracy took refuge in hill resorts during summer to avoid malaria. In the southern United States, one of the most severe outbreaks of yellow fever occurred in 1878, during one of the strongest El-Nino episodes on record.
The world’s climate system is an integral part of life supporting processes, one of the many natural systems coming under pressure from population explosion, economic activities, urbanization and deforestation. There is a widespread consensus that the earth is warming at an unprecedented rate. The last decade was the warmest and contained 9 out 10 warmest years ever recorded. The long-term health of populations depends on the continued functioning and stability of the biosphere’s ecological and physical systems.
Infectious disease outbreaks and their transmission should be viewed within an ecological framework. Population explosion around the world and worsening climate change impacts are putting greater pressure on the environment. Deforestation, urbanization, injudicious land use is providing opportunities for pathogens to spill over from animals to people, with catastrophic impacts. The diseases most frequently seem emerging in these scenarios are those that exist naturally in the wild ecosystems and circulate among animals.
In their article named “Bats, Coronaviruses and deforestation: Towards the emergence of Novel Infectious Diseases?” published in Frontiers of Microbiology in January 2018, authors Afelt, Frutos, Devaux state that coronaviruses are historically present in various bat species. Environmental and land degradation have resulted in transfer of these viruses to humans through intermediate vectors. According to the research paper, once these pathogens emerge in the immune naïve human populations, they result in large epidemics along with high mortality rates. Once adapted to humans, the CoVs may evolve to develop a more efficient transmission among humans, resulting in some individuals becoming “superspreaders”. In case of SARS CoV, 83% of the transmission was epidemiologically linked to five super-spreaders.
Climate change will overwhelm our systems, hence it is imperative for the policy makers to divert their attention toward infusing life in the crumbling health system in Pakistan. It is high time the leadership in Pakistan realizes that higher military spending negatively impacts health expenditures and therefore becomes an important risk factor for population health and well-being.
Dr. Mehreen Mujtaba
Worldwide, around 663,748 people have now been infected with novel coronavirus. The death toll is increasing daily, with 30,888 deaths attributed so far to the disease, bringing daily reminders that the environment plays a major role in human health and safety-- and can also spillover and hamper the economic development of countries, resulting in worldwide recession.
Countries around the world have historically been injecting millions of dollars into their military budgets, with meagre resources allocated to the health sector and research. Pakistan is no exception. According to the Stockholm International Peace Research Institute, Pakistan spends 4 percent of it’s GDP on military expenditure. In it’s new defense budget, government of Pakistan allocated PKR 1.15 trillion (USD 7.6 billion), a 1.3% increase over the previous year, whereas the budget set aside for health is PKR 13 billion, less than the previous year. Generally, when military spending increases by 1 percent, spending on health decreases by 0.6 percent and this trade-off is more intense in low and middle income countries, where a 1 percent increase in military spending results in a 0.96 percent drop in health spending.
Lets now analyze the current situation in terms of the health infrastructure’s ability to cope with the pandemic, in a country of more than 200 million people.
A stocktaking of the number of ventilators in the public and private sector hospitals around Pakistan shows that Khyber Pukhtunkhawa has 150 ventilators, Balochistan has 49 ventilators in total, Punjab’s public sector hospitals have 1300 ventilators as well as 100 new ventilators in Punjab Kidney and Liver Institute (PKLI), whereas in Sindh, the total number of ventilators in both public and private hospitals is 500. At the same time, according to a WHO report, there is only one hospital bed for every 5,000 people in Pakistan. WHO data also reveals there are approximately seven doctors, two nurses and one midwife for every 10,000 citizens.
The Covid-19 crisis provides an opportunity for change. There needs to be a paradigm shift to include “health for all” as an integral part of budget allocations. In order to mitigate future pandemics, the health system strengthening and allocating a substantial budget to the health sector is imperative.
Mitigating future threats requires smart leadership, investing in smart science, research and health care. The age of predictability is over, new challenges require innovative and new ways of thinking. They also require investing in the future of the country to develop a robust scientific community in order to tackle the challenges of tomorrow.
Climate change will overwhelm our systems, hence it is imperative for the policy makers to divert their attention toward infusing life in the crumbling health system in Pakistan. It is high time the leadership in Pakistan realizes that higher military spending negatively impacts health expenditures and therefore becomes an important risk factor for population health and well-being. The world needs to wake up and realize that the enemy is now not across their borders but can overwhelm them in the form of droplets suspended in air, and that the enemy is not always visible. It can be an invisible threat, and scientific predictions say their onslaught will only increase in frequency and intensity in the years to come.
With new emerging threats, the nature of our soldiers is also changing. Today the frontline heroes around the world are the ones working day in and day out to save lives, putting their own at risk. Unfortunately, these unsung heroes in our country aren’t armed to fight the battle; they are without their armors, shields and weapons, thanks to decades of negligence toward the health care sector.
*Dr. Mehreen Mujtaba is a freelance consultant working in the areas of environment and health.
