More coordination, please
The measles outbreak in the country, first in Sindh, and now in the Punjab, has highlighted certain important deficits in the country’s public health apparatus.
First and foremost, and let no one lose sight of it, is the inadequacies at the district and provincial levels. Health is a provincial subject and problems like epidemics are to be ably handled by the department. The Sindh health minister said his department didn’t have adequate equipment, a claim which federal sources say is not entirely correct. Either way, the provincial department should have been prepared for the situation even before the outbreak.
But epidemics in particular are a different animal altogether when compared to, say cardiac diseases or problem arising from unclean water. They have a large footprint and districts are helpless when it comes to them. As are, it is becoming clear, the provinces: the Punjab outbreak has already started claiming lives.
So, off to two federal ministries: inter-provincial coordination portfolio and natural regulations and services. The first is to provide interfaces for the provinces to interact with each other and cooperate in all matters, be they related to irrigation, forestry or, in this case, health. The national regulations ministry is in charge of regulating, in particular, the ministries that have been devolved to the provincial levels. This ministry does the work required to undertake the sort of regulations that provinces simply cannot tackle, not because of a lack of capacity (though a lack of capacity, there most definitely is) but because of the impracticality of it: if provinces were to, say, announce their separate drug policies and they were to result in different rates for those drugs, there would be much interprovincial arbitrage and pilferage.
The federating units need to work with each other to control the spread of epidemics.
This has grave repercussions for the country as well. Egypt, considered to be polio-free, has had a case recently, allegedly of Pakistani origins. India is also considering halting visas to Pakistanis for this reason specifically. And, horror of horrors, there are voices within Saudi Arabia that speak of halting Hajj visas to the country if they don’t get their vaccination drives in order.
