Arshad Mahmood Awan

Almost two years have passed since the World Health Organization (WHO) declared an end to the Public Health Emergency of International Concern regarding the COVID-19 pandemic in March 2023. For Pakistan, the pandemic claimed an estimated 30,000 lives, marking it as one of the most severe public health crises in recent history. While Pakistan’s death toll from COVID-19 was relatively lower than many developed nations, with the country ranking 29th globally despite being the fifth most populous, this should not be a reason for complacency. Rather, it serves as a reminder of the importance of being adequately prepared for future health emergencies. With the looming certainty of another pandemic, it is crucial that Pakistan learns from the COVID-19 experience and improves its healthcare infrastructure, response mechanisms, and emergency preparedness to mitigate the damage caused by future health crises.

Today, as we observe the International Day of Epidemic Preparedness, it presents an ideal moment for policymakers in Pakistan to reflect on the state of the nation’s readiness for public health emergencies. The lessons learned from the pandemic should spur a reevaluation of how the country plans, funds, and implements strategies to face future global health threats. There is no shortage of warnings from health experts and epidemiologists that the next pandemic is not a matter of “if” but “when.” Therefore, Pakistan’s approach to dealing with pandemics needs to evolve beyond mere response mechanisms and be centered around resilience and self-sufficiency.

One of the most glaring weaknesses exposed during the COVID-19 pandemic was Pakistan’s inability to procure essential medical supplies such as masks, ventilators, and vaccines in sufficient quantities. As the pandemic unfolded, countries across the world scrambled to secure vital resources, and Pakistan, like many developing nations, struggled to obtain the necessary supplies in time. The lack of financial resources meant that many families were unable to afford medical care, leaving them vulnerable to the virus. Additionally, the prolonged lockdowns, although necessary for public health, placed immense financial strain on the country’s population. The majority of households were unable to absorb the economic shocks caused by the lockdowns, underscoring the country’s inadequate welfare system.

Despite these challenges, Pakistan’s leadership was forced to take immediate action as the pandemic threatened to overwhelm the healthcare system. However, while many of the responses were swift, they were often piecemeal and reactive. As we now know, the country’s preparation for the COVID-19 pandemic was insufficient, and the economic, social, and healthcare systems were ill-equipped to handle the severity of the crisis.

Looking ahead, it is encouraging that international organizations, such as the World Bank and the Asian Development Bank, are contributing to Pakistan’s future pandemic preparedness. The World Bank-funded “Pandemic Preparedness and Response (PPR) through Operationalising One Health Approach Programme” is a step in the right direction, with the goal of strengthening the country’s disease surveillance and early warning systems. The program, backed by the World Bank, WHO, and the UN’s Food and Agriculture Organization, will also focus on upgrading laboratories and training healthcare personnel. However, while the funding from the Pandemic Fund, which allocated $418 million for 40 countries in October, is a positive move, it still falls short of addressing the full scope of the issue. In a world where health crises in one country can swiftly transcend borders, the relatively modest sum allocated to 40 countries with insufficient healthcare systems signals a worrying gap in global support for pandemic preparedness.

Furthermore, the funding for these initiatives is far from adequate. Even though an additional $6 billion is being mobilized to support healthcare programs in 75 countries, there remains a significant disparity in resources allocated to low-income nations. This persistent underfunding reflects a broader issue in global health policy, where the wealthy nations, despite their resources, are not doing enough to support healthcare development in the Global South. This puts countries like Pakistan at a greater risk, as health emergencies in such nations have the potential to quickly spiral into global crises, as witnessed during the COVID-19 pandemic.

In terms of domestic preparedness, Pakistan continues to struggle with basic healthcare access. Even after a 13 percent improvement in its universal health coverage index between 2015 and 2022, around half of Pakistan’s population still lacks access to basic healthcare services. This lack of access is a major vulnerability when it comes to managing health crises. When large sections of the population are already excluded from basic health services, the country’s ability to contain a health emergency is severely compromised. Public healthcare spending remains far below the 6 percent of GDP recommended by global health experts. This lack of investment leaves Pakistan with a fragile healthcare infrastructure that cannot provide the necessary support during a pandemic.

Pakistan’s continued dependence on foreign aid for its pandemic preparedness efforts only highlights the dire state of its domestic healthcare system. While international assistance is important, it is not a sustainable solution. Pakistan’s reliance on external aid makes it difficult for the country to independently address health emergencies and respond in a timely manner. A stronger, more self-sufficient healthcare system would be the best shield against future pandemics. This requires consistent investment in the healthcare sector, long-term planning, and a commitment to strengthening the country’s ability to respond to public health emergencies.

Beyond infrastructure and resources, another critical issue is the country’s approach to health education and public awareness. During the COVID-19 pandemic, misinformation and confusion were widespread, with many people unsure of how to protect themselves from the virus. A well-informed public is an essential part of any effective health response. The government must invest in public health campaigns, ensuring that the population is equipped with the knowledge and tools to respond to future health crises. This includes education on hygiene, vaccination, and how to identify and report symptoms of infectious diseases.

As we reflect on Pakistan’s pandemic preparedness, it is clear that there is still much to be done. The COVID-19 crisis should serve as a wake-up call for the nation to prioritize public health and invest in its healthcare system. Preparing for future pandemics is not only about purchasing medical equipment or strengthening surveillance systems; it is about building a resilient, self-sufficient healthcare infrastructure that can withstand global health challenges.

The ongoing pandemic and future crises are a reminder of the need for urgent and comprehensive action. The time to act is now, and Pakistan must seize the opportunity to transform its healthcare system, ensuring that it is ready to face the next pandemic with strength and confidence. Only through proactive measures, investment in healthcare, and international collaboration can Pakistan hope to protect its people and emerge stronger from future global health challenges.