The 1946 Constitution of the World Health Organization (WHO), preamble states that, “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.  The WHO further states that the right to health means that governments must generate conditions in which everyone can be as healthy as possible. Such conditions range from ensuring availability of health services, healthy and safe working conditions, adequate housing and nutritious food.

Health is one of the fundamental human rights supposed to be protected by the state. However, the mere acknowledgment of health care as a fundamental right may not help in providing such important services to the poor and needy people of third world countries.

Pakistan’s health sector suffers from successive government’s lack of vision and political will to make universal health coverage a reality.  It is quite unfortunate that the leading political parties often have minimal vision or strategy to solve the health care issues, mainly affecting the commoners.

Health systems are often judged by their level of fairness and responsiveness apart from being accessible and equitable to all segments of society. It is a sad manifestation that public health experts, available data and news reports clearly indicate that health sector, despite being an integral part of the manifesto of all ruling political parties in Pakistan, has not been able to achieve satisfactory success indicators.

There is an agreement that still a large number of maternal and newborn deaths are taking place at the time of delivery, especially in rural areas where absence of health care facilities are quite common.  Despite reporting of such high number of deaths the legislators have failed to respond in concrete manner.

The condition in public hospitals, health units and dispensaries by all means is not satisfactory.  The availability of qualified health practitioners is still a privilege rather than right in many parts of the country.  It is even more unfortunate that health practitioners, serving in government hospitals, are more interested in formation of their service structure, including perks and privileges.

Pakistan ranks quite low on human development index with abysmal health, education, and state of living indicators. The country has a double burden of disease, equally suffering from a high number of infectious and non infectious conditions. High population growth rate is a chronic issue in the country with low contraceptive prevalence rate. The country ranks 6th most high TB burden country in the world.

The province of Sindh has seen worst measles outbreaks that have caused the preventable deaths of 300 innocent children.  The epidemic is a clear outcome of government’s inefficiency to employ a proper immunization mechanism in the province. The emergence of Polio, which has been wiped out all around the world except three countries including Pakistan, is still a grave challenge.  Armed attacks on polio workers have further intensified the problem.

It is an irony that the country plagued with such health challenges has an ineffective and inefficient system mainly relying on out of pocket expenditures by the patients. Every year hundreds and thousands of families fall into the poverty trap mainly due to sudden and unforeseen expenses on health related problems.

A clear lack of political will is a primary reason of the poor state of public health care system in the country.  After successful completion of allotted five-year term, all political parties have started their preparation for the national and provincial assembly elections, scheduled to be held in May 2013.   The manifestos of all major political parties are at the final stage.   It is an important time for the Pakistani civil society organizations and health experts to lobbying for the inclusion of health focused agenda in political parties manifestos and makes the contestants accountable for proper delivery of services.

Pakistan is at the crossroads and unlike previous elections when people have tended to focus on personalities the next election should have focus pressing social problems, including much needed health care reforms.  The country’s civil society must draw up a manifesto to guide common people towards an issue-based electorate system.

About the Author:
Amir Murtaza is a researcher and column writer, he can be reached at

Document ID :AHRC-ETC-013-2013
Countries : Pakistan
Date : 13-02-2013