The outbreak of the highly infectious and often fatal coronavirus in China and the preceding challenges of containing Ebola and Zika viruses, Middle East Respiratory Syndrome (MERS) and the resurgence of polio are the most recent examples demonstrating that governments acting in isolation cannot control the spread of infectious diseases. These diseases could now spread more easily as a result of globalisation, tourism and cross-border and internal migration, driven by conflict. To control the spread of these diseases that pose danger to both the poor and the rich alike has led to the development of global health diplomacy.
The survival of the health sector depends on the “disruptive” forces to shake off the status quo. The future belongs to these disruptions or innovations in healthcare.
As President Xi Jinping said at the 19th National Congress last year, leaders are staring at the situation that demands attention “between unbalanced and inadequate development and the people’s ever-growing needs for a better life”. China is moving towards a sustainable economic model that not only focuses on growth but also on the quality of life of its people.
China’s health story is about its investment decisions in the area of healthcare. Almost 95% of China’s population is covered by insurance. This spirit of investment, if replicated in the Belt and Road Initiative (BRI), can alter the course of development of 60 nations, including Pakistan.
Health issues such as communicable diseases, health security, healthy lifestyle, illegal substance abuse, and road safety will need a new understanding and paradigm for handling as more people, information, goods and services traverse the proposed land and sea corridor. The infection will have a freer hand to barge through — taking advantage of an innocuous movement.
Hailed as one of the world’s largest development projects, the China-Pakistan Economic Corridor (CPEC) has an impact value that far exceeds economics, infrastructure, and trade; its potential to “disrupt” global health cannot be missed.
Pakistan can learn a lot from the Chinese experience in health. China’s expertise in community-based healthcare and providing clean water and sanitation for its nearly 1.4 billion citizens can be leveraged to improve and strengthen the health system in Pakistan, as it is a system grounded in human development and economic prosperity.
China’s concern on healthcare in Pakistan centres on improving basic sanitation and on giving access to healthcare with an aim to prevent any future disease outbreak. China plans to integrate economic partnerships with health.
A substantial difference will be made in access to primary care — a key to universal health coverage — with improved roads, uninterrupted energy supplies, and effective telecommunication.
During her latest meeting with CPEC Authority Chairman Lt Gen (retd) Asim Saleem Bajwa at her office, Punjab Minister for Health Dr Yasmeen Rashid promised the installation of healthcare facilities and services along the corridor. Bajwa has proposed setting up a mother and child hospital and a nursing college on the Punjab side of CPEC. Earlier, China and Pakistan launched an emergency centre in the southern port city of Gwadar.
Health has an interface with each component of CPEC — infrastructure, transport, investment, development and foreign policies of participating countries. No project is installed without an environmental policy that determines potential benefit and risk that the initiative will have on pubic and global health.
On the other hand, CPEC could give rise to opportunities. There could be increased trade in health products, services, and technologies. With better collaboration, there could be cross-border laboratories which can work at two levels: one, becoming a lynchpin to health security; two, making a healthcare hub to attract medical tourism.
As the world interconnects, health can no longer be taken in isolation. We are surviving in an integrated living system. The key challenges require attention and multisectoral solutions to reducing the prices of medicine, combating anti-microbial resistance, tackling the determinants of non-communicable diseases, the health effects of environmental degradation and climate change.
Is Pakistan ready to control any of these issues that are likely to catch up on us unattended? As our link with the global community increases as a result of increasing trade, this will be a test to harness the ability of the antimicrobial resistance, to undermine medical progress. We are not certain as to how climate change will affect our ability to deliver on the benefits of the system of biology, genetic engineering, computing power, and informatics and the development of materials, science and nanotechnology.
A disruptive force for global health is inherent in any of these issues, let alone all of them together. Excitingly, these challenges lack collective takers. A majority of the actions are concerned with domestic political concerns. Though on the global spectrum various global agreements on the sustainable development goals (SDG) have been developed, the diminishing willingness to invest in “others” and in public goods has undermined the spirit of collective actions and solidarity required for a global response. Moreover, the UN and other multilateral institutions are not prepared to handle interconnected challenges and systemic breakdown.
Both at national and international levels, a new political environment calls to reform the health sector. Leadership will have to demonstrate more effectiveness. It won’t be hyperbolic to say that the real threat emanates not from viruses or diseases but from the threat of ill-preparedness.
Published in The Express Tribune, February 13th, 2020.