The writer is a Howard Hughes Medical Institute professor of biomedical engineering, international health and medicine at Boston University. He tweets @mhzaman

Thinking back, planning ahead

There is every reason to worry about the current epidemic, the trends of which look concerning

Muhammad Hamid Zaman April 14, 2020
“Because we do not have enough people who know both medicine and mathematics” was the response from a senior colleague at a major research hospital in Pakistan when I asked him about the lack of robust models and projections of Covid-19 in the country that can guide our planning. The need for a strong team of epidemiologists has never been more vital. Yet, few, if any local models, have been developed to account for the current status of our health system, our socio-economics, average contact between people and the known dynamics of the virus. The models developed elsewhere in Europe and the US may capture the essence but need contextual understanding. We, on the other hand, have not had our researchers come up with models reflecting our realities.

This is not an accident — for several decades, Pakistani public health sector has lacked experts in mathematical modeling and most research is done by foreign institutions. There could be several reasons for that, but the most important one is our archaic education system that forces young students to choose between biology and mathematics. Most doctors coming out of our national system have never seen any real calculus and are uncomfortable with mathematics. There is no real reason to have this boundary. This arbitrary wall, which forces bright students to make this irrational choice continues to hurt us. This has been the case for decades — and during the Musharraf era, there was discussion of giving ninth grade students an option between biology and computer science. This is an issue that has been troubling many of us for years. I wrote about it in this paper in January 2012. Colleagues and friends took it up to the then CM of Punjab, whose office had shown some interest in rethinking curriculum, but then priorities went elsewhere.

Speaking of computer science, there has been a bizarre fixation and an exclusive emphasis on IT in the country. There is no question that digital literacy and data sciences are vital, but if that is all we care about and forget to emphasise basic sciences and engineering and the links between them, we will not be able to meet our public health challenges. Fancy bubbles on dashboards can only take us so far — there is a world beyond it, and that seems ignored and forgotten. We are paying the price of this ignorance.

This is not something that happened overnight either. Starting with the Musharraf government, to this day, we have had fantasies of leap-frogging other countries without any real investment in basic science and discovery. We have not achieved much in true scientific progress and are unlikely to do better in the near future. Today we may have (some) useful data about the progress of the disease, but we desperately need more tests, ventilators and PPE. The country does not have any real capacity to produce it and depends on the generosity of others. This should not have happened. Today, the government has a chief digital officer, but no one with a serious background in basic sciences or engineering to advise the PM. Previous governments also had initiatives on e-learning and a fixation on dashboards, but little interest in real investments for rigorous fundamental science and engineering.

The priority across the board should be to save as many lives as possible. There is every reason to worry about the current epidemic, the trends of which look concerning. But we should recognise that there may be another one in the not too distant future and as we rebuild, let us reflect on how we can do better. Thinking about how we train our frontline workforce is as good a step we can take.

Published in The Express Tribune, April 14th, 2020.

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