SBP’s healthcare initiatives

Louis Pasteur, the famed 19^th century microbiologist, once said, “Gentlemen, it is the microbes who will have the last word.” Nobody knows how long it will take scientists and virologists to come to grips with the coronavirus’ behaviour. The World Health Organization has however given good news that the vaccine to cure Covid-19 — one of the coronavirus-induced diseases — would be ready by the end of this year.

The infliction of Covid-19 has left even the well-advanced countries in the wilderness, not to speak of developing or under-developed countries, where the provision of healthcare has never been part of the developmental spending. According to the United Nations’ latest estimate, the coronavirus pandemic is costing the global economy $375 billion a month. Some 500 million jobs have been lost so far. Human development is on a reverse gear for the first time since 1990.

When the lockdown, to prevent the virus from further spreading, was imposed in Pakistan in the third week of March this year, hardly did anyone know that the path ahead was strewn with unprecedented bottlenecks. Not only did people burn out because of the economic meltdown, but the absence of social life also took a toll on the psychological wellbeing of nearly every second person. Though family reunion was the plus point of the lockdown spreading three months at a stretch, the economic hardship rarely allowed the bond to become an opportunity.

Had it not been for the Pakistan government’s benevolence, people might not have survived the virus’ relentless attack, which has sent the world economy into a tailspin.

First, it was the Ehsaas programme under which thousands of households were given Rs12,000 in cash. Then the State Bank of Pakistan (SBP) started multiple schemes to give loans at a 0% interest rate to banks for businesses so that they would pay salaries to their employees. Under another scheme, the central bank started a novel but effective programme of lending loans to hospitals for capacity building. In a country where the health sector has been neglected over the decades, anything amounting to this level of attention caught the interest of hospitals, especially of those running on charities, like the Saleem Memorial Trust Hospital. Its CEO, Shahzad Saleem, is all praise for the SBP’s initiative of originating the Refinance Facility to Combat Covid-19 and then executing it successfully.

Under this scheme, the SBP refinanced banks to provide financing at a maximum rate of 3% for five years for the purchase of equipment to detect, contain and treat the coronavirus. The SBP provided this facility to banks at 0%. Though banks had the leverage to charge 3% interest, there were banks that kept to the 0% rule — kudos to them.

Each hospitals and medical centre registered with federal or provincial health agencies and those engaged in the control and eradication of Covid-19 were eligible to initially get a loan of up to Rs200 million. Later it was increased to Rs500 million. The scheme has become so popular and its results are so astounding that the central bank shall, in the near future, ratchet up the refinancing figure to Rs1 billion. The SBP’s effort will indeed go a long way in addressing health inequality and the issue of resource inefficiency in healthcare facilities.

To further support the public and private sector’s effort in their fight against the pandemic, the SBP amended the foreign exchange regulations to facilitate the import of medical equipment, medicines and ancillary items. Subsequently, looking at the increasing workload the government further facilitated the health sector by allowing financing against existing equipment and the purchase of refurbished equipment for creating a special facility/isolation ward to deal with Covid-19. On July 6, 2020, the SBP also allowed refinance facility for the manufacturers of protective gear and equipment, including items such as masks, dresses, testing kits, hospital beds and ventilators.

Taking advantage of this opportunity to reorient the health sector, the SBP has allowed the extension of the loan to any hospital that would fulfil the minimum specified standards drawn out to become eligible for financing.

All these initiatives taken by the State Bank to enhance Pakistan’s health sector capacity is indeed laudable especially in the view that it has taken this leap without considering commercial risk.

Invisible to the human eyes, viruses are by nature mysterious and problematic. By the time the scientists find the solution to tame the virus, it would already have claimed thousands of lives and putting many more in peril for its disposition to mutate, commute and transpose.

Maria Van Kerkhove, the acting head of emerging infectious disease at WHO, said that since the coronavirus typically causes respiratory symptoms, the frontline safety measures may include: keeping hands clean by washing them with soap and water, maintaining distance with people who are sick, keeping a sneezing nose covered with a tissue or flexed elbow.

Pakistan is also part of the global effort to defeat the coronavirus and has been under lockdown on several occasions. Though it is a long fight and our resources are insufficient, the outbreak does provide a window of opportunity to put our house in order by adopting at least three pathways: one, to enhance public health capabilities and infrastructure, especially in the primary healthcare; two, to reorient the role of leadership and coordination for preparedness and response; and three, to propel research and development in the infectious diseases arena.

Fortunately, with the assistance of the State Bank of Pakistan, we have started a journey towards finding solutions to all these imperatives. In due course the country would be in a position to build a comprehensive and coherent framework to make the country safe against the threat of not only infectious but all kinds of diseases.

Published in The Express Tribune, October 8^th, 2020.

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