Present vs possible

Unfortunately, the future of health, not just in Pakistan, but everywhere depends on good science


Muhammad Hamid Zaman March 22, 2022
The writer is a Howard Hughes Medical Institute professor of Biomedical Engineering, International Health and Medicine at Boston University. He tweets @mhzaman

Like millions of Pakistanis, I also believe that we continue to punch well below our weight. We all meet brilliant people on the street, find inspiration in the classrooms and the workplace, yet collectively we continue to underperform. For as long as I can remember, we have been told by the leaders that the great (not just good, but great!) days are just around the corner, all we have to do is to entrust them with power for an extended period. Every government puts an arbitrary date in the future and says that by that date we will be among the greatest nations on the planet. Three years ago, in 2019, the then finance minister had said that Pakistan would be among the five largest economies in the world by the end of the century. We have heard versions of this story year after year, decade after decade.

But why do we keep falling for it? It is because we do see what is possible and think that it can be scaled across time and space. The tension between rhetoric and ground realities is rooted in a tale of two worlds that exist side by side in the country. A world of promise, based on some sparks; and a world of ugly realities based on everything that we see around ourselves. Like years gone by, this has been unfolding in the tenure of the present government as well. For reference compare what is happening in the health sector and what is happening in the realm of science. These two areas, in principle, should work in synergy but in reality they might as well be on two different galaxies.

While the health sector has not been perfect, it has delivered on important matters. Pakistan’s response to Covid-19 testing, vaccination, data-gathering and sharing has been exceptional. Pakistan has outperformed many countries large and small.

Even those who are fierce critics of the current government agree that the process has been carried out professionally and with a strong sense of purpose and decency. The health insurance system is also a much-needed initiative. Barring the first minister of health who was in the job for a very short period of time, the subsequent heads of the ministry have been domain experts.

Compare this to what has been happening in the science realm. For starters among the three ministers who have led the ministry since the government came into power, not one has any experience or expertise in the field. The first one had to step down due to his bullying of poor neighbours, the second’s claim to fame was a Ramazan app and series of bombastic claims about future Pakistani astronauts, and I am not sure where the third one is. Last we heard from him was when he was talking about electronic voting machines, a topic that is completely irrelevant to national science policy. The government’s use of its full force in dismantling of HEC, and its ill-fated and ill-advised insistence on converting the PM House into a university is a sign that science is neither a priority, nor do we have people who can go beyond their own fragile egos when it comes to national science vision or policy. It seems like the health sector is run by a scientific approach, and the science policy is managed by the poor health of a vision.

Unfortunately, the future of health, not just in Pakistan, but everywhere depends on good science. For as long as our science suffers from personal insecurities and destructive and archaic ideas, we will be unable to deliver on any promise, no matter how hard we try. While recent successful efforts in the health sector represent the promise of what can be done, the actions in the science domain are indicative of the rot that prevails. In the long-run only one of the two will survive, either the promise will be realised, or the sparks will become fewer and fewer. Egos, insecurity and incompetence are tipping the balance against the promise.

Published in The Express Tribune, March 22nd, 2022.

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