Pakistan has reported 3.4 million cases of malaria from January to August 2022. These are a million more cases as compared to 2021 and we still have four months to go. Officially there are only 26,000 cases of dengue in Pakistan. In nearly the same period Pakistan has reported around 275,000 Covid19 cases. Where daily reported Covid cases have declined to less than 100 a day for the last one month, reported cases of both dengue and malaria have increased substantially. Let’s dig deep to see what health crisis we are facing now.
After historic floods in Pakistan, both malaria and dengue were expected as large swaths of the country went under water. Though both dengue and malaria spread through mosquitoes, these are different mosquitoes with different life habits and thus need different strategies to control. Where malaria reported numbers are quite high, but dengue reported numbers are a fraction of malaria numbers. Why is that so when we personally know multiple people who have suffered from dengue in the last two months? Answer is simple as we don’t have good quality disease reporting systems. But then what about malaria numbers? Sindh has set up good microscopy centres to diagnose malaria cases and they are not afraid to report these numbers. Bulk of malaria cases are being reported by Sindh. Other provinces are always reluctant to find and report disease numbers. In Covid19 days we saw the same hesitation from many provinces. In the dengue outbreak of Islamabad in 2019, where Islamabad was reporting 800 cases per day, adjoining city of Rawalpindi was reporting around 100 cases a day. This was the practice in Covid19 too. How viruses and mosquitoes could stop at Faizabad interchange on the borders of Rawalpindi and Islamabad is a biggest unresolved mystery (pun intended) of public health.
COVID19 reported cases are also heavily under reported due to multiple reasons. I do believe that Covid cases are on a lower trajectory too though they still may be more than reported numbers. SARS-COV-2 (the virus which causes Covid19) is continuously churning multiple variants in different locations. Recently identified variants are completely immune evasive meaning that past infection or vaccination may not provide protection from a new infection. However, it’s still believed that vaccination and recent infection may help you keep out of the hospital. These Omicron sub-variants have evolved stealth techniques to evade body defences. Singapore, a highly vaccinated country, saw a steep increase of cases due to XBB sub-variant. In Canada, Omicron sub-variant BA.5 has a descendent BQ.1.1 which is dominating there. In India, BA.2.75 is spreading. For a virus or bacteria to evolve is a natural thing to do, to be more successful in spreading itself.
Dengue and malaria will subside in coming months especially in areas where winter will arrive early. However, most of our country faced floods and still standing water will take months for weather to be disadvantageous for mosquitoes. Until then, the government needs to step up their mosquito control efforts. Covid19 cases may rise in coming winter due to waning immunity from vaccinations and our living patterns of closing windows to stay warm.
Pakistan’s health system needs a fresh approach where a serious investment is made in disease surveillance and outbreak response systems. Currently different iterations of these systems are all donor-funded and not a priority area for Pakistani decision-makers. For that reason, we have absolutely no clue what is happening in Pakistan. This results in health policies which are not based on real facts, and precious resources are wasted.
Not just economic security and stability, Pakistan also needs health security where our population is best protected from prevalent diseases to ensure we have healthy minds and workforce. According to Unicef, 10 million children in Pakistan are stunted due to malnourishment. They are more susceptible to diseases and may show lower IQ numbers.
Our negligence to real core issues is making our next generation struggle and we are still engaged in a vicious war of power. Take a break and think about the population you want to govern!
Published in The Express Tribune, October 22nd, 2022.
Like Opinion & Editorial on Facebook, follow @ETOpEd on Twitter to receive all updates on all our daily pieces.
COMMENTS
Comments are moderated and generally will be posted if they are on-topic and not abusive.
For more information, please see our Comments FAQ