Prevention is better than cure

The irrational use of medications and negligence of hygiene or precautionary measures by people, abrupt or insufficient supply of healthcare necessities, and lack of effective proactive steps by the government remain prevalent during epidemics in Pakistan.

As soon as a disease or an epidemic surges in Pakistan, its curative agent either becomes unavailable or unaffordable in the country. In 2020, the pharmacies of Pakistan ran out of chloroquine after certain positive outcomes of this medicine were reported during Covid-19 clinical trials as a prophylactic therapy. As a result, chloroquine, which is an approved medication for the treatment of malaria, was neither available to prevent Covid-19 nor to treat malaria. Be it the dengue outbreak in 2022 when this country faced extreme shortage of paracetamol to now in 2024 when the increased demand for blood platelets for dengue overtook their supply, as well as escalated prices of commercially available herbal treatment by Carica papaya leaf extract. Chikungunya, with no disease-specific approved medication till today, carries symptomatic treatment. Hence, the chikungunya outbreak did not face any medication shortage for treatment, but in 2024 the emergency rooms and wards of major hospitals in Karachi were overfilled and led to space constraints for further admissions of suffering patients.

As per the data from the European Centre for Disease Prevention and Control, the estimated number of chikungunya cases worldwide till 30th September 2024 were 460,000 and associated deaths were 170. Amongst them, Pakistan reported 2,447 chikungunya cases. The annual increase in the number of mosquito-borne disease cases in Pakistan is a matter of immense governmental concern. A government spokesperson says the government has carried out several sprays against mosquitoes, larvicidal activities and awareness campaigns, but the question arises about why these activities are done after the extensive spread of these diseases. The heaps of garbage, stagnant water after rain, dirt from unwanted animal organs after Eid-ul-Azha and undrained sewage remain neglected for most of the year. These factors are responsible for giving rise to mosquitoes and other vector-borne diseases. Moreover, the sprays by governmental authorities against mosquitoes and other insects are not done periodically in every area of Pakistan.

Post-chikungunya pain and inflammation is so severe and persistent that most people are seen to irrationally use various medications that can lead to severe health threats. Be it allopathic, homeopathic or herbal treatment, people are blindly using the medications on verbal recommendations by non-healthcare individuals for good results against chikungunya without consulting any physician. People are ready to waste money as much as they can to treat chikungunya and its after-effects, but among them, numerous people are those who prioritise precautionary measures such as personal and environmental hygiene as secondary parameters throughout the year. And then these people put the whole blame on the government authorities for their environmental and medical-related issues.

It is high time for both the government and people to play their respective roles all the year round because none of them is solely responsible for such situations. Cleanliness of the environment must be assured by both at their ends. The government must periodically arrange awareness campaigns for people for all major healthcare concerns. The insecticidal sprays must be done from time to time across the country. Proactive measures against epidemics and seasonal challenges related to health must be a part of national healthcare strategies, and they must be well-implemented. People must promote the practices of personal hygiene, precautionary techniques and cleanliness of their homes. They must also rationalise the use of medications by consulting physicians for their diseases and taking counseling points about the mode of medication usage by pharmacists for their safety and well-being.