The political economy of the dengue epidemic

Punjab Chief Minister Shahbaz Sharif is doing the right thing lending himself to a high-profile campaign against the dengue mosquito wreaking havoc in his province. Statistics show that the female dengue vector has so far killed 99 people in Lahore alone and is gradually spreading. Across the border, Indian Punjab doesn’t seem to be affected so far, as if the dengue mosquito is ideologically loaded against our Two Nation Doctrine.

According to the most recent official figures, Punjab has 10,585 dengue-affected people, and 9,000 of these are in Lahore, which is unfortunately high enough for it to be called an epidemic. The result is a severe burden on the city’s hospitals and a rise in demand for medical care, mosquito repellents and even platelets (which fall sharply in the most serious dengue cases). The result is acerbic TV comment on a negligent government’s dereliction of duty and the PPP opposition’s unthinking back-biting in the provincial assembly. The truth is that Punjab like the rest of Pakistan is not equipped to handle a sudden upsurge of disease — any disease — especially one that has no cure. Fighting dengue, as a team of Sri Lankan doctors recently informed their counterparts in Lahore, can take years and requires a well-thought out and detailed plan of action. Pakistan is set apart from India and Sri Lanka where dengue has been laying the masses low for the past 20 years. The difference is Pakistan’s tumbling finances and a low economic growth rate. If it requires expensive preventive campaigns it has to borrow money and an affected Punjab is already groaning under an overdraft from the State Bank. The war against terrorism, which is said to be not Pakistan’s but America’s, has hollowed out the country’s coffers in lockstep with natural calamities, just as our military establishment is busy isolating Pakistan from its possible aid donors. Hence, Pakistan’s low response to the contagion has a part socio-political explanation as well.

But Mr Sharif’s response to the calamity is praiseworthy, given his disadvantages. He is personally lending his profile to the campaign and motivating others despite a shortage of spraying machines and parallel lack of stored medicine. He has acted against profiteering in the pharmaceutical market (with medical stores and laboratories that charge exorbitantly immediately closed) and has laid plans for an effective information campaign that will tend to lessen the bite of the disease when it returns with redoubled intensity in the years to follow. He will need to return Punjab to its clean-up routines that the local governments have abandoned. In Lahore, at least, vast areas with dense population have been covered with free examination of patients suspected of having caught the dengue infection, but more needs to be done.

In the category of ‘more that needs to be done’ is the return of local governments in Punjab. Shahbaz Sharif should go vaulting over the narrow consideration of keeping the rump PML-Q out of business and announce the holding of local bodies polls in the province. The benefits he will get will far outweigh any political advantage. Once the local governments are in place, the chief minister will be far better equipped to orchestrate his response against the dengue fever. He should realise that next year big cities other than Lahore, like Multan and Faisalabad, will fall sick and present him with a nightmare he cannot even imagine. The outreach of the local government is required urgently to tackle the dengue challenge and this has been made more than amply clear by the experience of the floods. When the TV channels go out to cover those affected by the floods, the state is nowhere to be seen.

India and Sri Lanka have learned to live with dengue on the basis of their local outreach in the countryside and city corporations in the urban areas. This is what Punjab needs and it can be achieved through devolution and not through concentration of power in the provincial capital. Let Shahbaz Sharif do the unusual thing and break the ranks of other chief ministers by putting in place authorities that will respond to his diktat against flooding and against the dengue mosquito.

Published in The Express Tribune, September 30^th,  2011.