Drugs, infection control in provincial hands

Fate of major health programmes and thousands of health employees hangs in the air after passage of 18th amendment.

ISLAMABAD: The fate of major health programmes and thousands of health employees hangs in the air after the passage of the 18th amendment by parliament.

With increased provincial autonomy, there are concerns on whether the provinces have the capacity to handle some of their new responsibilities as thus far they have only been involved in implementation of health initiatives and not in planning.

“There is some work going on in terms of the implementation of the 18th amendment and its impact on the ministry. Two areas, drugs and infection control, are our top priority. We are negotiating with the provinces and assessing their capacity. The implementation committee is working on a transition plan and we are looking into the consequences,” said the health minister’s secretary Khushnood Akhtar Lashari.

National programmes such as the one designed to control drugs may suffer immensely after the amendment is implemented. The programme is responsible for price control and to maintain a standard quality of drugs throughout the country. The export of drugs will also be affected. Where some provinces will manage to keep up with new responsibilities, others may suffer as the same expertise is not found  everywhere.

The issue of donor coordination will also arise, due to which imports may be affected. At present, international donors deal with one central authority but after the implementation of the 18th   amendment each province will have to be dealt with individually. Similarly, medicine suppliers will also have to contact each province separately.

Another programme which may suffer is of the lady health workers. Currently there are 100,000 lady health workers working under the programme and 5,500 serving under the mother and newborn child health programme. When devolved to the provinces their roles and responsibilities will be revised and need to be redefined.

The federal mechanism to monitor epidemics is also under threat. It is unclear whether provinces will be willing to take everyone on board or not. “Besides the adjustment of employees, the provinces are also asking for funds to facilitate them and cater to their problems,” said the official, adding that, “we are in a state of utter confusion and the 18th amendment is the recipe for the disintegration of Pakistan,” the official added.

Officials in the health ministry say that there are concerns about their future as people employed on the basis of provincial quotas may lose their jobs. “There will be 17,000 people unemployed in January,” said an official. “It’s going to be a massive mess,” he added.

Published in The Express Tribune, October 29^th, 2010.