The Economist Does a Hatchet Job On Pakistan's Handling of COVID19 Pandemic
By Riaz Haq
CA
In a recent article entitled "Is Pakistan really handling the pandemic better than India", The Economist says Pakistani Prime Minister Imran Khan has "crowed" about his government's handling of the coronavirus pandemic. It also cites an Indian-American professor who says "test not, find not" to raise questions about Pakistan's coronavirus data. Conspicuously absent from the article is any emphasis on the Covid-19 test "positivity rate" that is seen as a key barometer of the pandemic to guide decisions by health officials around the world. Both the tone and the content of the Economist piece smack of a blatant bias.
COVID-19 Test Positivity Rate
The percent positive is exactly what it sounds like: the percentage of all coronavirus tests performed that are actually positive. John Hopkins Bloomberg School of Health describes the positivity rate as " critical measure because it gives us an indication how widespread infection is in the area where the testing is occurring".
Pakistan has been conducting around 25,000 tests per day for several months. While this level of testing is low by global standards, it is good enough to indicate the percentage of population that may be infected. The positivity rate in Pakistan has been below 2% since the beginning of August, 2020.
Hospitalizations
The Economist piece does admit that "the proportion of tests coming back positive was also falling, as were the numbers of people being taken to hospital or being kept in intensive care". But it clearly downplays it while highlighting the low testing rate in the country.
Pakistan government's data and anecdotal evidence suggest that the number of daily deaths from coronavirus have declined to near zero. Hospitals are not seeing thousands of new patients either.
World Health Organization
World Health Organization (WHO) has praised Pakistan's handling of the coronavirus pandemic. It has included Pakistan among 5 countries succeeding against the COVID19 pandemic. In an opinion piece published in UK's "The Independent", WHO chief Dr Tedros Adhanom Ghebreyesus wrote as follows: "Pakistan deployed the infrastructure built up over many years for polio to combat Covid-19. Community health workers who have been trained to go door-to-door vaccinating children against polio have been redeployed and utilized for surveillance, contact tracing and care. This has suppressed the virus so that, as the country stabilizes, the economy is also now picking up once again. Reinforcing the lesson that the choice is not between controlling the virus or saving the economy; the two go hand-in-hand".
Pakistan's Health Chief Dr Faisal Sultan has explained the country's efforts to contain the pandemic in the following words: “We have found significant positives amongst those traced via contact tracing and thus it has impacted on reducing further spread via self-isolation, education and sensitization of the contacts. Quantification is sometimes not easy, but is being analyzed to see if a numerical value could be assigned with confidence.”
Community Based Health Program
“It’s one of the best community-based health systems in the world,” said Dr Donald Thea, a Boston University researcher, talking about Pakistan's Lady Health Workers Program. Thea is one of the authors of a recent Lancet study on child pneumonia treatment in Pakistan. He talked with the New York Times about the study. Published in British medical journal "The Lancet" this month, the study followed 1,857 children who were treated at home with oral amoxicillin for five days and 1,354 children in a control group who were given standard care: one dose of oral cotrimoxazole and instructions to go to the nearest hospital or clinic. The home-treated group had only a 9 percent treatment-failure rate, while the control group children failed to improve 18 percent of the time.
Launched in 1994 by former Prime Minister Benazir Bhutto's government, Pakistan’s Lady Health Workers’ program has trained over 100,000 women to provide community health services in rural areas. The program website introduces it as follows: "This countrywide initiative with community participation constitutes the main thrust of the extension of outreach health services to the rural population and urban slum communities through deployment of over 100,000 Lady Health Workers (LHWs) and covers more than 65% of the target population. The program contributes directly to MDG goals number 1, 4, 5 & 6 and indirectly to goal number 3 & 7. The National Program for Family Planning and Primary Health Care is funded by the Government of Pakistan. International partners offer support in selected domains in the form of technical assistance, trainings or emergency relief."
A comprehensive review of the program has found that as compared to communities not served by the LHWs, the served households were 11% more likely to use modern family planning methods, 13% were more likely to have had a tetanus toxoid vaccination, 15% more were likely to have received a medical check-up within 24 hours of a birth, and 15% more were likely to have immunized children below three years. The improvements in health indicators among the populations covered by the LHWs were not entirely attributable to the program alone; researchers noted that other positive changes such as economic growth, increased provision of health services and better education services helped to enhance the impact. While the program had managed to sustain its impact despite its large expansion, evaluators found that serious weaknesses in the provision of supplies, and equipment and referral services need to be urgently addressed.
The program is now a major employer of women in the non-agricultural formal sector in rural areas, and is being more than doubled in size if budget allocations can be sustained. If universal coverage is achieved, every community in the country will have at least one lady health worker, one working woman and potential leader, who could serve as a catalyst for positive change for women in her community. The health officials say that unlike the mid-1990s, when it was difficult to recruit women because of the minimum 8th grade education requirement, now there are large numbers of women who meet the requirement lining up for interviews in spite of the low stipend of just Rs 7,000 per month. Private sector is also helping the LHW program. Mobile communications service provider Mobilink has recently partnered up with the United Nations Population Fund (UNFPA), Pakistan's Ministry of Health (MoH) and GSMA Development Fund in an innovative pilot project which offers low cost mobile handsets and shared access to voice (PCOs) to LHWs in remote parts of the country. Mobilink hopes to bridge the communication gap between the LHW and their ability to access emergency health care and to help the workers earn extra income through the Mobilink PCO (Public Call Office).
Summary: The tone and content of a recent Economist piece on the efforts to contain COVID19 in India and Pakistan leave little doubt that it is motivated by malice against Pakistan and its leaders. The Economist says Pakistani Prime Minister Imran Khan has "crowed" about his government's handling of the coronavirus pandemic. It also cites an Indian-American professor who says "test not, find not" to raise questions about Pakistan's coronavirus data. Conspicuously absent from the article is any emphasis on the covid19 test "positivity rate" that is seen as a key barometer of the pandemic to guide decisions by health officials around the world.
Here's a World Economic Forum (WEF) video describing the efforts of 5 countries, including Pakistan, to contain the pandemic:
https://youtu.be/uZW9hADNo08
(Riaz Haq is a Silicon Valley-based Pakistani-American analyst and writer. He blogs at www.riazhaq.com)
