Sep 17 - 23, 20

In Pakistan, several positive developments in recent years, such as the 18thAmendment to the Constitution and the 7th NFC Award, have addressed a few long-standing grievances of the people concerning provincial autonomy (both fiscal and administrative), judicial appointments, and independence of the election commission. The media including print, electronic and social networks have developed into a strong institution over the last one decade. These are all promising developments from the point of view of people's empowerment in the country.

Yet all the trappings of political, economic and social governance have not been able to deliver political voice, economic growth or social justice to the vast majority of the Pakistanis. While the parliament has debated at length on issues concerning defence, national security, corruption, energy and social-spending, efforts have been minimal in actually doing something about these issues or implementing the laws that the Parliament has passed. Similarly, in the case of the judiciary the lower courts have not been able to provide justice to all, especially the poor.

On the economic front, often the institutions have not been successful in generating adequate economic opportunities. Though there has been an increase in pro-poor and social protection expenditures, development expenditure has remained a fraction of current expenditure. Despite various reforms, successive governments have not been able to raise revenues or curtail state expenditures, resulting in high budget deficit and debt burden. Most tax revenue comes from indirect taxes, with less than 2 percent of the population paying direct taxes.

Notwithstanding the government's goals to reduce inflation, weakness in monetary management of the economy has proved to be truly disempowering for the poor. The State Bank, despite being an autonomous institution, has been unable to implement non-inflationary monetary policy due to heavy government borrowing. This scenario of low growth, high inflation and insecure energy supply has translated into increased poverty.

The government has not released official poverty estimates since 2005. Our estimates, based on a wider definition of poverty of opportunity, indicate that poverty in Pakistan is around 29 per cent. However, during the last few years the government has increased its efforts to address poverty by increasing spending on social protection programs such as, Benazir Income Support Programme (BISP).

Recently, Pakistan has seen some positive developments, especially on the education front. The constitutional changes in the country brought about by the 18thAmendment have led to the recognition of education as a fundamental human right to be provided by the state. The country has also pledged to commit at least 7 percent of its GDP to achieve its MDG and EFA goals universal primary education by 2015. Pakistan's leaders also declared the year 2011 to be Pakistan's year of education, signaling that across the board reforms should be implemented to improve access to education for all.

Yet, all these commitments for reform, policy proposals and constitutional changes on paper have failed to empower people. Weak administrative structures, low budgetary allocations and even lower utilization and poor quality of education are key governance impediments to improve public sector delivery of education and health for the vast majority of Pakistanis.

While the government has made some efforts to prioritize education in the policy agenda, public sector delivery of healthcare is still waiting for policy attention. Access to health is perhaps the biggest challenge for people's empowerment in Pakistan. The country is faced with the double burden of communicable and non-communicable diseases on the one hand, and the increasing incidence of new diseases like HIV/AIDS.

There are considerable disparities in access to and quality of both education and health services between rural-urban areas and based on gender and income lines. The increase in income and wealth disparities over the last decade has further exacerbated such inequities and resulted in a growing share of private, out of pocket financing of both education and health.

The institutional machinery for the public sector delivery of education and health in Pakistan largely exist, the problem lies in its effectiveness to deliver. For the education sector, weak management and lack of accountability have resulted in poor quality of inputs in the education system leading to poor outcomes. Health system governance is burdened with parallel structures with overlapping responsibilities and authority resulting in duplication, wastage of resources, and high administrative costs. The recent dissolution of federal structures in the health system have raised important concerns for health sector governance in the country, especially with regard to the future of the vertical programs and various international commitments, many of which have been critical in improving health outcomes for the country.

The private sector in the country has got some of the well-endowed and best-managed education and health service delivery institutions in the country. Their contribution must be recognized and appreciated along with the fact that there is no lack of management capability in the country. So why is it that the public sector which provides education and health to the vast majority of the population is performing so poorly at a time when there is increased awareness among people about what should be done about such poor governance? Here, I refrain from suggesting any solutions. Solutions are all there in the numerous policy documents, as well as in our report. They only need to be implemented, and properly monitored and evaluated.

Country Presentation on Pakistan at Launch of SAHDR 2012, 14th September 2012.