Dec 27, 2010 - Jan 2, 2011

Health sector is one of the most neglected and low priority sectors in Pakistan. The prevalence of life-threatening diseases is very high in the country particularly in the underdeveloped rural areas of the country. Health concerns are aggravating because of waning per capita income of the people, extreme income inequality, and gender discrimination. Budgetary allocation to the health sector is also not sufficient to ensure basic health facilities to the masses. According to an estimate, 50 percent of total population is living below the poverty line and remote locations of the country have health problems, which have been otherwise nearly overcome in the developing countries.

The health profile of Pakistan compiled by the World Health Organisation revealed disappointing facts about the country, and is a point of concern for the people aspiring to have social and economic progress in the times to come. Pakistan's gross national per capita income is $2,590 in contrast to regional average of $4,821 and global average of $10,307. Adult mortality rate per 1,000 adults (15-59 years) is 204 as compared to regional average 203 and 180 global. Similarly, under-5 mortality rate per 1,000 live births in both sexes is as high as 89 as compared to regional 78 and 65 world average. There are also stark inequalities in health service utilisation across the country. For example, in rural areas 30 percent births are attended by skilled health personnel in a wide contrast to 60 percent in urban areas. Involvement of non-professionals in dealing with birth complexities is a major cause of maternal death. More disappointing is a fact that measles immunisation in 1-year-olds is 30 percent in rural areas as compared to 60 percent in urban areas. Beside other reasons, this is also attributed to the scarce number of health practitioners in the country. Only 7.8 physicians are available in the country for a 1,000 people, as compared to 10.1, an average availability in the region.

Compounding health concerns is a warning by the United Nations Children's Fund (Unicef) that Pakistani children are highly vulnerable to HIV infections if actions are not taken to prevent transmission of HIV/AIDS to children from mothers. Government of Pakistan has introduced the new guidelines to shield the children against the prevalence of HIV/AIDS.

In the wake of the Unicef's warning that advancing HIV prevalence in the children is a danger lurking in Asian countries, the ministry of health has come into the action to set forth the guidelines to nip in the bud the impending epidemic in Pakistan.

The guidelines for care of the children under threat of or affected by HIV/AIDS has been launched by the National AIDS Control Programme (NACP) in collaboration with the Unicef, National Commission for Child Welfare and Development, and Family Health International, to promote the understanding about the ways to prevent the transmission of HIV/AIDS.

The guidelines provide the courses of actions to treat the affected children and deploy the targeted interventions to stave off the HIV outbreak, said Dr. Sajid, National Programme Manager NACP, while addressing the launching ceremony in Islamabad on December 06, 2010.

There are near 100,000 cases of HIV/AIDS registered with the government from nationwide, according to an estimate by NACP. But, the pandemic is "showing a sign of advancing from a low prevalence/emerging epidemic to a concentrated epidemic in the near future", cautioned a Unicef's report.

Especially, children are more vulnerable to fall prey to the retrovirus transmitting from their parents. "The face of the children is hidden among the adult population," underscored Bettina Schunter, Unicef Pakistan HIV Specialist.

He said, "The rate of HIV infection among the general population in Pakistan is still below one percent, however, this figure could increase dramatically if unified actions are not taken and preventive measures put in place to keep the killer disease in check."

In past also, Unicef has extended supports to the Pakistani government in devising clinical and paediatric guidelines as well as the national strategic framework for the prevention of the parent to child transmission of HIV.

Similarly, foreign and local health ventures are also endeavouring to inhibit the horizontal transmission of HIV so that under five-year age mortality rate can be controlled. However, at present, majority of children, born HIV-positive, pass away before reaching five.

One of the chief reasons is obviously inadequate national health budget. Total per capita expenditures on health are scantily USD18 including USD4 by the government, in a quite variation to the internationally recommended USD45.

Government spends a little more than two percent of gross domestic products on health sector and total expenditure on health per capita is $51. Without progress in the health sector, access of masses to basic health facilities is not possible. There is a need to focus on overcoming health issues and diseases. HIV prevalence in born baby is an ominous danger that needs to be nipped in the bud. WHO stresses on measures to ensure universal access to HIV/Aids prevention, treatment and care. It has already developed health indicators to monitor interventions for women and children in collaboration with Unicef to prevent HIV infection in pregnant women, mothers, and children.

Government have to increase health budget to prevent outbreaks of life-threatening diseases and save population from emerging health risks. Sanitation is least bothered about in most of underdeveloped locations. Society, as a whole, is equally responsible for it. Giving male importance over female counterparts is also reason behind disparate access to health services. There is also a need of educating people about the risk of HIV/AIDS in children, especially in areas, which are hotbeds to such prevalence. Carelessness is a main reason and suburban and peri-urban areas can provide grounds to the 'silent killer' to sprout. It is a job of both government and private sectors to come forward to educate the people. (TS)