Non-existent health regulation plagues Sindh

Express Tribune

05-04-2025

In 2005, the last health policy was formulated in Sindh, which concerned the prevention and control of communicable and non-communicable diseases, improvement of maternal and child health, control of malnutrition, establishment of a district health system, regulation of private medical institutions, improvement of medical education, establishment of school health service, and control of illegal use of medicines. After the 18th Amendment, the formulation of a health and drug policy came under the purview of the provincial government.
Unfortunately, however, despite the passage of 20 years, the Health Department of Sindh has not been able to formulate a new health policy. During this time, the people of the province have consistently been plagued by infectious diseases and seasonal epidemics including chikungunya, crimean-congo hemorrhagic fever, malaria, dengue, HIV-AIDS, hepatitis, tuberculosis and Covid-19. Although trillions of rupees are released annually for the vertical programs of the Health Department, the lack of a health policy in the province is a clear reflection of the poor coordination among the stakeholders in the public health sector.
According to Dr Ikram Sultan, Former Director of Health Karachi, the failure of the government to devise a health policy meant that the Health Department was running on an ad hoc basis, and no targets could be set for the elimination of diseases from the province.
"Under a health policy, a time frame is set for the elimination of various diseases and then at the end of the year, the targets are reviewed to see what percentage of the disease has been controlled. Unfortunately, the people of Sindh are forced to live under the influence of various viruses every month and throughout the year. Establishing a healthy society has become a dream. Until or unless, data of diseases is made available, no target can be set for their treatment and eradication," said Dr Sultan, who went on to add that there was no drug policy in Pakistan either.
On a separate note, Dr Greesh Kumar, a health expert highlighted the fact that in the absence of a health policy, the infrastructure of hospitals and primary health centers running under the Health Department was also severely affected. "Conversely, public health problems have worsened due to which the pressure of patients at large teaching hospitals has become unmanageable. Therefore, often times patients do not get proper medical attention," revealed Dr Kumar.
According to a survey conducted by The Express Tribune, there is no centralized system for collecting data of patients and diseases across various government hospitals. At present, there is a Health Secretary in Karachi, Director of Health Karachi and other district hospitals however, the second important secretariat of the Health Department is established in Hyderabad, which is named the Director General of Health Sindh. The surprising part is that in order to attend the meeting held in the DG office, the staff members have to travel to Hyderabad, which wastes time and fuel.
On the other hand, no steps are being taken to improve the healthcare services and facilities at hospitals running under public-private partnerships. Where on the one hand there is a dearth of modern technology, on the other hand the Health Department is constantly facing a shortage of medical staff. Furthermore, there is a lack of government-level training to adapt the staff to modern requirements while no medical research centers are available to address health problems at the primary level.
Hence, a strong health policy is essential for the establishment of a healthy society. Not only will a health policy expedite the eradication of diseases but it will also improve the overall public healthcare system in Sindh.