ISLAMABAD: The Asian Development Bank (ADB) has recommended to Pakistan for putting in place legislation, protocols and funding sources to facilitate the rapid mobilisation of coordination centres in response to major disasters.
The bank in its latest report, “The Enabling Environment for Epidemic and Pandemic Risk Financing in Pakistan”, also recommended to review the current allocation of contingent funds for disasters, pandemics, and epidemics at the provincial level.
A risk layered structure is proposed to stimulate, develop, and implement financially sustainable and scalable disaster risk financing strategies and solutions, it added. The bank has recommended for providing targeted investments in the health system to reduce epidemic and pandemic risk.
The report noted that neither the federal nor the Khyber Pakhtunkhwa SehatSahulat Program (SSP) have funds allocated for responding to pandemics/epidemics. It recommended to include coverage for pandemics/epidemics in the SSP package and price actuarially for pandemic/epidemic cover when purchasing insurance for the SSP. Implement the federal SSP planned reserve fund to finance any unforeseen health care emergency or catastrophe and revise the benefits package to include pandemics/epidemics.
The country’s health spending per capita ($34) is the lowest among its neighbours, yet out-of-pocket payments are high at 54 percent. The government’s health provision system is weak, leading to 85 percent of total health expenditures being incurred in the private sector by patients across all wealth quintiles.
Pakistan is a lower-middle-income country with a population of 207.8 million, as per the 2017 census. By 2030, its projected population will be 263 million. In fiscal year 2021, Pakistan had a tax-to-GDP ratio of 9.4 percent, with 62 percent of tax revenues derived from regressive, indirect taxes. The country spends around three percent of GDP on healthcare, of which, 1.8 percent is private and 1.2 percent is public spending, it added.
Provide targeted investments in the health system to reduce epidemic and pandemic risk. It is essential to make the health system more resilient by filling the human resources gaps, especially of nurses and paramedics. A strong Integrated Disease Surveillance and Response system and a network of public health laboratories across the country
is needed.
Existing data systems are fragmented and not integrated and the data system for Covid-19 case reporting had to be set up ad hoc during the pandemic. Further collaboration with the private sector, better integration of the private sector in the country’s health system and governance, and enhancement of the digital health infrastructure according to the national digital health strategy is needed. Pakistan is still struggling with the comorbidity data because routine data is captured by vertical programs and hospitals, without integration. It needs to structure the health data according to the International Classification of Diseases coding system, the report noted.
The bank recommended for considering multiyear business interruption insurance that includes epidemics and pandemics from specialised insurers for the government budgets to allow for supporting businesses.
Copyright Business Recorder, 2024
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