Global·NewlyNewsPK

The shrinkage of Pakistan’s aid chart

PK · · Dawn Pakistan

Measles in the US, a cholera outbreak in the DRC, TB patient registration drops in Cambodia, Kenya, and Mozambique and closer to home, HIV outbreaks in children have all been linked to what doctors have warned are cuts to programmes and disastrous policy changes. Global funding has shrunk for healthcare across countries that need it the most which is why experts in Pakistan are really getting worried. The effects are immediately clear on the ground. In the busy streets of Lyari, Karachi, Amna Sualeh once navigated confidently through her community as a health worker with the Greenstar Social Marketing’s Sitara Baji (star sister) programme. Women trusted her to provide affordable intrauterine devices (IUDs), counselling on how to space out their children, and basic reproductive health services. “Before, with donor support, we could perform IUD insertions for just Rs500,” she says. “Now it costs up to Rs10,000 in private clinics. Many simply can’t afford it anymore.” Her clients, mostly working-class mothers, have begun skipping visits or turning to unsafe alternatives. As Pakistan’s macroeconomic crisis stretches out, many women have stopped coming altogether as their incomes have shrunk. This refrain is repeated across the provinces as overseas development assistance, once an indispensable backbone of the country’s public health system, contracts sharply. While not a principal focus of the global conversation on the impact of the Great Aid Recession , Pakistan enters the second quarter of the 21st century with its health system already stretched thin. It spends just 0.9 per cent of its GDP on public health, far below the WHO’s 5pc benchmark for universal health coverage. Life expectancy is 67.3 years, which is four years below the South Asian average, and conversely, infant and maternal mortality remain stubbornly high at 50.1 deaths per 1,000 live births and 155 deaths per 100,000 live births, respectively, more than double the rates of neighbours s...