A National Health Policy

On the 14th of January 2022, the prime minister of Pakistan launched the country’s first national security policy. This comprehensive document covers all aspects of human and national security and has presented policy options, challenges and statements of intent on almost all matters of national interest.

A cursory look at the policy reveals the level of efforts put in to provide a reasonable shape to this document. The team and all stakeholders engaged in the process deserve appreciation for this gigantic work.

It is indeed a big leap forward that citizens have been placed at the epicentre of national policy development. The document has aligned both state and human security in a way that will have major dividends for the state and its citizens if adequately implemented.

The document contains eight sections. In the first section, conceptual elements of Pakistan’s national security framework have been mentioned. In section II, six thematic sections with desired goals and objectives are mentioned. Section III mentions ‘national cohesion’, emphasising the preservation of ideology and culture, thus making public service responsive to the needs of citizens. Section IV focuses on economic security, specifically trade, energy, education and emerging technologies. Section V provides policy guidelines for ensuring defence, deterrence, territorial integrity, and space and cyber security.

Section VI focuses on ‘internal security’ and examines challenges of terrorism, violent sub-nationalisms, extremism and organised crime. Section VII is on foreign policy and assesses global realignments, Pakistan’s key bilateral and multilateral relationships, and overall approach towards diplomacy. Section VIII is about ‘human security’ and examines population and migration, health security, climate and water security, food security, and gender balance.

Of significant importance is the shift that it has brought in policymaking, by moving from geostrategic to geo-economics, state-centric to human-centric, reactiveness to proactiveness, from one entity to the whole-of-government approach, and from silos to inclusiveness.

For now, let’s zoom in on the much-ignored health security domain that the document has briefly referred to. The health of the population is the result of the state’s health, economic, political, environmental, security, food and communal policies.

Health becomes a national security issue when diseases cross borders and engulf a wider spectrum of society, rendering the system helpless. Therein, it requires the ‘whole of a national approach’. This was exactly Pakistan’s response when Covid-19 struck; the formation of the National Coordination Committee and the NCOC were steps taken in the right direction.

This civil-military coherence led to astonishing results especially when our health systems and strategic capacity in comparison to other developed countries were pretty meagre.

The 21st century can be rightly called the century of the virus. From polio to HIV/AIDS to Ebola, Zika, SARS, MARS and now Covid-19, viruses have eroded the whole spectrum of humanity at large; not only health but the economy and national security of nation-states as well.

The world saw how the most developed health systems like those of the US, Italy and Germany were shaken by the coronavirus epidemic. The other key threat to health security is frequent virus mutation, rising drug resistance and other zoonotic diseases. Threats of chemical, biological warfare and bioterrorism pose key risks to world peace. Burgeoning globalisation poses another threat to global health security; a disease at one corner can reach the other in the shortest possible time.

The policy paper briefly mentions health security, focusing on enhancing national capacity for surveillance and health emergency response. Some generic statements on nutrition, Sehat cards and Covid-19 have also been referred to.

But it lacks the key national policy guidelines required for the development of a secured health system in Pakistan. Despite the recent pandemic- not much has been put in for the development of a robust preparedness and response capacity. The kind of global health security apparatus required is unfortunately still a far cry.

Even a dedicated focal person for global health security hasn’t been notified, so the national action plan for the global health security agenda is staggered, to say the least.

Taking a cue from the national security document, the health ministry should redraft a comprehensive national health security plan and develop a mechanism to ensure its seamless implementation. This is one of the most cost-effective and efficient interventions that the health industry can have.

In the health emergency domain, three vertical EOCs are functioning – one for polio, the other for Covid-19 and the third for public health emergencies.

In the interest of resources and impact, the investments in all three vertical programmes must be integrated into one centre of excellence for an overarching ‘National Health Security’, with various vertical arms. This is a zero-cost but high-return intervention, merely a matter of political will and leadership.

The division of labour at the ministry may be redefined to allocate dedicated senior-level leadership and technical resources to health security. This bifurcation of the ministry would save money and time and enhance our preparedness for better emergency response.

Risk analysis and risk mitigation strategy must be developed for the implementation of this policy document. In a good development sector paradigm, such policy statements then require the concerned ministries, departments and sectors to develop meticulously strategic roadmaps, a detailed implementation action plan with timeline, indicators and resources.

There should be the development of a monitoring framework, initially by the national security division as a whole, and then subsequently by the concerned departments and ministries, so the implementation of this national policy can be monitored.

A live dashboard for overseeing the implementation of this national policy should be projected at the PM Office to monitor the implementation status in real-time.

Joint monthly reviews by all stakeholders, with the PM in the chair, would provide a political boost; the same mechanism with some modifications may be implemented at the provincial level as well. In the interest of stringent accountability, the development of an exclusive accountability framework would help in the smooth implementation of this cherished policy.

The National Security Policy has set the course for progressive, out-of-the-box strategic thinking and fills in the national spiritual and psychological vacuum, much required for taking this country where it is destined for.

The writer is a health and development expert, who has had an illustrious career with UN, USAID, World Bank, Gates Foundation, and various governments.

Email: [email protected]

Originally published in The News