This is a guest blog post by APF Pakistan Fellows Laiba Khan, Farva Batool, Daniel Waqar, and Roshan Chudhry providing an update on the tremendous healthcare, educational, political, and economic challenges facing Pakistan during the COVID-19 pandemic. This post is a follow-up to the article the fellows wrote in September 2020.

Vaccine Distribution

The Pakistani government has approved three COVID-19 vaccines for distribution: China’s Sinopharm vaccine, Russia’s Sputnik V vaccine, and the UK’s Oxford-AstraZeneca vaccine, and will begin distributing them to frontline healthcare workers starting in early February 2021. Pakistan will also be participating in the World Health Organization’s COVAX program, which is a project to develop, manufacture, and distribute COVID-19 vaccines, particularly to lower-income countries, although these vaccines will likely not arrive for several months.

The Pakistani National Command and Control Centre recently unveiled a comprehensive plan to administer the COVID-19 vaccine to citizens, which involves an eight-step process for registration and scheduling via SMS. COVID-19 vaccines will be free in Pakistan, but private companies will likely be allowed to sell vaccines as well. The Chinese government will be giving 500,000 doses of China’s Sinopharm COVID-19 vaccine to Pakistan by the end of January 2021 as a “goodwill gesture” between the two countries, and several of China’s vaccines have even been tested in Pakistan.

Given the significant misinformation associated with the COVID-19 vaccine, religious and cultural objections to vaccines, and longer histories of struggling to contain the spread of diseases like polio via vaccines, vaccine hesitancy will be a large hurdle for Pakistan to overcome. A November 2020 poll indicated that 37% of Pakistanis would not get a vaccine once one became available.

Healthcare

On October 28, 2020, the Government of Pakistan announced that the second wave of COVID-19 was hitting the country. During a media interview, Dr. Faisal Sultan, the Special Assistant to the Prime Minister on Health, stated that positive COVID-19 cases had increased to 700-750 compared to 400-450 a few weeks prior. Prior to the second wave, Pakistan was able to control the number of positive cases because its citizens more readily followed the Standard Operating Procedures (SOPs) identified by the government. These practices have lapsed in recent months.

Since the outbreak of COVID-19 in Pakistan, various telemedicine platforms continue to provide online consultation to the patients to save their visit to the clinic. The federal and provincial governments in Pakistan are partnering with hospitals and local healthcare clinics that utilize telemedicine platforms, such as Sehat Kahani, a telemedicine platform providing online consultations to patients across the country. The importance of telemedicine has been highlighted during this pandemic as both a means to control the virus and also in lessening the burden of healthcare workers.

Education

The Pakistani government recently announced the closing of all schools for one month. As the country shifts towards online-learning, Pakistanis face challenges in accessing adequate wifi and reliable supply of electricity. Fortunately, education experts have been paying attention and coming up with innovative solutions to tackle the issue. Even though millions of Pakistanis lack access to Wi-Fi, it is relatively more common and accessible for them to acquire satellite television access. In May 2020, Pakistan added an education channel to standard television programming across the country. Filled with content for students in kindergarten through high school, the programming provides each grade one hour of curriculum per day. While innovative, this approach doesn't address all of the current education challenges. Students still have too many free hours at hand now and their pace of learning continues to lag.

Imtiaz Ahmed, a government school headmaster, believes that it will take months to bring students back to the level they were at when the lockdown began.

He also expects fewer students to return to school as families have to put their children to work for additional income.

Political Situation

During the summer months of 2020, Pakistan received attention in the media and from international health organizations as a “bright spot” in South Asia because it had kept the coronavirus pandemic relatively under check through a number of “smart lockdowns” despite its comparatively weak healthcare infrastructure.

Any semblance of Pakistan’s successful efforts has been shattered, as COVID-19 hospitalizations have doubled in recent months, ventilator use rapidly increases, and cases rise by double digits.

Recent studies show that areas in rural Pakistan, such as Gilgit-Baltistan, face deeper challenges due to the lack of community cooperation with government agencies, lack of awareness about the severity of coronavirus, and insufficient COVID‐19 testing kits. Meanwhile, a number of large gatherings across Pakistan, including rallies by political opposition groups such as the Pakistan Democratic Movement, and the funeral prayers of religious leaders like Khadim Hussein Rizvi, have fueled concerns about widespread community transmission during demonstrations where few wear masks. 

Economic Impact

As the lockdown continues in Pakistan, primary exports such as textiles have declined, GDP growth has plummeted, individuals continue to face income shock due to shuttered business, and experts predict that unemployment rates and layoffs will continue to increase. In early April 2020, the Pakistani government launched the Ehsaas Emergency Cash Financial Relief Program to help vulnerable families in the pandemic, providing much needed financial support to rural and urban communities.

The State Bank of Pakistan cut interest rates for its borrowers in mid June, which eased pressures on businesses facing cash flow problems.

While it was predicted that Pakistan might fall into irrecoverable economic disarray due to the pandemic, the relief programs doled out by the government have helped to stabilize the shocks of the pandemic by providing much needed support for families and small and medium enterprises. The IMF and ADB report that Pakistan’s economy could be back on track as early as fiscal year 2021, with its fiscal deficit and public debt returning to normal levels and GDP growth to normal or even higher levels than before the lockdown.