"Health is like money; we never have a true idea of its value until we lose it."- Josh Billings
The COVID-19 pandemic, a catastrophic event, has made the whole world realize the significance of good health, making it more valuable than money. Many countries' inadequate response to this pandemic has revealed that health is often a neglected human right. These countries, including Pakistan, see the current outbreak as a crisis devoid of human rights considerations. Though the number of cases in Pakistan have reduced to a great extent, experts predict a devastating second wave due to negligence on the part of people. Pakistan's efforts against the first wave of COVID cases were impressive; with the incorporation of the human rights approach into this, the situation will be even more promising.
Health – A Fundamental Human Right
The right to health, or more formally, the right to the highest attainable standards of physical and mental health, was first recognized in the 1946 WHO Constitution. Pakistan's constitution also provides its citizens with the right to health under the right to life article. In a constitutional sense, rights protect citizens from the arbitrary use of powers by the state. However, as far as Pakistan's COVID response is concerned, the government has acted at its discretion. This action is justifiable initially because the country was in a state of emergency. But, to tackle any second wave, the government must engage the medical and epistemic community at all stages of the ongoing COVID response. It must caution the general population to be constantly vigilant.
The International Covenant on Economic, Social and Cultural Rights, of which Pakistan is a signatory, explicitly mentions "prevention, treatment, and the control of epidemic, endemic, occupational, and other diseases," as a fundamental right of people. Though the government is lauded for its performance in the first wave of the COVID cases, for the coming second wave, the government must not let its guard down. It must not be negligent; it must act as soon as the wave arrives to avoid any human rights violation.
Right to Health – Absolute & Universal
The right to health is not just universal but also inclusive. Pakistan's COVID response must cover all socioeconomic groups equally and fully. The fact that some hospitals are more equipped than others creates disparities. Rich and urbanites can access better services than the poor and rural citizens of the country. Private hospitals and testing facilities are providing the fastest COVID test results as compared to their government counterparts. Women – a demographic often left out from benefitting from the country's resources – need to be particularly included in the COVID response coverage. Special arrangements must be made for pregnant women who are vulnerable and at risk of death and injury due to a disruption of services during this response. Many pregnant women have suffered due to the temporary closure of Outpatient Departments (OPDs) – which are designed for people who visit hospital for diagnosis or treatment, but do not at the time require a bed or to be admitted for overnight care. Providing coverage to every socioeconomic group will make Pakistan's COVID response both just and equitable.
Health – A Right Compromised
Under the right to health, people are entitled to a robust system of health. Unfortunately, Pakistan never had one as healthcare was never seen as a priority. This fact can be deduced from the meager amount of funds the country has allocated to its health sector since its independence. According to the Pakistan Bureau of Statistics, in 2018, there were only 132,227 hospital beds in Pakistan and a total of 218,125 registered doctors for a population of more than 200 million. It is therefore no small wonder that Pakistan is listed as one of 57 countries with critical health workforce deficiency, with a doctor to patient ratio of 1:1300 as against the required 1:1000. The current government has shown the will to increase the health budget by introducing special COVID relief funds. At the same time, the pandemic has generated a favorable political will for a robust health system in Pakistan—undoubtedly a silver lining in the clouds. The country must not squander this moment. Now is the time for fundamental change—the way it should have always been.
The entitlement to access essential medicines has also been severely compromised during these challenging times around the world. Medicine prices have soared, and black markets for obtaining blood plasma and oxygen cylinders have abounded. In the recent past, Pakistan had an elaborate abortion black market, which put women's reproductive health in jeopardy. With the non-availability of these services, these players have once again become active. The government acted in case of price rise, but the situation is still not under control. More effort must be directed towards this to improve the human rights conditions.
Fixing a Right Gone Wrong
Contrary to popular belief, strengthening the health system is not a time-consuming process, and the current pandemic has provided the ideal opportunity for doing so. The starting point for this lies in making health government's top priority and having more funds allocated for the same. Fortunately, the government has shown favorable signs to manifest this course of action. One of the easiest ways to improve the health of a nation is to work on the health of mothers and children. When a woman's right to health, especially maternal health, is upheld, the better health of a country's future generations is automatically guaranteed. Prioritizing maternal and child health is a definite win-win both in the short and long term.
In a nutshell, making Pakistan's COVID response, human rights-based is the only way to effectively handle a second wave of the pandemic. The government must consider the improvement of the country's health sector not only as its top priority but moreover its essential constitutional responsibility. For it is only by doing so that the country can look towards a future where its citizens are safe from this and any other similar crisis in the future.