Pakistan: Measles and Weasels

By HUMA YUSUF

Pakistan is currently threatened by a measles epidemic. According to the World Health Organization, 103 children have died from pneumonia and other measles-related complications between Jan. 1 and 19. In Sindh, the worst-hit province, 66 deaths have been recorded this month; in Baluchistan, 33. In Punjab, Pakistan's most populous and politically influential province, the toll is only up to nine. Yet in addition to sparking fears of a health crisis, these deaths are already raising questions about the electoral prospects of the Pakistan Muslim League-Nawaz (PML-N), which forms the government of Punjab and, on the national level, is the leading opposition party to the Pakistan Peoples Party, or P.P.P. With a general election just months away, the leaders of Punjab don't want to be accused of failing to provide health care - again. And so even as the Punjabi government has played down the risks of a measles epidemic, Shahbaz Sharif, a PML-N leader who is both Punjab's chief minister and the head of the province's health ministry, has promptly taken action to prevent the spread of the disease. The provincial government has launched a public-awareness campaign, stocked up on vaccines, lowered the recommended age for inoculating children and tasked local officials with monitoring outbreaks. Sharif isn't taking any chances. In late November, the adviser to the prime minister on human rights called for Sharif's resignation on the grounds that, "No one in the Punjab government has taken responsibility of the utter failure and lack of governance, especially in the health sector." This criticism stems partly from political opportunism: The adviser is allied with the P.P.P., which is expecting fierce competition from the PML-N at election time. But it also is deserved. Late last year more than 40 people across Punjab died after consuming a toxic cough syrup produced locally. In early 2012, scores of patients died after being prescribed contaminated heart medication at the Punjab Institute of Cardiology, a provincial government facility in Lahore. The previous year an epidemic of dengue fever killed 247 people. Meanwhile, the Health Department of Punjab has been embroiled in a labor dispute with the Young Doctors' Association, resulting in major doctors' strikes. Not surprisingly, the PML-N's rivals regularly cite these failings as proof of the party's inability to govern. Also not surprisingly, Sharif doesn't want his handling of the current measles outbreak to become one more item on their list. And so he is trying to replicate his one big success of last year, when his department managed to curb a dengue fever epidemic: The number of reported cases fell from 21,000 in 2011 to approximately 250 in 2012. Of course, Sharif's swift action against the spread of measles doesn't amount to a serious effort to revamp Punjab's collapsing health sector. The patients are just lucky that what's good for the politicians happens to be good for them, too.