Monday, June 24, 2019
#Pakistan - Health of the budget - The Punjab government has reduced the health budget by Rs5 billion
Shehryar Warraich
Contrary to its claims, the Punjab government has reduced the health budget by Rs5 billion, which is a worrying concern.
In its recently announced annual budget, for the fiscal year 2019-20, the Punjab government allocated Rs279 billion for health sector. While the government claimed that the allocation budget was up by 20 percent from the current fiscal year (which ends June 30), the fact is that the caretaker government had allocated Rs284 bn for health.
To put it in other words, the Pakistan Tehreek-e-Insaf led provincial government has reduced the health budget by Rs5 bn. Moreover, some important healthcare programmes seem to have been overlooked completely.
The highlights of the health budget include setting up a children’s hospital in Bahawalpur. Besides, Rs3.5 bn has been assigned for revamping the Tehsil Headquarter (THQ) and District Headquarter (DHQ) hospitals across the province. Rs1.5 bn has been allocated for provision of free medicines to patients of hepatitis; at least eight hospitals are being set up in Layyah, Mianwali, Lahore, Rahim Yar Khan, Rawalpindi, Dera Ghazi Khan, and Multan; and Rs12 bn is to go to free drugs and healthcare services. The Sehat Card programme is also to be expanded to 36 districts of Punjab, with an allocated budget of Rs2 bn.
Quality of healthcare services needs to be improved.
The Punjab government manages a large number of health related facilities, be it teaching, research or tertiary. There are six universities, 11 colleges, 46 tertiary health facilities, 45 nursing colleges/schools, and numerous other institutions for allied services. As far as the primary and secondary healthcare facilities are concerned, Punjab boasts 32 District Headquarter Hospitals, 126 Tehsil Headquarter Hospitals, 316 Rural Health Centres (RHCs) and 2,506 Basic Health Units.
“Until recently, most of these facilities were poorly funded and managed, and lacked adequate staff and facilities,” says Mukhtar Ahmed Ali, a health expert and the founder director of Centre for Peace and Development Initiatives (CPDI).
Ali also speaks of presenting a Shadow Development Budget for the Punjab’s health sector. “Unfortunately, the FY2019-20’s health budget doesn’t offer much to improve the current health facilities,” he adds.
It is pertinent to mention here that in its manifesto for 2018-23, the PTI had promised to “ensure universal health coverage and enhance the focus on primary healthcare, while upgrading secondary and tertiary facilities; to upscale the Sehat Insaf Card Programme across Pakistan; double the size of the Lady Health Workers (LHWs) programme; increase the number of 24/7 BHUs and RHCs, equipped with basic package of services; establish training institutes for nurses and paramedical staff nationwide; upgrade secondary care facilities; and build state-of-the-art hospitals in major urban centres.”
For Ali, “Factually, the first health budget is not a true reflection of the promises made by the PTI in its manifesto. With the allocation of Rs3.5 billion a large number of primary and secondary health facilities would remain under-resourced.
An expert on SDGs, and the Chief Executive of Awaz Centre for Development Services (CDS) Zia Ur Rehman says that after the 18th Constitutional Amendment in 2010, under the international commitments, 99 indicators of the SDGs shall be implemented by the provincial government.
“It is important to allocate sufficient budget to set up more facilities across the regions, to further improve the quality of services and management in existing facilities, and to lessen the burden at the tertiary level which is not only concentrated in large cities but also inaccessible for the poor or those based in remote areas.”
Apart from the regular facilities, the Punjab government is managing a number of disease prevention programmes aimed at controlling different types of ailments such as Hepatitis, AIDS, Tuberculosis (TB), Integrated Reproductive, Maternal, Newborn & Child Health (IRMNCH), and the Nutrition, Malaria, Immunisation and Infection Control Program.
“Preventive healthcare strategies must be a priority area for any government,” says Dr Ashraf Nizami, Central President, Pakistan Medical Association (PMA), “because the schemes are designed to avert any incidence of diseases at the primary level.
“Reduction in health budget is a matter of concern,” he declares.
The government has allocated Rs40 bn for setting up new hospitals and upgrading the Children’s Hospital, Lahore, to the status of a medical university. The PMA appreciates the announcement of establishing new hospitals that are among the long-awaited projects, but Dr Nizami says the allocated funds for the new hospitals are insufficient. “This means that the government has decided not to complete these in one year’s time. Secondly, no amount is allocated to enhancing the capacity of the existing six medical public universities.
“The budget for purchasing medicines has also been ignored by the government,” he adds. “Likewise for the strength of nurses and paramedical staff at the district level. There is disappointment when you look at the paltry earmarking in the budget for scientific research and development programmes of healthcare.”
Health experts bracket the issue of safe drinking water supply with the health sector, as it causes various diseases some of which can also cause an epidemic situation. The Punjab government has allocated Rs8 bn for supply of clean drinking water, and Rs8.1 bn for rehabilitation of 662 dysfunctional rural water supply schemes. Mukhtar Ahmed Ali considers it an inadequate amount.
According to the data provided by the CPDI, one of the major health challenges continues to be the large percentage of births that are not attended by skilled workers. Lack of maternity services and child healthcare units at the primary level is the main cause of the high rate of maternal and child mortality in Pakistan. The new budget offers nothing to support such programmes.
In 2015, the Sustainable Development Goals (SDGs) were adopted by nations to end poverty, protect our planet, and to ensure that people enjoy peace and prosperity. Of the 17 agreed goals, Goal 3 concerns good health and well-being. The government of Pakistan was among the first few countries to adopt the SDGs as their national goals.
An expert on SDGs, and the Chief Executive of Awaz Centre for Development Services (CDS) Zia Ur Rehman says that after the 18th Constitutional Amendment in 2010, under the international commitments, 99 indicators of the SDGs shall be implemented by the provincial government. “Some of the major health targets for the SDG 3 include reducing the global maternal mortality ratio to less than 70 per 100,000 live births, by the year 2030; ending preventable deaths of newborns and children under five years of age; with all countries aiming to reduce the neo-natal mortality to at least as low as 12 per 1,000 live births and under-five mortalities to at least as low as 25 per 1,000 live births; combating AIDS, TB, malaria, and neglected tropical diseases as well as water-borne diseases like hepatitis, and other communicable diseases; reducing by one-third premature mortality from non-communicable diseases through prevention and treatment; promoting mental health and well-being; giving access to quality, essential health-care services and safe, effective, and affordable essential medicines and vaccines for all.”
The allocation of budget and related policy should be a true reflection of the commitments made by the government at national and international levels, Rehman adds. “It is evident that the current health budget like previous ones is opposite to the roadmap offered on ‘National Priority Targets’ in 2016, to implement the Goal 3.”
Bilawal is voice of the poor, farmer and labour instead of rich
Secretary information Gujranwala Muhammad Sageer Butt met with Chairman Peoples Party Bilawal bhutto Zardari during the budget session in the parliament. Muhammad Sageer Butt took the Chairman PPP Bilawal Bhutto into confidence on two accounts, one to perform well as the opposition and second to reject the IMF budget. Sagheer Butt showed his confidence on the leadership of Bilawal Bhutto and exclaimed that he was proud because ” our chairman is the voice of the poor, the farmer and the labour instead of the rich”.
Sagheer butt has invited Bilawal Bhutto to Gujranwala which he accepted. Bilawal will soon visit Gujranwala and meet with workers personally. Sagheer Butt also talked about party which was appraised by chairman.
انسانی حقوق کی کارکن گلالئی اسماعیل روپوش ہونے پر مجبور؟
ہم گلالئی اسماعیل کے معاملے میں بے حد فکر مند ہیں۔ ان سے آخری بار بات ایک ماہ پہلے ہوئی تھی: بہن صبا۔
پاکستان میں ایک 11 سالہ لڑکی سے زیادتی اور قتل کے واقعے پر کارروائی کا مطالبہ کرنے والی انسانی حقوق کی ایک عالمی شہرت یافتہ کارکن گلالئی اسماعیل کو مبینہ طور پر روپوش ہونے پر مجبور کر دیا گیا ہے۔
گلالئی پر انسداد دہشت گردی قانون کے تحت بغاوت کا الزام عائد کیا گیا تھا۔ انہوں نے گذشتہ ماہ 11 سالہ فرشتہ مہمند کے قتل پر انتظامیہ کے مایوس کن جواب پر احتجاجی مظاہروں میں شرکت کی تھی۔ فرشتہ کی لاش اس کے اسلام آباد میں واقع گھر کے قریب جنگل سے ملی تھی۔
گلالئی نے اسلام آباد میں ایک تقریر کے دوران پولیس اور سکیورٹی اداروں سے شہریوں کی حفاظت کے لیے مزید اقدامات کا مطالبہ کرتے ہوئے خاص طور پر پشتون برادری کی حفاظت پر زور دیا جس سے خود ان کا اور مقتولہ فرشتہ کا تعلق ہے۔
انہوں نے فرشتہ قتل کیس کے بعد ایک ٹویٹ میں کہا تھا کہ عسکریت پسندی، مذہبی بنیاد پرستی اور معاشرے میں پھیلی حیوانیت جنگ پر استوار معیشت کا نتیجہ ہے، جس نے معاشرے کو تباہ کر کے رکھ دیا۔
انہوں نے مزید کہا کہ جنگی معیشت نے پاکستانی معاشرے سے انسانیت چھین لی ہے اور بچوں سے جنسی زیادتی اور قتل کے واقعات میں خوفناک اضافے کی وجہ معاشرے میں پھیلی حیوانیت ہے۔
ٹوئٹر پیغام میں گلالئی نے مزید کہا کہ ہمیں بھولنا نہیں چاہیے کہ فرشتہ کے خاندان کو مقدمے کے اندراج اور اس کی لاش کے پوسٹ مارٹم میں شدید مشکلات کا سامنا کرنا پڑا کیونکہ وہ مہمند کے علاقے سے بے گھر ہو کر آنے والے لوگ تھے۔ ان کے بےگھر اور غریب ہو نے کی وجہ جنگی معیشت ہے۔
گلالئی کی بہن صبا اسماعیل نے ’Aware Girls‘ کے نام سے غیر سرکاری تنظیم کے قیام میں مدد کی۔ یہ غیر سرکاری تنظیم اس وقت سے امن اور برادری کی ترقی کے لیے کام کر رہی ہے جب دونوں بہنیں خود بھی کمسن تھیں۔
صبا نے اس ہفتے امریکی شہر نیویارک میں اقوام متحدہ کی مدد کے لیے لابنگ کی۔ انہوں نے شورش زدہ علاقے میں جنسی تشدد سے متعلق اقوام متحدہ کی خصوصی نمائندہ پرامیلا پیٹن سے بھی بات کی۔
انہوں نے دی انڈپینڈنٹ کو بتایا ’ہم اپنی بہن گلالئی اسماعیل کے معاملے میں بے حد فکر مند ہیں۔ ان سے آخری بار بات ایک ماہ پہلے ہوئی تھی‘۔
صبا کا دعوی ہے کہ ان کے خاندان کو مبینہ طور پر ہراساں کیا گیا اور سکیورٹی فورسز نے ان کے گھر چھاپہ مارا۔ ’میری بہن روپوش ہو چکی ہیں۔‘
گلالئی صوابی کے دور افتادہ علاقے میں پیدا ہوئیں اور پلی بڑھیں۔ دو سال پہلے انہوں نے ’ٹی ای ڈی‘ (ٹیکنالوجی، انٹرٹینمنٹ، ڈیزائن) کے نام سے قائم ایک میڈیا تنظیم کی کانفرنس سے زور دار خطاب میں انکشاف کیا تھا کہ کس طرح 16 برس کی عمر تک وہ جہادی بننا چاہتی تھیں۔
گلالئی کا کہنا تھا کہ ان کے پرانے خیالات کے حامل شہر میں پوسٹر لگا کر نوجوان لڑکے، لڑکیوں کو افغانستان یا کشمیر میں ’شہید‘ ہونے کے لیے بھرتی کرنے کی کوشش کی گئی۔
انہوں نے بتایا کہ ان کے لوگوں کو سکھایا گیا تھا کہ شہادت کے بعد کی زندگی زمین پر زندہ رہنے کے مقابلے میں کہیں زیادہ اہم ہے۔ جس شخص نے انہیں روکا وہ ان کے والد محمد اسماعیل تھے جنہیں انتہا پسندوں کے جہاد میں کوئی دلچسپی نہیں تھی اور امن پر یقین رکھتے تھے۔ گلالئی نے 16 برس کی عمر میں غیر سرکاری تنظیم ’Aware Girls‘ شروع کی۔
اس غیر سرکاری تنظیم کے زیر اہتمام تقاریب میں شرکت کرنے والوں میں ملالہ یوسفزئی بھی شامل ہیں۔
گلالئی کو اپنے کام پر کئی ایوارڈ مل چکے ہیں جن میں ’اینا پولٹکوف سکایا‘ (Anna Politkovskaya) ایوارڈ شامل ہے، جو 2006 میں قتل ہونے والی روسی صحافی کے نام پر ہے۔
سرگرم عمل خواتین کے ایک گروپ نے، جس میں Reach All Women in War کی ماریانا کٹزرکووا، شمالی مشرقی بھارت میں قیام امن کے لیے خواتین کی تنظیم کی بینا لکشمی نپرام اور ’کوٹا الائنس‘ کی جانا رہنسٹورم شامل ہیں، اپنے کھلے خط میں عمران خان کی حکومت پر زور دیا کہ گلالئی کا تحفظ یقینی بنایا جائے۔
یہ کھلا خط اقوام متحدہ کے سیکرٹری جنرل انتونیو گوتیریش کو بھیجا گیا۔کھلے خط میں لکھا گیا کہ گلالئی اپنی برادری میں ایسی بہت سی خواتین، لڑکیوں اور نوجوانوں کے لیے امید کی کرن ہیں جن کی آواز نہیں سنی جا سکی۔ ’گلالئی ایک جرات مند آواز ہے اور ان کے کام پر کسی بھی ملک اور دنیا کو فخر کرنا چاہیے۔‘
ایمنسٹی انٹرنیشنل کے ڈپٹی ڈائریکٹر جنوبی ایشیا عمر وڑائچ نے کہا پاکستانی حکام کی جانب سے گلالئی اسماعیل اور ان کے خاندان کو ہراساں کرنے، دھمکیاں دینے اور ڈرانے کا سلسلہ لازمی طور ختم ہونا چاہیے۔
انہوں نے الزام لگایا کہ ملک میں انسانی حقوق کی خوف ناک صورت حال پر توجہ دینے کے بجائے سکیورٹی ادارے اپنی توانائی اور وسائل انسانی حقوق کے دفاع میں بلند ہونے والی آواز کو خاموش کرانے پر صرف کر رہے ہیں۔
غیر سرکاری تنظیم ’Reach All Women In War‘ کی عہدے دار ماریانا کٹزرکووا کہتی ہیں نیا پاکستان اس وقت بنے گا جب انسانی حقوق کا دفاع کرنے والی گلالئی اسماعیل جیسی خواتین محفوظ ہوں گی اور ریاست، قانون نافذ کرنے والے ادارے اور انصاف فراہم کرنے کے ذمہ دار حکام انہیں تکلیف پہنچانے اور جان کی دھمکیاں دینے کے بجائے ان کی مکمل طور پر مدد کریں گے۔
گلالئی اسماعیل کے معاملے میں پاکستانی وزارت خارجہ، وزیر اعظم آفس یا وزارت انسانی حقوق کی جانب سے کوئی فوری جواب نہیں ملا۔
شورش زدہ علاقوں میں جنسی تشدد سے متعلق اقوام متحدہ سیکریٹری جنرل کی نمائندہ خصوصی پرامیلا پیٹن کے دفتر نے ان کی گلالئی اسماعیل کی بہن صبا سے ملاقات کی تصدیق کی ہے لیکن کہا کہ ملاقات میں ہونے والی گفتگو عام نہیں کی جا سکتی۔
Pakistan blacklisting absolutely a possibility: FATF president
Sriram Lakshman
It lacks in almost every respect of action plan, says Billingslea.
There is “absolutely a possibility” that Pakistan could be on its blacklist after the international financial watchdog’s next meeting in October in Paris, the outgoing president of the Financial Action Task Force (FATF), Marshall Billingslea, said on Friday. The comments were made at a press briefing at the end of the FATF plenary held in Orlando, Florida, an audio call of which was released to the press on Monday morning.
Pakistan had “significant” work to do and was, with regard to an action plan agreed in June 2018, “lacking in almost every respect”, Mr. Billingslea said.
“Pakistan was cautioned in February at the plenary that they had missed almost all of their January milestones. And they were urged to not fail to meet the milestones in May. Unfortunately, Pakistan has yet again missed its May milestones,” he added.
“Now the action plan itself is set to complete in September. So this [the June 16-21 Orlando plenary] was not the plenary where we would discuss a blacklisting issue. This was the plenary where we examine how far and how far behind Pakistan is on its action plan … and I must say they are far behind,” Mr. Billinglsea said.
“There is much that must be done by September. If they fail to implement the action plan by September then the FATF has made clear that we will consider next steps.”
China, Turkey, Malaysia, Indonesia, Saudi Arabia and the Gulf Cooperation Council were among those at the Orlando plenary who had asked that Pakistan be given more time to comply with the action plan, The Hindu had reported over the weekend.Getting on the FATF blacklist, which currently only has Iran and North Korea on it, could severely cripple and isolate a country financially, resulting in a downgraded credit rating and denying it loans and development assistance.Mr. Billingslea said he did not want to specify or prejudge outcomes and that this was his last plenary as President of the FATF, but reiterated that Pakistan had much work to do if it was going to meet the action plan requirements.
Not responsive enoughIn response to a question on whether Pakistan’s Central bank had enough regulatory measures in place and concerns about the grey economy in the country, Mr. Billinglsea said that Pakistan did not adequately appreciate the transnational terror financing risks.“… Pakistan does not either appreciate or chooses not to acknowledge the transnational, trans-border terrorist financing risk they face. Even though they did issue an addendum, an annex, to their national risk assessment following the February discussion. There are also a number of other structural and legal changes that have to be undertaken, including successful prosecution of terrorist financing cases,” he said.India had been pushing for Pakistan to get on the FATF blacklist for its failure to take “credible, verifiable, irreversible and sustainable measures” against terrorist activities. Billinglsea said, in response to a question on Pakistan having the capacity to meet its milestones, that if they did not currently have the capacity, they are expected to generate it, and soon, in order to meet their targets.
IMF decision
He said that any conditionality associated with Pakistan’s loan from the International Monetary Fund (IMF) would not automatically have a connection to the FATF outcomes, although the IMF could choose to link the two. The U.S. has been pushing for a conditionality on an approximately $6 billion IMF loan to Pakistan, agreed in May.
“So the IMF is an observer organisation to the Financial Action Task Force and so they have complete visibility into everything that occurs within the task force, including a very detailed understanding of what the Pakistani action plan is. The decision however, to condition fund disbursement under an IMF programme based on structural benchmarks that might be associated with the Financial Action Task Force is purely an IMF decision,” he said.
https://www.thehindu.com/news/international/pakistan-blacklisting-absolutely-a-possibility-fatf-president/article28129739.ece