Tuesday, March 10, 2020

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How to improve your chances against #coronavirus

By James Phillips

We don't have to be helpless in the face of coronavirus.
I understand that people are yearning for a sense of control in what feels like an out-of-control situation. I call my father more often than I did a month ago, and he helps me understand the anxiety that he and other folks over 60 feel as they're inundated with reports that they are more "vulnerable" to the effects of the virus.
The anxiety extends way beyond older Americans. Just look at the number of canceled conferences, the number of companies telling staff to work from home, the nationwide shortages in toilet paper, hand sanitizer, disinfectant wipes and other goods in stores and online.
The patients I see in my work as a physician in the emergency department speak of a general sense of helplessness, as though a tidal wave is coming, and there is nothing they can do except wash their hands, try to find black market hand sanitizer, stay home and pray.
    The virus known as SARS-CoV-2, which causes the disease called Covid-19, is currently spreading across the globe despite our best efforts, and I believe it will continue to do so. Every state, every country. As I wrote for CNN last week, I accept that my profession makes my own infection seem almost inevitable. Naturally, people are clamoring for answers to currently unanswerable questions. Will I get it? How many people are going to get infected and what percentage of them will die? Who will die?
    Nobody can tell you for sure. If you hear someone stating they can, you should not believe them and you should evaluate their agenda.
    There are far too many variables to allow for perfect predictions: potential seasonal variation, how well a population follows public health recommendations and the possible discovery of therapeutic medications, to name a few.
    As new infection numbers appear to drop in China and South Korea, keep in mind that our countries have different social and cultural norms that could play a role, including differences in compliance with government wishes an degrees of social intimacy. In addition, there are political differences: the authoritarian measures used to socially isolate tens of millions of Chinese citizens are not realistic options in Western democracies like ours.
    Of those who contract the virus, many are going to require hospital admission for pneumonia and/or complications of their preexisting diseases. Among those hospitalized, studies show that significant numbers will develop a complicated disease process called acute respiratory distress syndrome (ARDS). Many of these patients will require ICU care and a mechanical ventilator, and sheer math makes many of us in healthcare fearful that we could run out of rooms and ventilators in the coming months. Math matters.
    So far, coronavirus does not appear to be affecting healthy children, and as the father of a 2-year-old, I take solace in that. A recent study published in The Lancet medical journal, although small, also provides some hope that pregnant women are not transmitting the virus to their babies. As the husband of a very pregnant and understanding wife, this is also hopeful news.
    But I offer this: You are not helpless. There are other things you can do to empower yourself. First and foremost, the public health measures being recommended to us -- including hand washing, social distancing and avoiding large gatherings, really are the best means of protecting yourself from exposure. Prevention is and will remain the best medicine. However, many will still get infected despite adhering to these practices.
    What else can you do to improve your odds of beating Covid-19 should you become infected? One key step: Maximize your health now, before you get sick. Studies have shown that those most at-risk are over 60 and/or have preexisting health problems like diabetes, obesity, cardiac disease, lung disease or generalized deconditioning.
    If you have these (or other) medical problems, you can choose to be proactive and start addressing them with your fullest effort, starting today. You know that blood pressure medicine you never take because you hate taking pills and it makes you feel old? Start today. If you rarely, if ever, check your blood sugars and have allowed your diabetes to get out of control because the finger sticks and insulin shots are annoying -- get your sugars under control starting today. Got asthma or lung disease? Begin consistently using your prescribed inhalers.
    And, for goodness' sake, stop smoking and vaping immediately. Commit to losing 10 pounds this month and force yourself to walk at least a mile every single day, starting today. Get your flu vaccine right now.
    Even people without diagnosed medical problems should maximize their health. Exercise, weight loss, a healthy diet and good sleep are certainly beneficial to your body. Be empowered. By doing these simple things that your doctors have recommended to you for years, you have the power to improve your resilience. How much? It depends. But in the face of this virus, even a very small amount of improvement in your overall health could be the difference between mild or more severe symptoms, and for some, it could mean the difference between life and death.
      You are not helpless. Do everything you can not to get the virus. But make sure that if you do, you are already at your strongest.
      Be prepared, not scared.

      How Long Will It Take to Develop a Coronavirus Vaccine?

      By Carolyn Kormann

      On Monday, Donald Trump held a meeting in the White House to discuss his Administration’s response to covid-19, the novel coronavirus that has spread to every continent except Antarctica. At the time there had been more than a hundred and five thousand cases reported in at least eighty-three countries, leading to more than thirty-five hundred deaths. Seated around an oval table in the Cabinet Room were health experts from the Centers for Disease Control and Prevention, the Food and Drug Administration, and the National Institutes of Health, as well as pharmaceutical executives from Pfizer, Johnson & Johnson, Sanofi, and others. With more than a hundred cases already discovered in the U.S., which had resulted in six deaths (the virus has since infected nearly four hundred people in the U.S., and killed at least nineteen of them), Trump was concerned. But he was also confused, despite having had several previous briefings with the Administration’s top health officials. Grasping for some good news, he pressed the executives to deliver a vaccine within a few months, at which point Anthony Fauci, the longtime director of the National Institute of Allergy and Infectious Diseases (N.I.A.I.D.), spoke up. “A vaccine that you make and start testing in a year is not a vaccine that’s deployable,” he said. The earliest it would be deployable, Fauci added, is “in a year to a year and a half, no matter how fast you go.”
      The virus seems to have been circulating in the United States, particularly in Washington State, for the past month, and more cases are expected. A person can be infected but asymptomatic, and therefore unknowingly infect other people. This limits the ability of public-health tools to contain its spread. Even still, a covid-19 vaccine developed, licensed, and manufactured at a global scale in twelve months would be an unprecedented, remarkable, even revolutionary achievement. No other vaccine has come close to being developed that quickly. The fastest effort to date was during the Zika outbreak, in 2015, when one was ready for testing in about seven months, but the epidemic fizzled out before an approved vaccine could be sent through clinical trials. At the meeting on Monday, Trump said, “I like the sound of a couple months better, if I must be honest.”
      John Shiver, the global head of vaccine research and development at the multinational pharmaceutical company Sanofi, which is developing a covid-19 vaccine, was at the meeting with Trump. “There was some confusion there,” Shiver said, that certain officials did not understand that “being in people,” as in human trials, is not the same as having a product. Clinical trials are conducted on healthy people, which is inherently challenging. “You certainly don’t want a vaccine that can make it worse,” Shiver said. “There have been some vaccine candidates historically that could actually enhance the disease.” Sanofi is working with the United States Biomedical Advanced Research and Development Authority, a sort of biomedical darpa, to advance a covid-19 vaccine based largely on the vaccine candidate it had developed for sars. Shiver told me that the authority doesn’t expect to have anything ready for human trials until much later this year. “It’s difficult,” Shiver said, “to see how, even in the case of an emergency, a vaccine could be fully ready for licensure in a year and a half.”
      The Coalition for Epidemic Preparedness Innovations (cepi), an Oslo-based nonprofit organization, was established at Davos, in 2017, to help the world prepare for a “disease X” pandemic. One of its aims is to dramatically hasten the process of vaccine development. To create a viable, scalable vaccine “takes vast amounts of funding and R. & D.,” Rachel Grant, the advocacy and communications director at cepi, told me. “It is a long and complex business. It’s all doable, science can meet the challenges, but there is lots of attrition” before any vaccine gets to the point of licensure. The problem is twofold. First, there may never be a market for a vaccine at the end of the development process, because the epidemic is contained, or never comes to pass. Then, traditionally, if there is an epidemic, it may take hold in a developing country where the costs of research and development cannot be recouped. “The resources and expertise sit in biotech and pharma, and they’ve got their business model,” Grant said. “They’re not charities. They can’t do this stuff for free.”
      cepi, with funding from the government of Norway, the Gates Foundation, the Wellcome Trust, and several other countries (the United States is not among them), is trying to bridge the gap. The challenge of vaccine development is “what cepi was set up to solve,” Grant told me, “played out writ large in an episode like this.” Since the novel coronavirus emerged, cepi has ramped up its grant-making expenditures to more than nineteen million dollars. Two grant recipients—a Massachusetts-based biotech startup named Moderna and a lab at the University of Queensland, in Brisbane, Australia—have, remarkably, already developed a vaccine candidate that they will start testing in human trials in the next few months, and another biotech startup supported by cepi is not far behind. But, ultimately, to get three different vaccines through the final phase of clinical testing, Nick Jackson, cepi’s head of programs and innovative technology, told me, will require an estimated two billion dollars.
      Barney Graham is the deputy director of the Vaccine Research Center, at the N.I.A.I.D., in Bethesda, Maryland, which is collaborating with Moderna and other academic labs on a possible vaccine. Graham is one of the world’s experts on the structure of viruses and how they interact with human cells to make us sick. In the seven years before the covid-19 virus appeared, one of Graham’s projects had involved understanding the mers coronavirus, in order to potentially develop a vaccine. (mers, which can be transmitted from camels to humans, has been contained to the Middle East, and seems to spread mostly in confined spaces, like hospitals.) “There’s several ways of delivering a protein to a human body that will make a vaccine-type response,” he told me. Certain proteins, when injected into a human, are antigenic, provoking the body’s immune system to create antibodies. Traditionally, proteins are made “in a microbrewery type of bioreactor,” Graham said—a common flu-virus vaccine, for instance, is grown in chicken eggs—and it “takes up to two years to get that protein ready. That is not fast enough if you’re in a pandemic situation.” Researchers have long been working on so-called vaccine-platform manufacturing technologies for future use. The idea is akin to creating a frozen-yogurt maker for vaccines—same machine, different flavors. With vaccine-platform technologies, the hope is that the way in which the vaccine is manufactured and delivered to the body—such as Moderna’s messenger-RNA (mRNA) technology—will transport any antigen and, therefore, theoretically protect against any infectious disease. “You can make the RNA in the same way, purify it in the same way, release it in the same way, and yet make many different proteins,” Graham said.
      In Moderna’s case, the vaccine contains a synthetic version of mRNA. When injected into a muscle cell, the mRNA acts like a drill sergeant, ordering the cell to create a doppelgänger of one of the coronavirus’s surface proteins—known as “spikes,” which, together, decorate the surface of the virus, giving the appearance of a crown. The spike protein is only part of the virus and therefore won’t make a person sick. But it is a crucial component of how the virus infects a human cell. In a sense, the Moderna technology outsources the labor of building these spike proteins to our own bodies. Once our muscle cells follow the vaccine’s mRNA orders, and manufacture loads of these spike-protein doppelgängers, our immune system recognizes them as foreign objects and learns how to fight them by creating antibodies.
      Moderna has done several different vaccine trials with its mRNA “platform,” a few in partnership with Graham and the Vaccine Research Center. Among other things, they have tested mers coronavirus vaccines in mice. (There are now, including covid-19, seven known coronaviruses that infect humans, and many more carried by animals; four of them circulate in the population and are responsible for common colds, and the other two are sars and mers.) “The early data we already have with the mice shows it is working the way it should,” Graham said. “If this was a virus from a different family, we would not be nearly as prepared.”
      On the other side of the world, at the University of Queensland, Keith Chappell is working on what he and his two co-inventors call a “molecular clamp,” a different type of rapid-response vaccine platform, also funded in part by cepi. The molecular-clamp vaccine uses a more traditional method compared to what Moderna is making; its shot would already contain the spike protein. The big difference is that Chappell’s team has found a way to incorporate a lab-created polypeptide (or sequence of amino acids)—“the clamp”—into the spike protein, to insure that the protein remains stable, folded like origami, in precisely the right configuration, thereby provoking a strong, accurate immune response (i.e., lots of appropriate antibodies). After years of working in cell cultures (Chinese-hamster ovaries, or CHO, the standard mammalian cell line used in therapeutic biomedical research), Chappell’s team plans to start testing its vaccine on about a hundred healthy adult volunteers, and he estimates that a trial will begin sometime this summer. “It’s a terrifying prospect, what’s occurring currently,” Chappell told me, by phone, from his lab in Brisbane. “It’s a lot of weight on our shoulders, and a lot of pressure.”
      Even if the virus wanes in the warmer months, as does influenza, it will have circulated in the population already, and could reëmerge in the fall. For now, although the total number of infections worldwide is unknown, experts estimate, crudely, that the virus has a mortality rate between 0.5 per cent and two per cent. The flu, which kills, on average, between twenty thousand and forty thousand people each year in this country alone, has a mortality rate of 0.1 per cent. “We’re still learning a lot about the virus, what we were all watching for, and what has emerged is that it is readily spread person to person in a community setting, more so than sars or mers,” John Mascola, the director of the Vaccine Research Center at the N.I.A.I.D., told me. “That is not surprising, but it is concerning. There is the potential for the virus to really establish itself in a human population, and not go away quickly.”
      On Tuesday, Trump toured Mascola’s Vaccine Research Center, where about five hundred scientists are at work. (On Friday, the President signed an $8.3 billion emergency-aid package to counter the virus; some of the funds will go toward the Vaccine Research Center’s work.) Kizzmekia Corbett, the research fellow leading the covid-19 vaccine team, explained the basics of virology to Trump—a student whom she had not anticipated—and other researchers showed off jumbo models of the coronavirus’s spike protein as Trump looked on, nonplussed. “The environment here is one of a lot of excitement,” Mascola later told me. “It’s gratifying to be recognized by the leadership, but, honestly, a lot of what we do is not recognized at that kind of level, and that really doesn’t matter. We do what we do because of the love of the science and our commitment to public health.”

      Video - #PPP - Kal Bhi Bhutto Zinda Tha - Aaj Bhi Bhutto Zinda Hai..

      #Pakistan - Economy suffering due to incompetence of PTI govt: Bilawal

      Pakistan People’s Party (PPP) Chairman Bilawal Bhutto Zardari has said Pakistan’s economy has been compromised and is suffering because of the incompetence of the present government.
      Addressing a seminar titled ‘Current Economic Crisis and Solutions’, the PPP chairman said his party participated in the last general elections not only against PTI but also against PML-N. “PPP had a stance in the 2018 elections that we are heading towards an economic disaster. We identified that the economic situation is difficult and the situation of the economy is not how the PML-N representatives portray it to be,” he said. “PTI government has made economy drastically worse in last 16 months. You ask the common man, vendors, farmers or workers as to how they are living these days,” he said.
      “I believe that for any economy, confusion is the most menacing factor which tends to disrupt the processes. When your government and politicians are confused, they cannot convey their plans with clarity, and that is a disadvantage for the whole community,” the PPP chief said. “Imran Khan and his cabinet had decided not to go to the IMF, and instead of presenting their plan to the international money lender, they relied more on Pakistan’s foreign friends and allies. The money that was taken and its advantage that was assumed did not benefit as much,” he said. “Then the government took it upon itself to introduce stabilization measures such as devaluation and an increase in interest rates which were disastrous for everyone, from the common Pakistani man to people from every strata of the society,” he added.
      “There is a difference in approach of PPP and other parties … we believe that this burden should be shared with those who are able to tolerate and withstand it,” Bilawal said. “We will not allow negotiations with the IMF done by the IMF employees. I believe that this way, we can give an answer to them and portray a realistic image which is beneficial for the people of Pakistan as well as the institutions which are involved,” he said. “We will have to generate extra revenues, otherwise how is this country going to run? In 2010-2011, the sales tax collection of the federal government was at Rs 14 billion from Sindh. Then in 2011-2012, when the Sindh province collected sales tax for itself, it was Rs 25 billion which is a 79 percent increase in one year, and our average increase from FBR is 22 percent. With the exception of one year, we have met each of our tax targets. Our tax collection in Sindh is 22 percent while it is 10 percent at the FBR,” he added.
      Bilawal said in PPP’s government, introduction of GSP Plus gave Pakistan access to European markets. “We have to protect the benefits of this. Unfortunately, the previous and current governments have failed to do so. We are facing difficulties in trade with Iran and we cannot do trade with India,” he said. “InshaAllah, with your help, we can strategically, logically and practically approach the economic problems and solve them in order to stabilize the country,” he added.
      Leading economists including Qaiser Bangali, Shahid Kardar, Dr Qais Aslam, PPP leaders Aitzaz Ahsan and Qamar Zaman Kaira were also present on the occasion.

      Three Tsunamis for Pakistan

      by:  Sherry Rehman

      Like many parts of the world, Pakistan is going through a populist moment. A key trait of such campaigns is big-ticket promises of transformational reform in stark contrast to regime-outcomes.
      One of these outcomes mapped globally is a reliance on autocratic rule, the demonisation of dissent, rescinded civil liberties and media freedoms. A hallmark of the growing illiberalism such models foster is an embrace of thought-binaries. With a polarising tone set from the top, the public conversation becomes divisive and strident, igniting public anger and fear generated by declining standards of living and access to fundamental entitlements. The result is little or no public attention on social and development crises, let alone goals.
      The need to focus on three key trends, actually incoming tsunamis, hitting Pakistan is obscured in such an environment where policymaking is compromised by a relentless, disproportionate buzz on the daily ephemera of politics. More importantly, any cohesive across-the-country implementation of policy becomes an even bigger challenge. The media too finds it hard to stay on point, jettisoning debate on structural issues for hot-button ratings in such a blitz of sponsored, half-fake, commoditized news.
      What are the big risks to Pakistan as we enter the next decade and century of borderless contagions and national challenges?
      The first is Pakistan’s demographic time-bomb. With a stated population growth rate at 2.4 percent, we are now entering a period where we are the handful of countries in the world to prove Malthus’s pessimism right. Instead of Bangladesh, which has pulled up its governance socks, and bested us in lowering its population rate through a targeted policy, Pakistan is on the verge of multiple development crashes, magnified on the rocks of low economic growth.
      When economic growth dips its graph, also projected now at 2.4 percent, to match population, it is time to press an alarm button, and remember that both are conservative estimates. Why population growth matters is because its effect acts as a multiplier on other social and economic deficits, making it the single largest stress-inducer on creaky infrastructure, poor governance and diminishing resources.
      If we stand back to look at the numbers, they shock. Right now we have a new person born in Pakistan every twelve minutes. To be sustainable, it should have been at a half of this number. Since 1998, our population has gone up by 57 percent. These rates are completely unsustainable, because this suggests a doubling of our population by 2050. The impacts are huge. Had our population trends resembled Indonesia, or even Bangladesh, for instance, we would have had 40 million people less in poverty.
      Given that 60 percent of Pakistan is now food insecure, is a state and community-driven agenda not worth the public time? Lessons from Bangladesh suggest that big-scale campaigns involving religious scholars, school curricula and television pulpits are needed to do the heavy lift. The messaging has to be loud and clear, not ambiguous or conditional. With contraceptive prevalence at 35 percent only, our reproductive health system needs an upgrade, through a revision of strategy both at the national and community levels.
      The Lady Health Workers programme needs resources, which were upped last in 2010. Families need to be small to be healthy, educated and working. Right now, over a million young people are entering the job market every year. Only a very robust economy growing at 8 percent can provide jobs and shelter for its people. With our economic goals levelled forever at macroeconomic stabilization, high interest rates and declining manufacturing, no number of magic international investments even under CPEC will create those jobs.
      Tied to the population alarm bell is the climate stress danger. In the last two years, Pakistan has moved from the world’s seventh most affected country to the fifth. Irrespective of our global carbon footprint, our vulnerability is high to rising temperatures and extreme weather. This is not some abstract science, but a reality that impacts both citizens and state in escalating quantums. Last year, Pakistan recorded the highest level of heat in the world in Jacobabad. This year, globally, Turbat was the hottest city in the world.
      These are not all numbers from some development conference. The results are in our back yards and on bodies. Heat-induced deaths, droughts and crop-reductions are causing lower agricultural yields than a decade ago, while our glacial melt triggers flash-flooding combined with every monsoon. Policy communities and parliaments need to start talking about reducing greenhouse gases.
      Air quality in Pakistan’s cities and villages has given Punjab a fifth season. Instead of waiting for India to stop burning crops, we need to protect our people from Delhi-like black-lung syndrome by taking timelined steps to convert big industrial emitters to clean fuel tech and kilns to zigzag converters. Fuel imports and vehicle exhaust systems have to upgrade to Euro 4 or 5 levels if we are not to expect radioactive dystopias. India has stated a policy ambition to go electrical by 2030. Why can’t Pakistan at least do some of the above?
      Water at zero is Pakistan’s other big looming crisis. While there is a general public discussion on adapting to urban water deficits, they have little or no resonance in policy agendas except at COP meetings or multilateral forums. Governments and communities both need to understand the stakes here, especially for the poor. At this point, only 20 percent of Pakistan has access to clean drinking water, while the rest consume fecal and industrially contaminated toxins. Lead and arsenic are now endemic to the Indus plain, while our per capita usage of water is, wait for this: the highest in the world.
      According to the UN (and not some fly-by night data-creator), Pakistan will officially be water scarce by no distant century, but by 2025. Given that Pakistan is principally glacial-fed, unlike India which is monsoon-fed, we are not in a position of comfort to allow strategic drift.
      Water is what powers our homes, lives and agricultural economy. Yet it is agriculture that consumes most of our ground water, and poor sanitation that contaminates our drinking water. A policy change by governments to incentivize crops that consume less water is needed urgently. In sugar, wheat and rice we export out our virtual blue water in spades, for instance. If the rapacious British Raj could build Punjab the largest man-made irrigation system in the world, why can’t postcolonial governments focus on structural needs instead of just hot topics? Drip and modern irrigation needs to be discussed on television shows instead of politically divisive and ecologically inefficient big dams. For citizens, it is home-conservation, recycling, eating less meat and reducing plastic waste which is needed, for a start.
      At the end of the day, governments have to act and lead. In Pakistan, the federal government has to have convening power and political goodwill to make the policy gridlock work. We are not an ethnically homogeneous country. The federation must generate both transparent data, political will and public policy to connect the dots across the provinces to overcome the governance crisis in Pakistan today.

      Without such common goals connecting the resource and capacity dots to create resilience, Pakistan will not be in position to mitigate let alone manage the upcoming crises.

      #Pakistan Womansplaining Rights

      by:  Sherry Rehman

      As millennial women join every year now to celebrate their womanhood on 8th March, and to bond in solidarity for defining the rights to their lives and choices, many people in Pakistan still actually ask, why women march?
      This is not the only question. A great number of people, including influencers, still ask why women even want the right to their bodies, and more broadly, life choices. One of the most insidious derailers is invariably couched in class-sanctimoniousness. Why focus on body politics, don’t Pakistani women need basic social services, first they say, as if feminists don’t demand that. In doing so they ignore the diversity of women in these movements, or the fact that economically vulnerable women face a disproportionate impact of rights deprivations.
      Obviously, the Aurat March slogan has cut such an open nerve across a wide class swathe that it has led to many stepping back in diffidence. Others have even apologized on social media for this “extreme” ask. I have a very clear view on this. Allow me to “womansplain”, not as someone talking down at men or even women, but as a woman who wants other women to be heard as much as myself.  Here’s why I think women need to talk even more about what they want and need.
      Nothing substantive is ahistorical.  Nor in my view is any civil or human right gained from the comfort zone of perfect ideas or personal distance. To effect real change, especially to break down barriers of patriarchy or race, one has to have skin in the game, and give oneself the right to be radical. Because without radicalism, rights don’t fall into anyone’s lap, not in Pakistan, not anywhere in the world. In a world defined by gross inequalities, in fact, it’s a little amoral to not be radical.
      Many of us have spent our adult lives explaining why we want rights over our own bodies, choices, careers, income, childbirth, identities, and lives. These are baseline asks. Worse still, we demand equality, and some even power. In this bruising quest, my generation was lucky to be led by big brave voices in what became a clear, identifiable women’s movement in the mid-1980s, which linked its goals to the restoration of democracy. Benazir Bhutto became the political face of the restoration for democracy while Asma Jahangir and other heroes created Women’s Action Forum, other groups, and the Human Rights Commission of Pakistan. Many legal and legislative battles were won, but only partially. Today, 35 years later, we and the younger women are still fighting the old battles while layering on new fights.
      I recount all this because there are many reasons why women march, most of them structural, others political, while many are cultural. In Pakistan, just like anywhere in the world, the fight for women’s rights is a battle over power. Of course, the power to exercise one’s choices are limited by class and opportunity for men too, but for women, despite advances made, the limits on choices still make many old walls close in, while new predations lay their building blocks. Women march to knock these over.
      One of these new walls being built on old ramparts of misogyny, is the discourse on women’s bodies, which has historically preoccupied many minds, both public and private. Instead of worrying about why a woman dies in childbirth every 20 minutes in Pakistan mostly because they are married off too young, many leading voices have expressed anxiety over why women want the right to their bodies and lives.  This fear of women gaining control over their bodies is very real. It permeates all social classes, not just the bottom of the rural social pyramid, but also urban elite enclaves.
      Paradoxically, such multiple cross-class resistance has already marked Aurat Marchers as successful in one sense. When movements build momentum, they create intellectual, social and political debate amidst disruption, through which they also leave a mark. One mark is the discourse they create as well as the silence they break. The controversy over women’s right to choose their life-paths is a good point. It is out now in the light for its meaning to be stripped of false ideologues and moral gatekeeping. Another clear but intangible imprint over time is laid in precedents set, perceptions shifted, role-models created. For instance, the broad appeal of Aurat Marchers should make it safe, or politically correct, for many non-activist women in taking their moral solidarity to the street. For many of them the personal has not become the actively political, yet they are able to join in to show support. Another success of this second-wave feminist momentum is that it has for now, created boundaries against impunity for abuse on public platforms. Because of support energized by the Aurat March, media opinion-shapers, celebrities, politicians and tv anchors have started pushing for women-haters to be called out, as exemplified in the Marvi Sirmed vs Rehman face-off. Whatever the online trolls may say in their hate play, on balance, her win was a win for women everywhere.
      Yet no fight in the battleground for women’s rights in Pakistan is ever free of assaults, and revisions occur like sunset every day. Women’s access to healthcare and literacy, equal pay and uncounted hidden work are the long arc of the fight. The manifesto of change is long and inclusive. However, the political debate on “my body, my right” has sparked so much heat on public platforms, from parliament to television, that women at all levels are repeatedly still called out for seeking rights over their bodies as either absurd, or wanton, or both.
      Many sympathizers also suggest that the Urdu framing of the words “mera jism, meri marzi” from “my body, my right” is provocative, has shifted focus from the gist of a fairly fundamental ask. Right or wrong, the quibble is not reason to imply that it is anchored in moral laxity. Quite the opposite, from what one sees in the manifesto. Women are marching for all sorts of rights, including the right not to be honour killed, or assaulted at home, or harassed anywhere. Not distance people from what women are marching for. In fact, let me say there’s a fairly “mainstream” argument to be made here. To seek such a right in Pakistan, and space for others to seek more, one can appropriate the appeal to human rights, Jinnah’s words, the Constitution and the kitchen sink, as much as one can find its justification in religion.
      Again, the questions we need to frame such a slogan in are fairly fundamental and really should give rise to introspection about our collective failures. According to UN data, 48.1 % of Pakistani women have no say in their health decisions. These may be failures of the state, but that is not the point. Who should have control over an adult woman’s right to marry, give birth, have a say in her health decisions? A man, because he has power? I don’t think so. This is Pakistan, where some of the best stories are its women, and this is the 21st century. Does our culture really want to condone acid crimes when a woman spurns a suitor? Do women not have a right to plan their childbirths, or are we still supposed to be chattel? Do women not have a right to speak out against rape and sexual harassment? Why must women who march be accused in court petitions of an agenda that spreads anarchy, vulgarity and hate?
      Pakistan has made laws against such practices. So do detractors realize that when they obstruct the right to choose autonomy over women’s bodies, they are tacitly espousing the right to violence against women? Statistically, home is still the most dangerous place for a woman in Pakistan. That is where much of the violence originates, as well as most “honour crimes”. As for choice, does Islam not ask for witnesses at a woman’s marriage to protect her right to choose, and specify agreement three times, in case she’s being coerced? So, what is exactly wrong with marching for such rights? Frankly, nothing. This is all about power moving beneath our feet, nothing more, nothing less.

      Every incipient movement has a beginning, a plateau and a reckoning with history. This one is young, full of hope, and To Be Continued. Along the way it must grow its base, create inter-generational links, invest in time-lined strategy. It must build networks across institutional champions, political parties and governments in order to translate some of its demands into tangible, realizable goals. These will have to be addressed, created over time, and culturally buttressed. It will take tenacity, courage and a few good women and men. Right now, we have

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