Dubious distinctions.

PAKISTAN now has not only the fifth largest population in the world but it also bears a very heavy burden of disease. Also, negative determinants of health or risks to health abound and are on the rise.

The combined effect of these three factors is harrowing. At the cost of being dubbed a pessimistic naysayer, I present below a factual, tragic shortlist of our dubious distinctions in health.

At a time when nothing else is going right in national life, it is a strong reminder about the state of the health of the nation, to be taken into account as and when - and indeed if at all - we are prepared to fix it.

To start with, we are multiplying like rabbits. From around 36 million in 1947, we have increased to around 220m and at this high rate of growth we are projected to number 350m by the year 2050, ie in the next 27 years only. Aside from being the fifth largest population in the world, we rank fourth in Asia.

We have the second highest neonatal mortality rate (NMR) in the world, ie out of every 1,000 live births, 40 newborns die within 28 days of life. Only Lesotho with an NMR of 44 is ahead of us and we are in the company of South Sudan which also has an NMR of 40. The NMR of Finland is 1 and that of Iran 8.

A shocking 37.6 per cent of children less than five years of age in Pakistan are stunted. Globally, we rank an abysmal 13th in this regard; below us are only the poorest countries in sub-Saharan Africa.

Physical and mental stunting takes place due to malnutrition, and if not treated during the first 1,000 days of life, ie around three years of age, it becomes irreversible. This is an entirely preventable and treatable condition. In Iran the percentage of stunting is only 4.8.

Behind the shocking statistics on the health of Pakistanis is a tale of chronic negligence by the state.

In 2018, 42pc of women aged 15-49, ie women of reproductive age, had moderate iron deficiency anaemia which is a major reason for underweight children born to these mothers and also a risk factor for maternal mortality due to post-partum haemorrhage.

Many of these underweight babies tend to suffer later from stunted growth. Iron deficiency anaemia among women is entirely preventable and treatable.

There are only two countries in the world where transmission of wild poliovirus has not been completely disrupted, Pakistan and Afghanistan, and the disease continues to cripple our children. Despite billions of dollars that have been spent on eradication efforts...

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