Incomplete systems & markets

PAKISTAN has one of the highest diabetes prevalence rates in the world. About one in three adults is living with diabetes here — some 33-34 million people. Shouldn’t there be public information campaigns to raise awareness about preventing/ living with diabetes? Where are these programmes in Pakistan? Heart disease is the leading cause of mortality in Pakistan; it is responsible for an estimated 30-40 per cent of deaths. Pakistan’s cardiovascular disease rate is 648.6 persons per 100,000; the ischemic heart disease rate is 188 per 100,000 persons. Both are the highest in the region. Some of the leading risk factors for heart disease are diabetes, high blood pressure, obesity, tobacco usage and air pollution. Around 20pc of our adult population consumes tobacco (there is a 32pc prevalence rate among men and 6-7pc among women). Other than printed warnings on tobacco products and a ban on tobacco advertisements, one does not see a significant campaign to prohibit or even discourage tobacco consumption. Around 18-26pc of our adult population is believed to be hypertensive, with some 70pc undiagnosed. Neither do we have a public awareness programme for prevention of hypertension. We don’t even have sufficient diagnostic facilities. Most people discover they are hypertensive when health complications, like heart disease, arise. Why does our healthcare system lack diabetes prevention and management programmes? Breastfeeding initiation rates are low in Pakistan as is the exclusive six-month breastfeeding rate. Pakistan still has one of the world’s highest infant mortality rates and some 40pc of its children are malnourished. Contaminated water in the feed of infants is a major contributory factor. Sadly, despite the fact that breastfeeding initiation or knowledge about exclusive breastfeeding for six months and programmes for ensuring better support for mothers are not that costly — and far cheaper than addressing child malnourishment and high infant mortality rates — we ar