World through a Pakistani Lens

Tag: Pakistan COVID-19 Response

  • Pakistan’s COVID-19 Response: To Test or Not to Test

    With so much information floating around and being absorbed or otherwise, I will not bore you with the numbers but simply provide a distillation of our on-going discussions focused on “should we be testing everybody in Pakistan?”

    This is an important discussion as it impacts other on-going discussions around the cost of testing, the mode of testing (which test), access to testing kits, delivery of these tests (citizen goes to test or test comes to citizen), and handling of those testing positive.

    From the discussions I have been a part of the consensus seems to be emerging towards testing through symptomatic targeting and, definitely, against universal testing! Here is the logic leading to this conclusion.

    The cost of universal testing is a prohibiting variable but not primarily due to the outright fiscal burden but rather the procurement aspect. Even if delivered cost of the testing was around USD 50 (~PKR 8,000) per unit, we are looking at 3 to 4 percent of GDP as the cost (same as the annual defense spending of Pakistan). Then is the issue of procuring and delivering over 200 million tests.

    This does not stop here, as this is followed by a review of how these tests will be delivered. Whether the citizen is asked to approach a test delivery site, or the test is delivered to the citizen’s doorstep, the universal testing process is time un-wieldy and impractical based on simple back of the envelope calculations.

    Should the universal testing somehow become practical, there are daunting social challenges. Since more than 95 percent either fall in the no effect plus recovered bracket, and almost half the population will eventually be infected (based on present predictions), knowing that a citizen is positive will create a social stigma and a social pandemic in the ability of society to deal with each other.

    Symptomatic and citizen responsibility driven testing as opposed to universal testing is thus the right approach which also appears to be followed by most including by the Pakistan government. We suggest using technology in both push and pull modes supplemented by radio and TV broadcasts and further supplemented by the volunteer (the “Cororna Tiger Force” being assembled by the Prime Minister).

    A mind-mapping exercise around the symptomatic and citizen responsibility driven testing shows that with these options working in parallel, we can cover almost all of Pakistan in about 45 to 60 days and really understand the magnitude of the pandemic allowing us to rapidly assemble coping and mitigation strategies!

  • Pakistan’s COVID-19 Response and the International Financial Institutions: Where is the Rapid Needs Assessment and a National Action Plan?

    In times of disaster, and we are in one, almost all nations opt for a national action plan to both react and to proactively prepare for relief, recovery, and restoration/rebuilding; often including building resilience post disaster. In global vernacular it is called DRM or Disaster Risk Management, also often Disaster Risk Mitigation and Management. Disasters often lead to or exacerbate existing fragilities and conflicts leading to localized or spreading violence. Pakistan has hitherto been well served by always timely preparing such disaster needs assessments and plans—not only for internal consumption but to manage external offers of assistance. Has Pakistan done so for the CONVID-19 pandemic at our hands? I provide here, some suggestions unless these actions have already been undertaken and the public has not been informed.

    On the Corona assessment, the govt can request the ADB, WB, EU and UN to do a joint assessment under the 2008 Protocol of Cooperation, or it can ask the Bank only (both options have pros and cons). This could be a simple letter to Bank from MOF, requesting for “support the Government of Pakistan in carrying out and Covid-19 Impact and Needs Assessment (CINA), in accordance with the global EU-UN-WB PDNA/DALA methodology. PDNA is Post Disaster Needs Assessment and DALA is Damage and Loss Assessment (which is a sub-tool of PDNA used by EU, UN and WB).

    However, this is more complex that a PDNA. In FCV situations, the tool that comes closest to this kind of situation is the Recovery and Peace Building Assessment (RPBA)—previously known as the Post Crisis Needs Assessment (PCNA). A very successful PCNA was conducted in Pakistan by WB, UN and EU (and ADB) under Govt leadership in 2009-10 for the FATA crisis. Hence there is a precedence that can be established and used.

    The tool that I propose using is a PDNA-RPBA hybrid that was developed in Ukraine, later used in Nigeria and many other places. A recent one was the Rohingya crisis in Bangladesh.

    While some may rebut this idea, this can be an enormous management tool for the government even post crisis and can be done by a dedicated team while reactive measures are being taken to manage the pandemic. Do let us know if we can assist in any way.

  • Pakistan COVID-19 response working group

    We have set up a group of disaster, conflict and fragility experienced and concerned professionals who under the aegis of PIDE using a 360 degree approach are identifying, analyzing, discussing, and formulating responses to Pakistan CONVID-19 and socializing the same. The 360 degree approach horizontally covers all sectors and vertically integrates the various tiers of government [including union councils and communities].

    Daily, we widely disseminate bulletins and blogs and newsletters based on our daily deliberations and analytical work. The advisories have covered diverse issues from cost of lay-offs to identifying the sectors where employment vulnerable including who they are to technological approaches to tracking and monitoring to delivery; public health and logistics and energy and relief to the flow of information—critical in a pandemic—to how to work with the international financial institutions in aid of Pakistan; from food security to conflict and religion to communities and volunteerism. We are casting a wide net to share and understand and sift through diverse ideas and analytics.

    We are now trying to create a single situation room in the country to house this effort and unify the multiple and often inefficient singular and otherwise efforts that waste precious time and resources despite their good intentions—be they in the government or in the private sector. The situation room also requires to rapidly and proactively identify and assess potential impact and resulting needs from people to energy to finance to water to food security to developing resilience and recovery post crisis. This must be done now!

    The aim is to strengthen the governments’ hands and its institutions tasked therein. NDMA is the front line of any such response. My own experience in working with NDMA (at its inception) during the 2005 Earthquake in Pakistan and then again during the 2010 Floods, makes me sure that we need to house this situation room within the NDMA. We are continuing to make this effort, and hope that through this blog, some of the readers can socialize the idea with NDMA of Pakistan.

    https://www.pide.org.pk/pdf/PIDE-COVID-Bulletin-7.pdf