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Cooperative federalism

At the time of writing this piece, the total number of confirmed cases of Covid-19 in Pakistan has moved beyond 5,000 and more than 90 precious lives have been lost to it. Even though our country borders two of the earliest centers of the disease – China and Iran – we are fortunate that its spread has remained slow here so far. This provides us some time to prepare ourselves against it, prevent and preempt its increase and provide the best possible treatment to citizens suffering from it.

But to do so we need to put many mechanisms in order – including how various tiers of the government respond to this pandemic. As we all know, the 1973 constitution bases our governing system on cooperative federalism – one in which federal, provincial and local governments must work with each other collaboratively and collectively. This system empowers the provincial governments to equip healthcare services through revenue generated from provincial taxation and further obliges the federal government to provide resources for that from the national divisible pool through the National Finance Commission award.

In the case of Covid-19, this division of responsibilities has not worked as efficiently as it should. The level of response to the disease by different provincial governments has varied widely – mostly in accordance with their respective capabilities and levels of investment they have made to strengthen their public sector healthcare system. These differences have been visible even at the first level of their response – in containing the spread of the disease and creating awareness.

As we have learnt from the Chinese experience, awareness – followed by intensive screening and testing – is the first and foremost requirement for effective containment of the disease. In our case, different federating units are handling the issue of ‘lockdown’ differently. The result is an ongoing controversy over not just its duration and purpose but also its extent.

It is in the context of this situation that the federal government has taken a cautious, and conscious decision to maintain a balance between life and livelihood. Fully aware that a complete lockdown of all commercial and business operations would result in large-scale unemployment and food insecurity, it has moved to ensure that daily wagers, industrial workers and self-employed people can survive while scaling back economic activities somewhat.

The federal government has, therefore, initiated Pakistan’s largest ever social safety net with the aim to distribute Rs12,000 among 1.2 million households. The federal government is also mindful of the fact that a ‘corona-free’ distribution of these handouts depends on the efficiency of district administrations which, essentially, come under the provincial governments.

Then comes the treatment of Covid-19 patients. Here, too, different provinces are following different procedures. They possess varying quantities of testing kits, protective gear, sanitizers, medicine and ventilators. But even their moves to increase their inventory of these items demonstrate varying degrees of commitment and initiative.

So, what does our response to the pandemic teach us? The positive news is that the provinces are taking responsibility for being the first line of defence against the disease. However, their responses are far from being cooperative, coordinated and in consensus – which is the essence of a cooperative federal political system.

To rectify the situation, we must start at the beginning. No lockdown, for instance, can succeed if it is left to each province to enforce. Its success will depend upon whether all units of the federation are observing the same level of control since no province on its own can stop inter-provincial movement of goods and people. Lax controls in one province, thus, risk the incidence of the pandemic in others. Likewise, decisions about the transportation of essential commodities – such as food, medicine and medical equipment – during a lockdown also require agreement among the federating units.

The same holds true for social safety initiatives. To avoid their duplication or to ensure that no deserving individual, family or community is left out, the provinces and the center need to follow the same policies and processes. Similarly, the federating units must coordinate their efforts to treat those who have contracted the virus. They must agree on a single treatment protocol all across Pakistan – both for treating the sick and guaranteeing the safety of healthcare providers.

As the federal minister for inter-provincial coordination, I have a ringside view of how the institutions responsible for maintaining federal relations in Pakistan work – or don’t work. Also, from my experience in government as well as in opposition, I have come to understand the importance of strong coordination and collaboration between the federal and provincial levels of government. This is not just a necessary condition for our responses to Covid-19, it is also a vital ingredient of an effective political system.

But how do we go about it? Our constitution guides us. Articles 153 and 154 provide that issues should be discussed and settled through the Council of Common Interest (CCI). The CCI not only provides equal representation to the provinces and the center, it also offers ample opportunities for its deliberations and decisions to be based on informed inputs from the provincial and federal ministries and departments concerned.

Since the federating units have not achieved the level of mutual trust and coordination they require to fight against a disaster of Covid-19’s magnitude, it is becoming urgent that the CCI is involved in bringing them together. If the deadly spread of the disease in New York (where initially the city mayor, the state governor and the president of the United States were each following a different policy and strategy) is anything to go by, we must realise that no federating unit will be able to cope with the disease on its own. Only a truly federal Pakistan can guarantee that we successfully contain its transmission and effectively address its medical and socio-economic effects.

The units must devise a plan on how to create awareness, define the extent of lockdown and efficiently and effectively ensure treatment and accessibility to essential food and medicine for our citizens.

Dr Fehmida Mirza, "Cooperative federalism," The News. 2020-04-15.
Keywords: Health sciences , Healthcare services , Food security , Economic activities , Social safety , Political system , Institutional reforms , Social impact