Pakistan’s Covid success story

Five years back, on March 18, Pakistan recorded its first Covid fatality — the pandemic which was sweeping the globe bringing death to Pakistan as well.

The world was facing the biggest pandemic threat in a hundred years. Pakistan rose to that challenge and was considered amongst the most successful countries in the effectiveness of its response based on our ability to contain the impact of Covid-19 on both lives and livelihoods.

What made this happen? What caused a country which routinely ranks amongst the worst global performers in almost all rankings from health to education to justice to corruption to economy rank amongst the best in its Covid response?

Larry Summers who was chief economist of the World Bank, president of Harvard University and treasury secretary of the United States said, “If the US handled the [Covid] pandemic as well as Pakistan, we would have saved in the neighbourhood of $10 trillion”. Then-PM Imran Khan said at the 100-day ceremony of the National Command and Operation Centre: “The NCOC has made the whole nation proud the way it has guided us through an extremely difficult situation”.

The lessons from Pakistan’s Covid response are worth learning from, not just to deal with any future pandemic but also the overall challenges the nation faces. And there are few nations on earth who face as many challenges as Pakistan does.

The most important aspect of Pakistan’s Covid response was that it was based on a whole-of-the-nation approach. The governance structures involved included both civil and military components of the federal government and all provincial governments. With the political diversity of these governments, it meant that almost all the major political parties were involved: the federal government run by the PTI and its allied parties; the provincial government of Sindh run by the PPP; Balochistan run by BAP; Azad Jammu and Kashmir and Gilgit-Baltistan under the PML-N (in the initial critical months); and Khyber Pakhtunkhwa and Punjab under the PTI.

All these governments worked in close daily liaison with the nerve centre of the COVID response – the NCOC. This was possible despite the highly polarised political landscape due to there being no discrimination in NCC and NCOC decisions in the sharing of information, provision of support and allocation of resources.

However, the whole-of-nation approach recognised that all governments working together was a necessary but not sufficient condition for success. For real success, citizens individually and the key segments of society needed to be mobilised. This included media, industry, traders, transporters, ulema, telecom companies, data scientists, IT specialists and all other segments of society — but above all doctors and other healthcare workers. The way the whole nation responded was a source of immense pride and was reflected in the results achieved.

So how can this collective response from the nation be achieved based on the Covid experience? Some of the critical elements in my opinion were as follows:

The nation accepted the legitimacy of those who were making critical decisions. This moral legitimacy is vital for creating trust amongst citizens and getting their cooperation in return. No amount of coercive power can match the power of citizens voluntarily agreeing to follow the decisions made by those whom the citizens have themselves elected and placed in positions of power. The nation belongs to its citizens and not to any political leader, party or state institution.

Seeing the unity of effort from the national leadership regardless of political affiliation, the nation believed that this effort was for the overall good and not any one group or person in particular.

Transparency of the decisions being taken and the results being achieved, good or bad, for the entire nation to see added to the confidence. This transparency and equitable decision-making helped create trust which is almost totally absent in normal circumstances in Pakistan, where the distrust between the citizen and the state is at an alarming level.

An example of equity in decision-making was the Covid vaccination drive. The decision on the sequence of vaccinations was driven by science and equity. Healthcare workers were prioritised and were given vaccination before even the topmost echelons of government because they were the most vital for the national Covid response. Similarly, data showed that the older you were the greater your risk of fatality from Covid. Hence we started with the seniormost citizens when the vaccination for the general population was started. A poor man or woman in their seventies or eighties was vaccinated before the prime minister or the NCOC chair.

Another critical part of the success came from the very close collaboration between civilian and military authorities. The NCOC was chaired by the planning minister and had a full-time military contingent forming the backbone of the operation led by a 3-star general as the national coordinator of the NCOC. The health minister provided the leadership in the NCOC for the health aspects of the response. Both civilian and military components brought their own strengths to this endeavour and made it as effective as it was.

One key thing to be noted is that, while the military component was vital for the success, the leadership and the final call was unequivocally with the civilian leadership. The NCC, which was the apex decision-making body, was chaired by the prime minister. It is vital for the success of any national endeavour which involves the support of the people of the country, that the ultimate decision-making authority resides with the elected leadership of the nation in whom the citizens have placed their trust.

It is said justice must not only be done but seen to be done. Similarly, leadership must not only be carried out but seen to be done, especially in times of crises. The regular media talks from the national leadership kept the nation informed about what was being done and why and played a key role in galvanising public support and confidence. It was ensured that while these media talks project hope and confidence, they were always honest and respected the right of the citizens to know the whole truth.

Another important aspect of the Covid response success was the data and science-based decision-making. The decisions about how to fight the pandemic were based neither on emotions nor the whims of any leaders. Pakistani policy in key areas of national importance is based far too often on either emotions or whimsical decisions of leaders.

One serious consequence of this approach is that we are unable as a nation to take benefit of the technical and professional expertise available in the country for dealing with the developmental challenges that we face. Another consequence is that we end up forming national policies without the necessary calculation of benefits and costs. This has caused us grievous harm.

The Covid response experience has shown that when we are united and involve the whole nation, we can overcome the greatest of challenges. My comments on the whiteboard set up at the 100-day ceremony of the NCOC were: “Yet again, Pakistan has shown in the last few months that when we come together, we can overcome any challenge. Pakistan Zindabad”.