Louder than words
With a little more focus on reproductive health, the situation can be improved to a considerable extent
By Muhammad Athar Masood
The lack of attention paid to reproductive health is one of the major problems being currently faced by the health sector in Pakistan. However, a little more focus on this oft-neglected area has shown an appreciable improvement in the status of reproductive health in Lodhran district of Punjab.

The power of the corporate media never ceases to amaze. In Pakistan we are just beginning to learn how the electronic media shapes (usually urban) public opinion. In the western capitalist countries, the media’s role in the polity is a well-known fact and there are entire dissident discourses built around non-corporate or ‘alternative’ media outlets.

The latest media furore has, of course, surrounded the shocking attack on the Sri Lankan cricket team in Lahore. The fallout after the Supreme Court verdict on the Sharif brothers’ eligibility for elections was quickly replaced as headline story by the even more sensational images of a dozen gunmen running riot in the middle of one of the busiest (and elitist) commercial areas of Lahore. Not surprisingly, parallels to similar images from the Mumbai attacks last November started to be made almost immediately.

I am not trying to suggest that there were no parallels to be made, but what followed soon after indicates the real objective of the commentaries. The barrage started with a story on the front page of this very newspaper indicating that a high-ranking police official in the Punjab government had warned more than 10 days before the attack on the Sri Lankans that the ever reliable Research and Analysis Wing (RAW) was planning to sabotage the ongoing cricket series to deepen Pakistan’s considerable international sporting isolation. The story was made much more compelling by the publishing of a confidential letter written by the police officer in question.

The relative sophistication of this typical RAW refrain was in the story’s emphasis on the subsequent replacement of the said police official along with a host of other civil and police bureaucrats that were apparently partial to Shahbaz Sharif, who by this time had been evicted from the Chief Minister’s House. In other words, the fact that RAW might have orchestrated the attack was a secondary concern; of primary significance was the federal government’s refusal to act on a clear piece of intelligence information.

What this piece of reporting indicates is the media’s unquestioned commitment to the state’s dominant India-centric security narrative. This unfortunate fact became obvious in the aftermath of the Mumbai attacks, when the Pakistani media followed hot on the heels of a jingoistic Indian media in drumming up war hysteria. It was almost as if the Pakistanis felt they had to match their Indian counterparts. The Lahore attack was an opportunity for the Pakistani media to up the ante, so to speak.

It is eminently possible that RAW (or for that matter, other intelligence agencies) did have something to do with what happened in Lahore this week. But that is neither here nor there. The raison d’etre of intelligence agencies is conspiracy. What matters is that the media does not go beyond the tired invocation of Indian hegemonic designs when such incidents do take place. The same can be said about the frontal criticisms of the federal government. The media discourse remains stuck in old narratives about corruption, hunger for power and personality clashes.

Again, it is important to note that the PPP government is not undeserving of criticism, to say the least. I wrote last week that the PPP has displayed a disappointing lack of maturity in recent weeks, thus it should expect a fair amount of stick from the media. I am particularly unsympathetic to the plight of the bombarded-on-all-sides PPP leadership every time I see Salman Taseer holding a press conference to launch another attack on the Sharifs, which the latter promptly reciprocate.

Nevertheless, the point is that the media does not attempt to push the boundaries of the established (and degenerate) political discourse. And this takes us back to where we started: the question is does the media even desire to break new ground or is it in fact a crucial component of the prevailing structure of power? It is worth recalling that the electronic media was hailed by all and sundry as being the fountainhead of a new public morality when Iftikhar Chaudhry was sacked almost two years ago. The leadership of the legal fraternity made it a point to regularly congratulate the media for the role it played in hastening the end of dictatorship.

The corporate media is not motivated by any particularly noble motive. The individual working journalist may be, but the structure of the 21st century media corporation is like any other corporation; the motive-force is profit, thus there is unending competition between media outlets to break stories that sell. In Pakistan, the Urdu print media has perfected the art of sensationalising news, and so the stage was already set for the new electronic media outlets to reinforce the prevailing trend. The sacking of the Supreme Court chief justice and the subsequent protest movement was the story that sold as the electronic media was erupting into the living room of the average urban Pakistani family. This created the fiction that the media was motivated by

‘democratic’ causes, and this fiction has continued to persist since.

I believe that, for the most part, the electronic media does not play a progressive role. At the very least, it promotes inertia. One can have a good time watching a well-meaning public intellectual issuing a verbal lashing to an indulgent general or federal secretary without having to ask more difficult questions about one’s own involvement (or lack thereof) in practical struggles to transform state and society. In fact, more often than not the images that are beamed into our homes by the electronic media reinforce our resignation about the existing state of affairs.

Following the RAW revelations, the media is now rife with reports that the perpetrators of the attack on Sri Lankan cricketers have links with al-Qaeda and the Taliban. Presumably, RAW is also linked with al-Qaeda and the Taliban. Everyone seems out to destabilise Pakistan. And so the international media starts to report in increasingly grim terms that Pakistan is on the verge of being a ‘failed state’. But we have been hearing this for years. What will come next and what should we really believe?

The popular media can and should play the role of the fifth column. But a popular media is not run by marketing and sales departments that earn the bulk of their revenues from advertisements. It is run by people themselves. At the present time, the only thing resembling popular media in Pakistan are the FM radio stations of Maulana Fazlullah and the like. And there are many doubts about the authenticity of the mullahs. The handful of relatively non-commercial radio stations in urban centres are constantly under threat of being shut down by the powers-that-be. The mullahs continue to operate with impunity, while the common people still await the establishment of a real fifth column.

A veteran bureaucrat with more than five decades of experience, Sindh Minister for Environment and Alternative Energy Askari Taqvi was born in Ajmer (Rajasthan) in 1931. He did his Master’s in Economics and his LLB from Sindh University. In 1954, he joined the Civil Services of Pakistan, and served different government ministries and departments on coveted posts.

Askari Taqvi joined the Muttahida Quami Movement (MQM) in 1994. Currently, he is a member of the party’s Technocrat Group, as well as Executive Committee of Research and Advisory Council. He entered the real world of politics when he contested for a Sindh Assembly seat from Karachi in Feb 2008 elections and won with a huge margin.

Askari Taqvi knows his shortcomings and the limitations of his department. That is why he has no inhibitions in admitting: "When I joined the department, I did not know much about environment, but I am in the process of learning. It’s a challenge for me." His only brush with environmental issues came when he was serving as additional secretary in the Environment and Urban Affairs Division. The News on Sunday interviewed Askari Taqvi recently. Excerpts follow:

The News on Sunday: What were the reasons behind declaring 2009 as the Year of Environment and what role has your department been playing in this regard?

Askari Taqvi: The basic purpose of declaring 2009 as the Year of Environment was to increase awareness about environmental issues – individually, collectively and officially. After declaring 2009 as the National Year of Environment, the federal Environment Ministry developed a comprehensive plan of activities for engaging all stakeholders to play a proactive role in environmental conservation and achieve sustainable development. The activities that started on Jan 1 will continue throughout the year. The ministry has designed activities to celebrate all international days related to environment. Other planned activities include lesson-sharing; research studies on hydrological, geophysical and socioeconomic topics; sessions on environment-related subjects; etc. The environment departments in all the four provinces have been asked to chalk out their own plans in accordance with the particular issues of their areas for complementing the federal activities. Unfortunately, the common people lack awareness regarding issues like poverty, environmental pollution, etc. As a result, no significant work has so far been done in the country in general and in the province of Sindh in particular. The provincial environment department can only monitor the situation, guide different departments, envisage plans and raise awareness. It has no authority to punish someone; it can only take the people who are polluting the environment to the tribunals as a last resort.

TNS: What environmental plans have you envisaged at the micro-level in Sindh?

AT: Our broad strategy is aimed at gearing up other departments to chalk out plans in such a manner that they enhance their performance in terms of improving the environment of Karachi. The environment has a significant impact on the health of people, but it remains underestimated. To this end, we are planning to change the curriculum of the pre-primary classes, so that children could understand the concept of environmental pollution from the onset and can later change their elders to create a healthy society. I have also suggested to the education minister that during 2009 and onwards a weekly informal session should be dedicated to environmental learning in schools. I myself go in different schools to plant a tree and have informal sessions with children on environmental issues.

TNS: What are the major environmental issues of Sindh, in particular of Karachi?

AT: In Karachi, environment pollution revolves around two basic problems – shortage of drinking water and poor sanitation. Water pollution, noise pollution, air pollution and absence of solid waste management have collectively contributed to poor environment in the city. In Karachi, all the animal waste from Cattle Colony (Bhains Colony) goes into the sea. As a result, the majority of marine animals, including fish, die and the ecosystem is disturbed. There is no systematic way of destroying this waste, except to use it for making cow dung cakes. Our department has, with the help of the private sector, set up a small bio-gas plant at Landhi on experimental basis. After its success, another big plant will soon be set up in the area by employing British technology and with the help of investment from New Zealand. Being tried in Pakistan for the first time, the plant will make use of the waste of 0.45 million buffaloes of Landhi, besides producing 25 megawatts of electricity and 15,000 tonnes of manure.

TNS: What are you doing to reduce industrial pollution, which has remained a farfetched dream for successive governments?

AT: In Pakistan, industrial development was undertaken in such a way that it did not keep pace with the future needs of the country. Similarly, no arrangement was made for the disposal of wastes coming from industries of Karachi and its adjoining areas, and getting mixed with the sewerage water. Proper laws regarding environment standards for industries are very much there. After taking charge of the provincial environment ministry, I have also conveyed these again to the relevant industries. I have also warned them that if they fail to meet these standards, we will prosecute them through the Environment Protection Agency. I have also suggested some cost-effective solutions to the provincial minister for Industries, who has promised to look into them. Currently, the Ministry of Industries is planning to set up a treatment plant and the Karachi Water and Sewerage Board (KWSB) has also appointed a consultant to prepare its feasibility study. In all, they plan to set up four treatment plants in Karachi. Similarly, we have talked to the district nazim of Hyderabad and have also sent a foreign consultant to advise the city’s administration on solid waste management and setting up of a biogas plant. The private sector has already set up two water treatment plants in Hyderabad. Now the polluted water from the city, which earlier used to enter the Phuleli canal, has reduced to a great extent. Since no such work has been executed so far in other cities of Sindh, the chief minster has ensured financial assistance if we make similar projects for other cities too. The donor agencies are also willing to provide funds for this purpose. We have conveyed this message to all relevant departments.

TNS: What plans do you have for reducing dependence on conventional energy sources and exploiting alternative sources?

AT: Pakistan has been facing a severe shortage of water and energy. Similarly, oil and gas are also diminishing quickly, but despite this all IPP projects are either oil- or gas-based, and contribute to air pollution and global warming. We want that the country reduces dependence on fossil fuels – such as petrol, diesel and gas – and harnesses alternate sources like wind energy, solar energy, sub-soil water energy or the tidal waves energy. There are two main hurdles in switching to these alternate sources: first, lack of technology; and second, the cost factor. In order to convert sea water into drinking water, we are planning to establish a plant for the whole coastal belt – through solar power and, if possible, wind power – that will not only produce energy but will also treat water. Similarly, sub-soil saline water can also be treated by using solar energy. We have already discussed the project with the World Bank, Alternative Energy Development Board, Sindh government and chief minister. However, due to the lack of expertise, we have still not been able to prepare a feasibility report for the project. We are trying to get technical assistance from Spain and other countries where such work has been done in the past. Within two to three months, an expert will be available after which further development will take place on the project. I have also asked the KWSB to start work on solar plants for reducing the burden on existing energy sources. All these initiatives will ultimately ensure availability of water, improve sanitary conditions and reduce poverty.

TNS: What are you doing to reduce vehicular emissions?

AT: This is a major issue, especially in Karachi and Hyderabad, but nothing has been done so far because of the involvement of some vested interests. The licenses of old, smoke-emitting, horn-blowing buses are renewed on annual basis. I have made a new plan and have also acquired equipment for its execution. Now the licences will be issued after proper check up of the buses, which hitherto was done purely on the basis of personal contacts. If implemented properly, we may expect some positive development in the near future. The government is also thinking about replacing the existing fleet of buses with CNG buses, but again some vested interests are opposing this idea tooth and nail. Similarly, rickshaw drivers were given the deadline of 2007 for converting from two-stroke to four-stroke engines, but they have extended it to 2010. Until the relevant departments do not enforce these orders strictly, nothing will happen. We are also receiving complaints about petrol adulteration and its smuggling from Iran. Action is also awaited in this connection. I would urge the media to take up these issues on a priority basis.

The world’s leading economies either are in recession or are heading for it. The global economic downturn, which started last year, is all set to continue during the current year as well. According to the International Monetary Fund (IMF), the global economy will grow by a meager 0.5 percent in 2009. This will be the lowest growth rate for more than half a century. The IMF has further predicted that, on average, developed economies will shrink by 2 percent during the current year. For instance, the German economy will contract by 2.5 percent, while the Japanese economy will shrink by 2.6 percent.

The global recession is likely to have significant implications for Pakistan, particularly in terms of fall in exports, capital inflows and jobs. Before we look into these implications, we need to answer three important questions:

1) What is recession? Market economies are susceptible to periods of recession and high inflation. Recession is a downturn in economic activity in which actual gross domestic product (GDP) falls well below the potential GDP. The fall in GDP is accompanied by fall in corporate profits, real incomes and employment. Generally, the major cause of a recession is the fall in consumer demand or spending. Since investment demand is derived from consumer demand, investment also falls. As investment demand falls, the demand for labour further falls, resulting in unemployment. The fall in aggregate demand drives prices down. Since wages are sticky in downward direction, corporate profits fall, leading to a fall in stock prices. The reduced demand for credit pushes down the market interest rate, leading to a fall in the value of the domestic currency. Recessions last a year or two after which the normal economic conditions are restored. However, a recession may also lead to a depression in which fall in output and employment is both protracted and severe.

How to deal with recession? According to John Maynard Keynes, arguably the foremost economist of the modern era, recession is essentially weakness of the aggregate demand and, therefore, its cure lies in stepping up the aggregate demand. This can be done by pursuing expansionary fiscal and monetary policies. The government should increase public spending, reduce taxes and cut interest rates. These measures will stimulate the economy by increasing people’s purchasing power. As people spend more, demand for goods and services will increase. Businesses will respond by stepping up their investment, which means hiring more workers and, thus, further pushing up incomes and the aggregate demand. Some economists believe that market forces have the capability to restore the economy to its normal position and that government intervention will only worsen the situation. Even if this argument is sound, politically no government can afford to do nothing while people are being rendered jobless. Hence, governments act upon the Keynesian prescription. For instance, the US government has recently come up with a $787 billion stimulus package, dubbed by President Barack Obama as the "most sweeping" recovery package in the American history. The package provides for tax cuts and increase in public expenditure, and is aimed at saving or creating 3.5 million jobs.

3) How recession in one country affects other countries? In the first place, during recession, domestic purchases fall and, thus, imports of both finished and intermediate goods decrease. Secondly, in order to save the domestic industry and jobs, governments are tempted to pursue protectionist policies, which means raising trade barriers. For example, the US stimulus package contains ‘Buy American’ provisions, which provide that public works and procurement funded by the package will use only domestic goods. Thirdly, due to capital crunch at home, foreign direct investment (FDI) outflows are reduced. For instance, according to the United Nations Conference on Trade and Development (UNCTAD), global FDI inflows decreased 21 percent during 2008. Fourthly, fall in incomes and job losses lead to reduced demand for migrant labour as well as restrictive immigration rules, as a result workers’ remittances shrink. In the context of the global recession, migration from developing to developed countries will fall. The World Bank has predicted decline of 6 percent in remittances worldwide during the current year.

Finally, we come to the likely effects of the global recession on Pakistan. For Pakistan, the 27-member European Union and the United States are the two largest export markets, accounting for nearly 55 percent of its exports. Japan and China are also major export markets for Pakistan. Recession in these countries will strongly reduce the demand for Pakistani exports.

The decrease in the country’s exports will be both indirect and indirect. The direct effect will be on export of finished goods, such as made-ups, garments, and sports and surgical goods. The indirect effect will be on export of intermediate goods, such as yarn and fabrics, which undergo value addition in these countries and are then exported to other countries.

Since exports are an important instrument of job creation, fall in exports will affect jobs and, thus, incomes and output. This impact should be studied in conjunction with other factors, such as inflation, energy crisis and increase in interest rates, which impact adversely on exports by raising the input costs. Fall in exports will also add to Pakistan’s record current account deficit.

Another impact on Pakistan will be in respect of terms of trade (ToT) – the difference between export and import prices. Favourable or improved ToT enables a country to buy a larger quantity of goods (imports) in exchange for a smaller quantity of exports. Given the size of markets in the EU, China and the US, the fall in imports will depress their world prices and, thus, prices of Pakistani exports. The result will be deterioration in Pakistan’s ToT.

A country’s overall welfare is positively related to its favourable ToT. A developing country like Pakistan needs to import machinery, equipment and raw materials to maintain the growth momentum. Deterioration in ToT will make it difficult for the country to buy the necessary industrial goods and, thus, may slow the growth momentum. Unfavourable ToT will also compound the balance of payment and fiscal problems, because the country will be forced to borrow to bridge the trade imbalance.

FDI inflows into Pakistan will also be affected. During the last few years, Pakistan attracted healthy FDI considering bad law and order situation and political uncertainty. During FY08 and FY07, Pakistan received FDI worth $5.15 billion and $5.12 billion, respectively. During the first seven months of FY09 (July 2008-Jan 2009), FDI worth $2.20 billion was registered. However, due to recession in Pakistan’s major sources of FDI – the US, UK and Japan – foreign investment in Pakistan is likely to be reduced. The reduction in FDI inflows will affect domestic output, jobs and foreign reserves.

Like FDI, workers’ remittances have played an important part in Pakistan’s growth. During the last six years (FY03-FY08), remittances worth $28.87 billion were recorded. During the first seven months of FY09, Pakistanis living abroad remitted $4.28 billion. The likely fall in workers’ remittances will affect private spending and savings, as well as put pressure on foreign reserves and the exchange value of the rupee. Moreover, tightening of immigration laws in Pakistan’s foreign labour markets will increase the employment level in the country.

(Email: hussainhzaidi@gmail.com)

Addressing the launching ceremony of Punjab Educational Endowment Fund (PEEF) in Lahore on Jan 18, then-Punjab Chief Minister Mian Shahbaz Sharif announced that by next year the provincial government would double the budget for PEEF to Rs4 billion. He said almost half of the position holders in Matriculation and Intermediate examinations hailed for underdeveloped districts of the province, and most of them could not pursue higher education because of lack of funds. The then-Punjab chief minister pledged that PEEF would give scholarships to students from class eight to the postgraduate level, adding that scholarships would also be given to students studying in private educational institutions.

A lot can be said in favour of this move of providing quality education to students from the poor areas of the province. However, no one has thought about evaluating it from a broader socioeconomic perspective – about providing an equal opportunity of access to education to all those who are capable of it and introducing vocational institutes for those who, after 12 years of schooling, may not be fit for higher education. In this regard, an integrated educational programme for ensuring that the so-called ‘elite’ educational institutions – which are costly, but do not necessarily provide quality education – become part of the uniform educational model should have been shared.

It is great to talk about doling out scholarships to a few to study and rub shoulders with the privileged class of the society, just because the standard of government-run educational facilities is pathetic. Students attending these public educational institutions are unable to compete with their privileged compatriots who qualify from the ‘elite’ educational institutions where entrance requires a high level of academic ‘excellence’, while the exorbitant fees cannot be afforded by everyone.

The vision of politicians is reflective of their social commitment and class-orientation, besides their own upbringing and, of course, vested interests. In our class-ridden society, Shahbaz Sharif has portrayed the sentiments of a typical class-oriented subject for whom segmentation of society into upper, middle and lower classes is merely a routine matter. For him, the problem is not related to bringing about qualitative changes in the standard and curriculum of public institutions, or making efforts for uniform syllabi in all educational institutions of the province, but to maintaining the status quo of class discrimination.

The two most important social sectors, education and health, are poised in the folds of private organisations working with the principal objective of making money. Since both, education and health, are essential requirements of humans, they will make conscious effort and go to any extent for providing them for themselves and their families, even if it means that they must pay a heavy price.

In developed countries, this burden is borne by governments, because only a healthy and educated nation can move towards progress and growth. Those nations that realised the importance of a healthy and educated population focussed their attention on these areas many decades ago and are now reaping the fruits of their efforts by enjoying standards of living that a Third World country can only dream of.

Not that there are no discriminations in the facilities offered to the public (like the wealthy can still send their children to private schools and obtain medical treatments in private hospitals), but the basic level of public institutions does not fail to provide level playing field for all. Hence, in most countries of the West, even the child of a labourer can benefit from an up-to-date curriculum and later compete with the son of an industrialist without any impediment. Similarly, there may be long waiting time in the state-run hospitals, but there is no distinction between the treatment of the rich and the poor. Can we say that the situation is similar in our country?

Children attending government schools and traditional madrassas hardly learn anything except to read and write. They suffer at the hands of out-dated curricula and poor infrastructure, along with incompetent teachers who prevent them from attaining a decent level of education that is viable in today’s competitive world. On the contrary, armed with sub-standard education, they aspire to get white-collar jobs and consider as undignified any work that involves physical labour or vocational skills. Thus, a farmer’s offspring would rather head to the city in search of some office job (no matter how menial), rather than using his learning for improving his occupational abilities.

Likewise, children who are born in vocation-oriented families mostly follow their example only when they have been deprived of schooling. Once they get the Matriculation certificate, they start despising and looking down upon their family business seeking new jobs in a market that is already glutted with prospective candidates. These issues also result in massive rural to urban movement, causing the cities to choke with increased demand for housing that eventually leads to an outburst of slum dwellings in and around the posh localities. Of course, increased movement of people also means a rise in the rate of crime and other social evils.

In the interest of this province, a wiser step would have been to direct precious funds in improving standard of education of the public schools, bringing them under one board of education. A centralised system of examination would ensure equal opportunities for all with one syllabus and uniform quality of education. At present, 20 different boards prescribe their own curriculum, and conduct secondary and intermediate examinations all over the country. They are independent of each other without there being any coordination between them. Thus, students qualifying from these boards may have one certificate, but differ widely in their knowledge and aptitude in accordance with their respective boards.

To make matters worse, we have ‘far-sighted leaders’ who sympathise with the poor by offering their children a chance to enter institutions that are beyond their reach. It is ironic that the government itself looks down upon its set-ups and becomes overawed with what the private sector has to offer. One wonders why the education department is so helpless! Apparently, lack of funds does not seem to be the problem; the Punjab government has billions of rupees to spare for scholarships. The only thing lacking is will and vision; the virtues of a leader who is well above the class-ridden superficial values that give rise to the stratification of social classes, thus leading to inequalities that are difficult to reconcile.

(The writers, authors

Over the last few years, a close circuit of interest groups (the subject of last week’s column) has increasingly enriched public policymaking. Terms like ‘old boys’ network’ or ‘kitchen cabinet’ have been employed to highlight the role of these groups in the formulation of public policy. For example, a small group close to President Asif Ali Zardari currently sets the direction of the ruling Pakistan People’s Party (PPP), as has been pointed out in various media reports and commentaries.

Similarly, in Britain, a small circle of advisors close to then-Prime Minister Tony Blair framed the Labour government’s policies during his tenure. This process of decision-making with the help of close friends was unveiled in the Butler report, commissioned to look into the decision leading to Britain’s participation in the war on Iraq. The report dubbed this style of closed shop policymaking as "sofa-style government".

The closed shop policymaking elite comprises policy networks and ‘in-groups’. The network theory of public policy is an attempt to overcome one of the major flaws in the theory of Institutionalism: its inability to appreciate micro differences between different policy sectors. As the last article indicated, institutions, while legitimating and filtering a policy, do not address the specificity of a policy field.

The idea of policy networks first surfaced in the work of Heclo and Wildavosky, in 1974. In a major study titled The Private Government of Public Money, which focussed on the British Treasury, they pointed to the existence of an informal Whitehall Village and policy networks, which ensured the dominance of the treasury in the budget-making exercise. At around the same time, Carter wrote of an ‘iron triangle’ between interest groups and congressional committees in the context of US politics. It was then that the word lobbyist began to surface.

A few years later, in 1979, Richardson and Jordan, in a book titled Governing Under Pressure, showed that the parliament hardly mattered in public policymaking, while civil servants and interest groups dominate decision-making shrouded in great secrecy. Further refining the idea of policy networks, two British academics, Rhodes and Marsh, defined, in 1991, policy networks as a cluster or complex of organisations connected with each other by resource dependencies and distinguished from other clusters or complexes by breaks in the structures of resources dependencies.

Central to the definition of policy networks is the idea of resource dependencies that brings networks together. Rhodes and Marsh, the two key theorists of policy networks, also identified five types of networks, depending on membership, vertical interdependence and distribution of resources among members. The identified networks range from highly integrated policy communities to loosely integrated issues networks.

The first type of networks, policy communities, are characterised by extremely integrated networks with stable relationship, continuity of highly restricted membership, a high degree of vertical interdependence and frequent interaction between their members, all of whom command resources. As described above, Heclo and Wildavosky identified a stable policy community in the form of Whitehall Village in the treasury. The traditional policy community was either government-driven, government-led or, at least, sanctioned or tacitly approved, while the emerging policy community tends to be more independent.

The second, professional networks, are defined by the pre-eminence of one class of professionals dominating the policy process. The most cited example in policy literature is of the National Health Service of Britain.

The third, intergovernmental networks, are based on representative organisations of local authorities. For example, Local Government Association in Britain is a network of local councils. Such networks are distinguished by limited vertical interdependence and extensive constellation of shared interests.

The fourth, producers’ networks, are defined by primacy of pure economic interests in policymaking, with fluctuating membership and limited interdependence among economic interests. The Organization of Oil-Exporting Countries (OPEC) can be cited as an example in this regard.

The fifth, issue networks, primarily involve consultation and not shared decision, because there is no shared understanding among the members. They are characterised by large membership with infrequent interaction between members, as well as unequal power distribution among the members that also reflects unequal resources. One of the recent active issue networks was the Jubilee 2000 Campaign, which was built around the issue of debt forgiveness. The campaign achieved its limited objective of getting debt reduced for most indebted countries of Africa.

Briefly, policy networks tell us about informal relationships in policymaking. They also inform us about the complexity of a given policy field, as opposed to institutions that treat policy at the macro level. We can also call policy networks as ‘in-groups’, in so far the participation of policy actors is concerned. Policy networks are mostly stable communities, injecting input into the policy process on a regular basis.

This is in contrast to the role of ‘out-groups’ that have no chair around the policy table. ‘Out-groups’ gatecrash into a policy field through extraordinary events and happening. For example, race riots afford ‘out-groups’ or excluded groups an entry in policymaking. The policy network theory, despite enjoying sustained attention in academic circles, has been criticised too. For example, British academic Keith Dowding maintains that the role of networks is hyped and often factors outside networks account for policy change. Despite its usefulness in explaining policy formulation, the theory of Rhodes and Marsh has been in retreat in recent years, and the advocacy coalition framework advanced by Jenkins and Sabbatier has replaced it as the model of analysis.

The US State Department’s annual Human Rights Report accuses Pakistan of major violations and abuses during 2008. "Despite some improvements after the state of emergency at the end of the previous year, the human rights situation remained poor. Major problems included extrajudicial killings, torture, and disappearances," it says.

The 2008 report takes Pakistan to task on a wide range of issues, such as prison conditions, the manner in which courts and judges have been undermined, trial procedures, arbitrary arrests, lengthy pre-trial detention, judicial dependence, corruption, rape, domestic violence and other forms of abuses against women, discrimination against religious minorities, inter-sectarian religious conflict, human trafficking, exploitation of children, etc.

The report conducts thematic inquiries and cites findings on cultural events, freedom of association and workers’ rights among other issues. It points out that Pakistan continued to restrict academic freedom: "The atmosphere of violence and intolerance fostered by student organisations, typically tied to political parties, continued to limit academic freedom." The report also scrutinises media freedom: "Journalists and their families were arrested, beaten, and intimidated, leading many to practice self-censorship." Moreover, it identifies corruption as a serious problem.

"Military operations in the country’s northwest killed approximately 1,150 civilians, militant attacks in that region killed 825 more civilians, sectarian violence in the country killed an estimated 1,125 persons, and suicide bombings killed more than 970 individuals. Ongoing battles with militants left approximately 200,000 persons displaced at year’s end," the report finds. Taking account of the killings in 2008, the report relies on the findings of the Human Rights Commission of Pakistan (HRCP), which records that "a large number of noncombatants have been targeted and killed by the security forces and, so far, no inquiry or investigation has been carried out."

While giving dozens of examples of incidents of disappearances in Pakistan, the US State Department’s report admits that "during the year politically-motivated disappearances declined, but police and security forces continued to hold prisoners incommunicado and to refuse to disclose their location." On a positive note, the report gives credit to Pakistan for returning to civilian democratic rule during the year: "International observers noted that parliamentary elections on February 18, while flawed, were competitive and reflected the will of the people."

The report not only candidly criticises Pakistan for human rights abuses, but it also – in a rather rare gesture – acknowledges America’s own failings in the field of rights. For example, it expresses concern about allegations of torture and abuse of detainees scooped up in the so-called ‘war on terror’: "As we publish these reports, the Department of State remains mindful of both domestic and international scrutiny of the United States’ record."

Secretary of State Hillary Clinton vows, in preface to the report, to address human rights abuses by the US: "Not only will we seek to live up to our ideals on American soil, we will pursue greater respect for human rights as we engage other nations and people around the world." This is a welcome shift in the US foreign policy under President Barack Obama.

It is no secret that Pakistan has violated a wide range of human rights as an American ally in the ‘war on terror’. The New York-based Human Rights Watch has disclosed that the victims are Pakistani and non-Pakistani terror suspects; men, women, and children; journalists, who have reported on the war on terror; and medical personnel, who allegedly treated terror suspects. Moreover, there have been several accounts of detainees, journalists and human rights activists who were either interrogated by US intelligence agents or present during the interrogation of terror suspects at secret detention centres in Pakistan.

Commenting on the report, HRCP Director I A Rehman says: "The US, while pursuing what it perceives as its national interest, does not take into account the harm it causes to other countries, including Pakistan. The ‘war on terror’ has jeopardised human rights all over the world, including in the US and UK. In Pakistan, human rights have been affected in the form of amendments to the anti-terrorism act, unlawful detentions or disappearances and the rise of militancy. However, a host of other forms of human rights abuses are our own handiwork."

This is not the first time the country’s human rights activists are scratching their heads in anguish or the government has been reminded of its poor human rights record. Terming the US State Department’s report "fair, balanced and adequate", Rehman adds: "Despite having a poor human rights record in Pakistan, we have the audacity to point out human rights abuses in other countries."

The privatisation of state-owned enterprises (SOEs) is on the rise in Pakistan as part of structural adjustment of the economy. Whatever title one likes to give, such as public-private partnership (PPP), the process is designed along the neo-liberal policy prescriptions that paint a rosy picture of the privatisation process as an ideological commitment rather than making a case for equitable economic development.

To make a convincing case, most of the pro-privatisation data is taken from developed countries and the same policy prescriptions are generalised for developing countries. What is eventually presented are exaggerated claims about the virtues of rolling back the role of the state and importance of market price signals. Both these claims are, however, highly contentious, especially if we look at the development experience of other countries, including the East Asia tiger economies.

Just like other countries, in Pakistan, most of the privatisation-related statements try to make ‘transparency’ of the process a point of prime importance. In fact, public policy blindly and near-religiously (perhaps under advice from the international economic policy establishment) believes in privatisation as a superior kind of economic management that can bring economic prosperity to the country.

It is true that privatisation proceeds have been able to fetch about Rs475 billion since 199, but the state of economy is far from on a steady growth path. The argument here is that even with ensured ‘transparency’ and use of money earned from selling of state assets for poverty alleviation, privatisation may not yield the desired economic gains, because it is essentially a politically, socially and institutionally wasteful exercise. This argument is especially valid where other options are available.

Therefore, in order to understand the political economy of privatisation, an interesting way could be to understand the process of economic development through an industrial policy design framework. Such insights show that economic change is a process of ‘capital accumulation’ and ‘productive investment’. Prof Nixon, who teaches at the University of Manchester, argues that these two processes are logically separate. Agreeing with Prof Ha-Joon Chang of Cambridge University, one may also say successful economic transformation in modern economy needs a developmental state to coordinate these two processes.

Under the International Monetary Fund (IMF) in Pakistan, it is claimed that the so-called ‘free market’ automatically creates situations of capital accumulation and productive investment through ‘right price’ signals. The resultant economic outcome is efficiency gain. However, after looking at the economic growth experience of East Asia, it appears that the role of the state has been more dominant than that acknowledged by the neoliberals. Factually, these economies have not been free market economies, and an embodiment of liberalised and de-regulated system of economic dispensation of society. In fact, the market operations were made to be both socially and politically efficient, and markets were ‘governed’ in a planned rational way.

The East Asian economies, an embodiment of developmental state, intervened into the market and altered the processes of capital accumulation and productive investment in line with the needs of priority sectors. During the 1990s, when Pakistan was passing through a rigorous phase of privatisation, China was increasing profit margins of SOEs to facilitate economic growth in a coordinated way. It has been recently reported that China is making adjustments in industrial development plans to fight recession elsewhere, providing policy credit to sunrise industries, and re-allocating human capital in both rural and urban production systems.

Although Pakistan cannot replicate what has happened and is happening in East Asia, as well as in India, a lesson can be drawn to seek other options. It has been argued by many contemporary researches that ‘change of ownership’ does not make much economy-wide positive difference. Comparative analysis between the East Asian and Latin American economies, on the other hand, informs that the state’s ability to control capitalists (now called entrepreneurs) from becoming parasitic ‘comprador’ class is important along with autonomy of the state institutions from regulatory capture. In short, improved economic governance means increased ability of the state to monitor accumulation and investment in the economy.

Considering the politico-economic implications of economic development, what is required as policy is a change in the perception that ‘private’ and ‘public’ sectors are competing enterprises. They should not be made to compete, but cooperate through a coordinating agent called the state under a well-defined industrial policy providing administrative guidance for sectoral capital accumulation and productive investment.

Empirical evidence from many countries, including East Asian ones, tells that industrial policy can create social and economic efficiencies (at the systemic levels), while crowding in the private sector through market expansion with increasing returns to scale. This process is difficult than privatising assets even in the most transparent manner, but it offers a path to sustained economic growth.

It must be noted that in Pakistan, as well as in India, privatisation of the telecom sector has increased the role of the private sector, but an unambiguous empirical argument is still lacking that could establish that the increased scale of investment in this sector has actually created a situation for economy-wide long-term equitable economic growth. The central issue is that our public policy seldom twists the ‘determinants of long-term equitable economic change’. In fact, the state should actively emphasise technological and managerial capability acquisition in the public and private sectors with which the industrial sector improves and innovates both the products and processes.

It is said that investment increases after privatisation. However, using long-term data, many researches now show that after privatisation in developing countries, investment first increases and then decreases. Prof Paul Cook has mentioned that after privatisation, the government reduces investment in that sector and this may result in infrastructural decay. Hence, privatisation is not the solution. It may be a social and political curse rather than a dividend, as argued by many analysts pointing at the unemployment and price-hikes due to privatisation.

It has been proved by research that 71 percent of non-utility sector privatisation results in negative change in employment. Likewise, in Pakistan, evidence suggests that 44 percent of privatised units showed decline in performance, while 34 percent were later closed. Therefore, Pakistan should try to evolve a good industrial policy that aids economic growth strategy, crowding in both the private and public sectors. The solution is to resist the processes of ‘capital accumulation’ and ‘productive investment’, and explore other options of ensuring equitable economic development.

In a poor slum of the bustling city of Karachi, Attiya (name has been changed to maintain privacy) tries to avoid tears from rolling down her cheeks as she watches her two children play in the courtyard. She is grateful for all that God has blessed her with but reminisces about her past, wondering how life would have been different if her other two children had lived to see the day.

In the last 10 years, Attiya has experienced two stillbirths, both of which occurred in the last term of pregnancy and were due to the carelessness of the health provider. At the time of delivery during her last pregnancy, she did not have enough time to rush to a health centre, thus she procured the services of a dai (traditional birth attendant) at home.

It is a well known fact that dais are not equipped with the instruments or knowledge required to deal with complications nor do they observe hygiene standards when carrying out obstetric-related procedures, which is why Attiya’s husband sought the help of a doctor before the situation got out of hand.

Little did they know that the doctor was as incompetent as the dai, and was, in fact, a quack! She had no medical qualification and had previously worked at another clinic in the community performing menial jobs. The only medical skills she had was what she acquired from observing the doctor. Many women in the community had consulted her during their pregnancies and she was responsible for a number of them dying during childbirth. Fortunately, Attiya survived the ordeal, but her baby did not. The doctor struggled to resuscitate the baby after it was delivered, but was unsuccessful in doing so because labour had been prolonged and water had flooded its lungs while in the uterus.

The lack of regulation in the private health sector allows such self-proclaimed doctors to flourish. The preceding account is just one of the many examples that illustrate this predicament. It is evident that people are often willing to pay for health care when they consider it to be of good quality, but they are rarely in a good position to judge the technical quality of the service provider or the place where services are procured. Moreover, the lack of relevant legislation and monitoring of the private sector has significantly hampered the expansion of high quality services across the country, due to factors such as the lack of a permanent employment structure.

The unfortunate incident of Maria Shah, a midwife who was a victim of an acid attack while on duty and who succumbed to her wounds just recently, is a telltale sign of the of insecurity felt by qualified providers in this field, as well as the need for the enforcement of necessary legislation.

In times of such disillusionment, the recent initiative of the Sindh government to draft three bills pertaining to the regulation of hospitals, the identification and accountability of quacks, and mandatory pre-marriage blood tests has given hope to the people. Considering that a similar draft ordinance proposed by the state administration in 2004 remained pending with the Governor’s House until 2007, the renewed effort by the Sindh government is welcome.

In view of the poor health scenario in Pakistan, the prompt implementation of the proposed bills is imperative for sustainable development. Even within South Asia, Pakistan’s performance in terms of some major health indicators has been poor, even in comparison with countries like Bangladesh. Moreover, Pakistan has fallen short in terms of attaining the Millennium Development Goals (MDGs) related to maternal health and mortality. The government has committed to reducing maternal mortality rate (MMR) dramatically; however, a recent survey puts the figure at 276 deaths per 100,000 live births, which is well below the country’s commitments under the MDGs.

The issue of increasing the quality and access of medical services in Pakistan is exacerbated by the trend of government expenditure on health. According to the World Health Organisation (WHO), public health expenditure as a percentage of gross domestic product (GDP) decreased from 2.5 percent in 2000 to 2.1 percent in 2005, which sheds light on the potential of the private sector to pave the way for a healthier Pakistan. Though private expenditure as a percentage of total expenditure on health slightly increased from 80 percent in 2000 to 82.5 percent in 2005, this change was not sufficient to meet expectations as the sector still remains plagued with a plethora of problems.

The absence of regulations in private hospitals and clinics, the threat to human lives from quack doctors and healers, and the ad hoc administrative policies continue to remain the significant menaces of the private health system. Additionally, many of the services provided in this sector are of low quality despite being high in cost. These factors are entwined with the plight of many others like Attiya who fall prey to the inadequacies of the private sector due to lack of awareness regarding competence of the provider. While mourning the death of her last child, Attiya had turned to her husband and said: "If only I had known who could save my baby, I would have showered all my wealth on her."

The lack of attention paid to reproductive health is one of the major problems being currently faced by the health sector in Pakistan. However, a little more focus on this oft-neglected area has shown an appreciable improvement in the status of reproductive health in Lodhran district of Punjab.

A cursory glance at the available statistics shows that besides a considerable increase in the number of patients approaching basic health units (BHUs), there has also been an increase in the number of family planning and mother and child health care cases dealt at these BHUs every year since 2005.

After the initiation of the Leadership in Reproductive Health programme in Lodhran district, in mid-2008, an awareness campaign singularly focussed on reproductive-health related issues was launched by District Support Unit of the Punjab Rural Support Programme (PRSP) in the catchment areas of all 48 BHUs. Support groups comprising people from all occupations, who were in place ever since the PRSP took over management and control of BHUs in 2005, were made instrumental for this purpose.

Due to effective management and keen supervision, this campaign bore fruit and a considerable increase was noticed in the number of deliveries at BHUs. Besides, it also showed that the semi-illiterate people of the rural areas have become aware of the importance of delivery of a child by a doctor or a qualified lady health visitor (LHV) at a BHU, instead of a dai (traditional birth attendant) at home.

The awareness campaign was augmented by special capacity building sessions for LHVs, which were conducted with the help of information, education and communication (IEC) material. The District Support Unit of the PRSP, noticing this positive trend among the people, equipped LHVs working at all the 48 BHUs in Lodhran district with necessary equipment (babies weigh scale, adult weigh scale, independent set of stethoscope and blood pressure monitor), so that women patients approaching a BHU, whether pregnant or mothers carrying newborns, could be examined with maximum possible attention.

Against the normal practice in the country, where male population is ignored while addressing the family planning-related issues, another intervention was made with district office of the Population Welfare Department. Through a special arrangement, it was made convenient that the male mobilisers of the department keep a close liaison with the social organisers of the PRSP and attend the support group meetings held at every BHU once a month to motivate men regarding the use of effective contraceptive methods.

Since the beginning of this year, another special campaign aimed at infection prevention while managing reproductive health cases has been launched, and a BHU has been designated as a hub of this activity, which includes day long training on infection prevention to traditional birth attendants by a qualified lady doctor.

(The writer is district support manager of the PRSP in Lodhran.

Email: athar68@yahoo.com)