Anti-microbial resistance causing 1 million deaths in Pakistan annually — health experts

Anti-microbial resistance causing 1 million deaths in Pakistan annually — health experts
A nurse prepares a vaccine to treat a child suffering from pneumonia, at the Children's Hospital in Lahore on January 31, 2024. (AFP/File)
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Updated 19 May 2024
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Anti-microbial resistance causing 1 million deaths in Pakistan annually — health experts

Anti-microbial resistance causing 1 million deaths in Pakistan annually — health experts
  • Self-medication, unjustified prescription, taking antibiotics for shorter duration major reasons of antimicrobial resistance
  • Officials and public health experts urge people not to use antibiotics without the advice of trained and qualified physicians

KARACHI: Antimicrobial resistance (AMR) is the third leading cause of deaths in Pakistan that directly or indirectly results in 1 million deaths in the South Asian country annually, officials and public health experts said on Sunday.

They said this at a press conference in Karachi in connection with the National Antimicrobial Stewardship Summit 2024, organized by Getz Pharma drug manufacturer in collaboration with the National Health Services Ministry, Health Services Academy (HSA) and the National Institute of Health (NIH).

Around 300,000 people die annually due to drug-resistant bacteria, while AMR contributes to 700,000 deaths because of complications following treatment of diseases, according to the experts.

The deaths are linked with “irrational use” of antibiotics as Pakistan is the third largest consumer of antibiotics in the world, after China and India, and consumed antibiotics worth Rs126 billion in 2023 alone.

“Antimicrobial resistance is now the third leading cause of death after cardiovascular disease and maternal and neonatal disorders in Pakistan because we now have infections caused by bacteria that are not responding to third- and fourth-generation antibiotics,” said Prof. Shahzad Ali Khan, vice-chancellor of the Health Services Academy in Islamabad.

“Abuse of antibiotics by doctors, quacks, and people themselves is making these important medicines highly ineffective,” he said, urging people not to use antibiotics without the advice of trained and qualified physicians.

The summit was attended by over 1,400 health care professionals, including health secretaries and directors-general from federal and provincial governments, officials from the NIH, Drug Regulatory Authority of Pakistan, medical societies and health care regulatory authorities, senior physicians and policymakers.

Khan maintained that antibiotics were “wonder drugs” that saved millions of lives during world wars and pandemics, but their “irrational use or abuse” had led to AMR, which was now becoming a global public health concern.

“Self-medication, unjustified prescription of antibiotics by quacks and physicians, taking antibiotics for a shorter duration, and the production of substandard antibiotics by some companies are some of the major causes of antimicrobial resistance,” he said.

Prof. Javed Akram, former Punjab health minister and president of the Pakistan Society of Internal Medicine (PSIM), said AMR was the third major challenge facing Pakistan after population growth and non-communicable diseases (NCDs).

“People are now dying due to infections that are extremely hard to treat due to the resistance developed by bacteria against these medicines,” Akram said.

“On one hand, Pakistan has become the world capital of diabetes and other non-communicable diseases, and on the other, we have developed Extremely Drug-Resistant (XDR) typhoid, Multi-Drug Resistant (MDR) TB, and various other infections that are extremely hard to treat with most of the available antibiotics. This is because we have been using antibiotics like candies.”

He urged people not to consume antibiotics on their own, saying antibiotics have similar side effects as cancer treatment therapies.

Dr. Afreenish Amir, an NIH representative and senior microbiologist, said AMR had spread to almost all countries and regions, including Pakistan, owing to the “misuse and overuse” of antibiotics.

“This contributes to the increasing burden of infections due to resistant bacteria while limiting treatment options for managing such infections,” she said.

The experts also highlighted the “overuse and abuse” of antibiotics for livestock and said it was responsible for 80 percent of AMR in the veterinary sector. They called for creating awareness among the masses regarding the irrational use of antibiotics in humans, livestock and poultry.

In his keynote address, Prof. Zulfiqar Bhutta, a renowned pediatrician and public health scientist, urged people to get their children vaccinated against typhoid, saying Pakistan was the only country in the world where the Typhoid Conjugate Vaccine (TCV) was being administered to children to prevent the drug-resistant, water-borne disease.

Dr. Wajiha Javed, an associate director of public health at Getz Pharma, said over-the-counter availability of antibiotics, use of these medicines for a shorter duration, and unnecessary prescription of antibiotics by quacks and doctors should be looked into by the authorities.

She said substandard antibiotics containing less or low-grade raw materials were also responsible for AMR and announced that her firm was working work with the government to develop a national action plan on AMR.

On the occasion, a declaration was also signed between the Health Services Academy, NIH and Getz Pharma for the implementation of Antimicrobial Stewardship (AMS), while Memorandums of Understanding (MoUs) were also signed with 13 medical societies in this regard.


‘Elite must pay,’ PM says as Pakistan sets big tax target amid IMF talks

‘Elite must pay,’ PM says as Pakistan sets big tax target amid IMF talks
Updated 38 sec ago
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‘Elite must pay,’ PM says as Pakistan sets big tax target amid IMF talks

‘Elite must pay,’ PM says as Pakistan sets big tax target amid IMF talks
  • Pakistan has to find ways to increase revenues to reduce fiscal deficit as part of reforms being discussed with IMF
  • IMF is demanding fiscal consolidation, broadening tax base, improving tax administration and debt sustainability

ISLAMABAD: Prime Minister Shehbaz Sharif said on Thursday the elite classes of Pakistan needed to pay their share of taxes, a day after the government announced its national budget and set a challenging tax revenue target of 13 trillion rupees ($46.66 billion) for the year starting July 1, a near 40% jump from the current year. 

Pakistan has to find ways to increase its revenues to reduce its fiscal deficit as part of reforms being discussed with the IMF, with whom Islamabad is in talks for a bailout of up to $8 billion. The IMF wants Islamabad to carry out gradual fiscal consolidation, broaden its existing tax base and improve tax administration and debt sustainability while protecting the vulnerable.

"During the budget preparation, I made it clear that the elite must pay taxes," Sharif was quoted as saying in a statement by the PM Office after a meeting on tax reforms, digitization of the economy and measures to increase revenue. 

"We will eliminate tax evaders and those who assist them."

Calling the national tax watchdog, the Federal Board of Revenue (FBR), the "most pivotal wheel" of the national economy, Sharif said the incumbent government would provide all resources for the uplift and digitalization of FBR's human resources.

The top priority was to lower the tax rate while increasing the number of taxpayers, Sharif added, reiterating his government's resolve to impose minimal taxes on the poor and middle class.

"We are prioritizing the complete digitization of the tax system and enhancing the capacity of the workforce," Sharif said. "We are taking steps to bring eligible taxpayers into the tax net as soon as possible."

The rise in the tax target in the national budget is made up of a 48% increase in direct taxes and 35% hike in indirect taxes over revised estimates of the current year. Non-tax revenue, including petroleum levies, is seen increasing by a whopping 64% while sales tax would increase to 18% on textile and leather products as well as mobile phones. A hike in the tax on capital gains from real estate has also been announced. 

Key objectives for the upcoming fiscal year include bringing the public debt-to-GDP ratio to sustainable levels and prioritizing improvements in Pakistan's balance of payments position, the government's budget document shows.

Pakistan has projected a sharp drop in its fiscal deficit for the new financial year to 5.9% of GDP, from an upwardly revised estimate of 7.4% for the current year. 

On Monday, the central bank warned of possible inflationary effects from the budget, saying limited progress in structural reforms to broaden the tax base meant increased revenue must come from hiking taxes.

The bank, in a bid to boost growth, cut interest rates for the first time in four years on Monday, slashing them by 150 basis points, in the face of a sharp decline in inflation from a high of 38% last year to 11.8% in May.

GDP would expand 2.4% in the current year, missing the budgeted target of 3.5%, the government said, despite revenues rising 30% on the year, and the fiscal and current account deficits being under control.

The upcoming year's growth target has been set at 3.6% and inflation projected at 12%, Aurangzeb said.

 

With inputs from Reuters


Pakistan seeks US support for ‘favorable’ international financing to fix power sector woes

Pakistan seeks US support for ‘favorable’ international financing to fix power sector woes
Updated 25 min 34 sec ago
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Pakistan seeks US support for ‘favorable’ international financing to fix power sector woes

Pakistan seeks US support for ‘favorable’ international financing to fix power sector woes
  • Energy Minister Sardar Leghari meets US delegation led by Assistant Treasury Secretary Brent Neiman
  • “Fan replacement program” being launched for first time in Pakistan to increase energy savings, Leghari says

ISLAMABAD: Pakistan’s Energy Minister Sardar Awaiz Leghari has sought US assistance in securing international financing at “more favorable rates” to fix deficiencies in the South Asian nation’s ailing power sector, a statement from his office said on Thursday.

Restoring the viability of the energy sector is a major demand of the IMF, with which Pakistan is in negotiations for a new bailout loan ranging from $6 billion to $8 billion to avert default in an economy growing at the region’s slowest pace.

The IMF wants Pakistan to prevent further accumulation of circular debt in its power sector arising from subsidies and unpaid bills, and implement reforms to reduce costs by improving electricity transmission and distribution, moving captive power into the grid, improving governance, and combating theft.

Additionally, Pakistan needs to maintain power and gas tariffs at levels that ensure cost recovery, with adjustments made to safeguard the financially vulnerable, through existing progressive tariff structures.

In a report released in January, the IMF said Pakistan had missed its target for power sector arrears, largely due to lower-than-expected recoveries and tariffs.

On Thursday, a delegation from the US treasury department called on the Pakistani power minister and discussed collaborations in the energy sector as well as Islamabad’s reform agenda. 

A statement from Leghari’s office said he told the delegation about “the importance of US support in securing international financing at more favorable rates for Pakistan’s power sector.”

“He expressed the need for US technical assistance to address the gap between seasonal production and demand,” the statement added. 

Leghari informed the US delegation about plans to address the power sector’s deficiencies, adding that the reforms were aimed at improving Pakistan’s energy mix and rectifying other issues. 

The energy minister also informed the US delegation about reforms to increase private sector participation in the distribution and transmission of electricity. T

Discussing debt management, the energy minister also apprised the US team of a “fan replacement program” being launched by Pakistan in a bid to increase energy saving.

“The US Assistant Secretary of Treasury [Brent Neiman] appreciated Pakistan’s power sector reform initiatives and assured all possible cooperation to resolve Pakistan’s power sector problems,” the statement said. 


Pakistan shares close at record high after budget dispels concern over capital gains tax hike

Pakistan shares close at record high after budget dispels concern over capital gains tax hike
Updated 13 June 2024
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Pakistan shares close at record high after budget dispels concern over capital gains tax hike

Pakistan shares close at record high after budget dispels concern over capital gains tax hike
  • Benchmark share index closed up 4.9 percent at 76,338 points after presentation of budget, which looks to raise tax revenue of $47 billion
  • Budget aims to strengthen case for new IMF bailout deal, as Pakistan seeks estimated loan ranging from $6 billion to $8 billion

ISLAMABAD: Pakistan’s benchmark share index made its biggest single-day gain in nearly a year to close at a record high, a day after the government unveiled a budget that cheered investors by avoiding an anticipated increase in capital gains tax, despite an ambitious tax revenue target.

The benchmark share index closed up 4.9 percent at 76,338 points after the presentation of the budget, which looks to raise tax revenue of 13 trillion rupees ($47 billion) for the year starting July 1, up nearly 40 percent from the current year.

“The market was expecting an increase in capital gains tax and so investors had reduced exposure significantly,” said Adnan Sheikh, assistant vice president of Pak Kuwait Investment Co.

A record day was expected following the budget and Monday’s cut of 150 bps in the central bank’s policy rate, as “equities are the best option for the medium term,” said Sheikh.

Pakistan’s international sovereign bonds also rallied with longer-dated maturities seeing the largest gains. The 2036 bond added 1.4 cents — its biggest gain in more than two months — to be bid at just over 77 cents in the dollar, Tradeweb data showed. .

Following a post budget press conference on Thursday, Finance Minister Muhammad Aurangzeb told Reuters that Islamabad plans to raise up to $1 billion through international bonds in the 2025/26 fiscal year, adding that up to $300 million will be raised through Chinese markets.

Apart from the capital gains tax, analysts say the budget and other revenue measures were in line with expectations.

The budget aims to strengthen the case for a new bailout deal from the International Monetary Fund (IMF), as Pakistan seeks an estimated loan ranging from $6 billion to $8 billion, to avert default in an economy growing at the region’s slowest pace.

“We believe this budget will serve as prior action for a new IMF program,” Topline Securities said in a note.

Topline said that if parliament passes the budget in compliance with IMF measures, it expected a forward price to earnings ratio of 6.93 in three years time, for a historic high, from 3.4 now.

Defending the decision to boost tax revenue, Aurangzeb said the present tax-to-GDP ratio of a little under 10 percent was not sustainable.

Key objectives for the upcoming fiscal year include efforts to increase the ratio gradually to 13 percent in the next three years, Aurangzeb told a press conference after presenting the budget in parliament.


Pakistan’s top investigation agency moves court against acquittal of ex-PM Khan in state secrets case

Pakistan’s top investigation agency moves court against acquittal of ex-PM Khan in state secrets case
Updated 13 June 2024
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Pakistan’s top investigation agency moves court against acquittal of ex-PM Khan in state secrets case

Pakistan’s top investigation agency moves court against acquittal of ex-PM Khan in state secrets case
  • A high court in Pakistan earlier this month overturned jailed former PM’s conviction on charges of leaking state secrets
  • Despite acquittal order by Islamabad High Court, Khan will remain in prison for now due to a conviction in another case

ISLAMABAD: Pakistan’s Federal Investigation Agency (FIA) has challenged in the Supreme Court a decision by a high court to overturn jailed former Prime Minister Imran Khan’s conviction on charges of leaking state secrets, the ex-premier’s party said on Thursday.

Khan, 71, had been sentenced to 10 years in prison by a lower court on charges of making public a classified cable sent to Islamabad by Pakistan’s ambassador in Washington in 2022. He has been in jail since August last year.

On June 3, the Islamabad High Court (IHC) overturned the state secrets case conviction, saying an “instant appeal is allowed” and Khan was acquitted of the charges. Shah Mahmood Qureshi, Khan’s foreign minister during his tenure from 2018-2022, was also acquitted of the charges. Both however remain in jail due to other legal cases against them. 

“FIA has challenged IHC decision, acquitting former Prime Minister Imran Khan & Former Foreign Minister Shah Mahmood Qureshi, in the Supreme Court of Pakistan,” Khan’s Pakistan Tehreek-e-Insaf (PTI) said in a text message sent to journalists. 

“Interestingly appeal filed by FIA is based on short order of IHC whereas detailed verdict is yet to be announced.”

Khan has said the classified cable was proof of a conspiracy by the Pakistan military and the US government to topple his government in 2022 after he visited Moscow just before Russia’s invasion of Ukraine. Washington and Pakistan’s military deny that accusation.

The state secrets case was one of four in which Khan was convicted just ahead of Pakistan’s national election in February. In two other cases the sentences have since been suspended.

But despite the June 3 acquittal, Khan, a former cricket star, will remain in prison serving a seven-year sentence over another case relating to his marriage to his third wife, Bushra Khan, also known as Bushra Bibi, which a court said contravened Islamic law. 

A ruling on the couple’s appeal against the sentence was postponed last month and the proceedings transferred to another court after a judge recused himself following an accusation of bias made by Bibi’s former husband, according to Khan’s lawyers.

Khan and his party were banned from contesting the February election, but candidates backed by the jailed leader still won the most seats. They did not have the numbers to form a government, which was instead led by an alliance of his rivals led by Prime Minister Shehbaz Sharif.

With inputs from Reuters


Pakistan says will collaborate with Arab states for implementation of UNSC-backed ceasefire plan in Gaza

Pakistan says will collaborate with Arab states for implementation of UNSC-backed ceasefire plan in Gaza
Updated 45 min 8 sec ago
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Pakistan says will collaborate with Arab states for implementation of UNSC-backed ceasefire plan in Gaza

Pakistan says will collaborate with Arab states for implementation of UNSC-backed ceasefire plan in Gaza
  • Pakistan will start its new term as non-permanent member of the UN Security Council on January 1, 2025
  • Ambassador Akram says Pakistan seeks dialogue with India to address outstanding issues, including Kashmir

ISLAMABAD: Pakistan will work with Arab states and other Muslim countries to seek the implementation of two United Nations Security Council (UNSC) resolutions for a ceasefire in Gaza, Islamabad’s top diplomat at the United Nations said on Wednesday, a week after Pakistan was elected as a non-permanent member of the Council.

Pakistan will replace Japan, which currently occupies the Asian seat, on January 1, 2025, to begin a two-year term after being elected to the top UN body for the eighth time with 182 votes in the 193-member General Assembly. 

“We are trying to do together with our Arab and Muslim brothers, to get an implementation of the Security Council’s decisions on a ceasefire, on providing humanitarian access for the besieged people, the Palestinians, and Gaza, and to promote reconstruction and finally of course to promote the vision of a two-state solution which everybody agrees is the only course through which a durable peace can be established in the holy land,” Pakistan’s Permanent Representative to the United Nations, Ambassador Munir Akram, told Arab News in a Zoom interview from New York.

On Monday, the UNSC backed a proposal outlined by US President Joe Biden for a ceasefire between Israel and Hamas in the Gaza strip and urged the Palestinian group to accept the deal aimed at ending the eight-month-long war.

Akram said the United States proposal called for the implementation of a ceasefire plan, which was negotiated by Egypt, Qatar, and the US.

“Now the question is whether this resolution will be implemented and again, the question of implementing resolutions when it comes there, the United Nations has limited capability for enforcement,” he said, adding that the UN had no military means to implement its decisions and sanctions required passage by the UNSC, which was difficult due to the power of veto. 

The world had witnessed many instances where actions had been blocked in the Security Council because of the use of the veto, Akram said. 

“This is where we have to explore what is possible and what is doable to get to the objectives that we all want, which is ceasefire in Gaza, humanitarian help, reconstruction, and a two-state solution.”

As a non-permanent member of the UNSC, the ambassador said Pakistan would promote an international order based on the UN Charter, emphasizing self-determination, sovereignty, territorial integrity, non-interference, and prohibiting the use or threat of force.

“We will seek for the implementation of the UN resolutions on Kashmir and other conflicts and will also be seeking to strengthen UN peacekeeping capabilities to make UN peacekeeping more effective,” Akram said. 

When asked about his country’s expectations from Indian Prime Minister Narendra Modi who has been sworn in for a third term, Akram said Pakistan “looked forward” to the possibility of dialogue to address all outstanding issues, including the principal issue of Kashmir.

The Muslim-majority Himalayan region of Kashmir has been a flashpoint between Pakistan and India since their independence from British rule in 1947. Both countries rule part of the Himalayan territory but claim it in full and have fought two wars over the disputed region.

“Pakistani government is open to a constructive dialogue with India,” Akram said. “We hope this will be a dialogue without preconditions and that we would be able to promote more normal relations and a relationship based on the principle of sovereignty and equality of states.”