Malfunctioning Democracy: Attacks on Pakistani Journalists Amidst the Pandemic 

2020 in Review: Pakistani Students and the Pandemic

<p><span style="font-size: medium;">&nbsp;By <a href="http://www.researchcollective.org/researchers_info.php?cat=author&amp;val=A_001">Haris Gazdar</a></span></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhas8HDpOAv_3Zx6hM8XJAeaiD-omDtGkA7b3oG-hni0U4KIjEgNZg_WLWX5EnvEHUvACfu30YmLwJ47xihwUVl97-HIGABHP8xufCSo44Y3doxBgbPMITEcDQtwd2_k_OKAUuNdk8LXYI/s2048/HG+Blog.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1365" data-original-width="2048" height="426" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhas8HDpOAv_3Zx6hM8XJAeaiD-omDtGkA7b3oG-hni0U4KIjEgNZg_WLWX5EnvEHUvACfu30YmLwJ47xihwUVl97-HIGABHP8xufCSo44Y3doxBgbPMITEcDQtwd2_k_OKAUuNdk8LXYI/w640-h426/HG+Blog.jpg" width="640" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Women and girls in Qamber, Shadakot, north-west Sindh. Picture credit: <a href="https://commons.wikimedia.org/wiki/File:Women_and_girls_in_Qamber,_Shadadkot,_north-west_Sindh,_Pakistan_(8406155976).jpg">Wikimedia Commons</a>.<br /><div style="text-align: left;"><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><br /><div class="separator" style="clear: both;"><i><span style="font-size: medium;">This blog is based on a response by the author at the annual Sustainable Development Conference of the Sustainable Development Policy Institute on 14th December 2020.</span></i></div><div class="separator" style="clear: both;"><span style="font-size: medium;"><br /></span></div><div class="separator" style="clear: both;"><u><span style="font-size: medium;">Question<br /><br /></span></u></div><div class="separator" style="clear: both;"><span style="font-size: medium;">What major policy changes in existing national policies and programs you would like to see at federal and provincial government level to move towards universal social protection in Pakistan?&nbsp;</span></div><div class="separator" style="clear: both;"><ul><li><span style="font-size: medium;">Who do you think will be the main stakeholders? And do you find any torchbearer in this regard who can lead the process both at federal and provincial governments?</span></li><li><span style="font-size: medium;">How important will be the role of the private sector in this regard and what can be done particularly to improve the public private partnership to move towards the universal social protection? Are there any best practices that you can share with us?</span></li><li><span style="font-size: medium;">What do you think can be the strong foundations to build a business case for the universal social protection in Pakistan (particularly when there is always an argument of low fiscal space whenever there is a discussion on having a universal social protection system in the country)?</span></li></ul><div><div><u><span style="font-size: medium;">Answer</span></u></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">We have the bare bones of a universal social protection system which was established over a decade ago in the form of the Benazir Income Support Programme.&nbsp; There are several important accomplishments to date, all of them achieved early on. And plenty of challenges.&nbsp; The main accomplishments were:</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Targeting from a well-defined universe</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Delinking social protection from employment</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Increase in scale with respect to fiscal outlay</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Women as primary beneficiaries</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Key partnerships between databases (particularly NADRA) and payment agencies (banks/Telcos)</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">In the initial period there was talk of the programme focusing on food insecurity, and the targeting mechanism did, indeed, help to identify the relatively food-insecure families.&nbsp; But this thematic focus, or for that matter any other specific thematic focus, never really became a benchmark of progress.&nbsp; The programme was far too engaged, perhaps for good reason, with achieving its own operational goals.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">The move to universal social protection will require several important changes which must leverage the successes achieved over a decade ago:</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Articulation of key social protection objectives – in my opinion food security should receive priority, but also economic vulnerability</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Re-establish a clearer linkage with livelihoods and/or absence of livelihood opportunities, but also a focus on a range of vulnerabilities such as different ability, old age</span></div><div><span style="font-size: medium;">•<span style="white-space: pre;">	</span>Dynamic social registry with a rights-based approach and self-targeting (with various mechanisms for verification and audit of course).</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">Federal and provincial governments, and indeed local governments, have key roles and mandates in this regard.&nbsp; For all the media presence and slick imaging, the repackaging of BISP (into Ehsaas etc) conceals a cold hard fact: the core of social protection system, which is the unconditional cash transfer (UCT) to women in poor households has not been maintained and updated.&nbsp; The basic design requirement of renewing the targeting (or recertification) within 48 months of establishment has not be fulfilled – or around 2015. Five years on from that date, we have no clear indication of when the recertification (or the so-called National Socio-Economic Registry or NSER) will be carried out.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">Under our current system the federal government enjoys taxation powers across a range of relatively higher-yielding heads of tax, and their performance in tax collection has been poor. Provincial governments have performed better since the 7th National Finance Commission. But until there is a major change in the tax mandates, federal government will continue to have the fiscal resources for social protection.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">There is also a strong rationale for federal government lead in national redistributive transfers, and a whole range of untargeted subsidies are already routed through the federal tier.&nbsp; Over the longer-term, the future of social protection is closely tied up with tax performance and reform. More on that in a bit.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">Moreover, federal government also controls major official databases such as NADRA which have become indispensable – for good reason or bad – for the administration of social protection interventions.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">But provincial governments and their local government partners (let’s be clear that constitutionally local government is a provincial subject), actually have presence on the ground, and have mandates in a range of areas where the next generation of social protection programming – food security, labour, agricultural workers, health, disaster management (partially), protection of the differently abled, education etc – will arise.&nbsp; ‘Next generation’ in the sense of going beyond an unconditional cash transfer (UCT).&nbsp;</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">Provinces need to build strong and dynamic social registries and federal government systems need to extend active cooperation and support in this regard. This is because under our constitutional system a dynamic social registry, which has close operational links with line departments such as labour, differently abled persons’ empowerment, health, population welfare, local government, agriculture, food etc. is only possible at the provincial tier.</span></div><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">The type of political reforms that will lead to these changes are similar in scale, or even the unfinished businesses of, reforms like the 18th amendment involving:</span></div><div><ul><li><span style="font-size: medium;">Recognition of right to social protection, including legal mandates and correspondingly protected fiscal allocations</span></li><li><span style="font-size: medium;">Federal-provincial fiscal reforms including taxes and subsidies</span></li></ul></div></div><div><br /></div></div><div class="separator" style="clear: both;"><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;&nbsp; &nbsp;</span><span>&nbsp;</span></div><div class="separator" style="clear: both;"><span><br /></span></div></div><br /></div></td></tr></tbody></table><br /><p><br /></p>

Towards Universal Social Protection – the Story Thus Far

Why COVID-19 is Fatal for Children

Healthcare Workers’ Mobilization in Pakistan 

 Absent Again: Women and the Covid-19 Response in Pakistan

<p><span style="background-color: white;"><span style="font-family: times;">by <a href="http://www.researchcollective.org/researchers_info2.php?val=A_001" target="_blank">Haris Gazdar</a></span></span></p><p><span style="background-color: white;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHtlDWJ-V93Pho5L277NKhV8BbFZJizzbOHK37l3FOsj4rFMlp70jmdrW0lF5OU8g4A54_OE_aZZ2UUZMYRBZmJMW3FKF5tV3L3MbxdI0NL242wIRR53Uq5vn0uqFr12DjdsYSHTOLAKV4/s2048/59a830ba42f63.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1229" data-original-width="2048" height="375" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHtlDWJ-V93Pho5L277NKhV8BbFZJizzbOHK37l3FOsj4rFMlp70jmdrW0lF5OU8g4A54_OE_aZZ2UUZMYRBZmJMW3FKF5tV3L3MbxdI0NL242wIRR53Uq5vn0uqFr12DjdsYSHTOLAKV4/w625-h375/59a830ba42f63.jpg" width="625" /></a></div><div style="text-align: center;"><span style="color: #999999; font-size: x-small;">image by Asif Hassan/AFP</span></div><p></p><div style="background-color: white; margin: 0px 0in; text-align: left;"><span style="background-color: white;"><span style="font-family: times;">“If consciously or otherwise you were brought up believing that Karachi in 1947 was "a land without people for a people without land" this must be a disturbing time for you.&nbsp; Commiserations.<br /></span></span><span style="font-family: times;">&nbsp;And if in your imagination Karachi was not part of Sindh, commiserations again. Check Google Maps. What is Karachi? A settlement on the sea shore, occupying land between the Hub and Malir Rivers, to the north of the farthest reach of the Indus delta.<br /></span><span style="font-family: times;">&nbsp;<br /></span><span style="font-family: times;">You assumed, without ever caring to actually know, that you were entitled to the water that flows down the Kirthar Range, and the Indus, but only if it comes in taps. Commiserations. Water flows down. Sometimes taps come in the way. Sometimes not.<br /></span><span style="font-family: times;">&nbsp;<br /></span><span style="font-family: times;">Urban planners duped you into assuming that the land, its rocks, hills, riverbeds, bushes, backwaters, mangroves, the sea, its tides and currents don't matter. Omnipotence of civil engineering. Commiserations.<br /></span><span style="font-family: times;">&nbsp;<br /></span><span style="font-family: times;">You need to lash out. Of course you do. From omnipotence to impotence. What else will you do? The word Sindh, forget Sindhis for a minute, the word Sindh, it strikes fear because it shatters the fiction of omnipotence. Commiserations, and compassion.<br /></span><span style="font-family: times;">&nbsp;<br /></span><span style="font-family: times;">Take time out. Let things settle. A crime has been committed. Relax, you are not the criminal. But you are not the most wretched victim, certainly not the only one. Let it sink in: there is no land without people, there are no people without land.<br /></span><span style="font-family: times;">&nbsp;<br /></span><span style="font-family: times;">You are not impotent, omnipotence was an illusion. The fear is understandable. Let it pass. Sindh will irk you less. Sindhis too. The land is eager to teach, through people who have given it the time, their stories stores of knowledge, wisdom even, will make you powerful again.”</span><span style="font-family: times;"><br /></span><span style="font-family: times;"><i>This post is adapted from a Twitter thread by the author published on 2 September, 2020. Follow <a href="https://twitter.com/CollectiveKHI" target="_blank">@CollectiveKHI</a> and <a href="https://twitter.com/HarisGazdar?s=20" target="_blank">@HarisGazdar</a>&nbsp;to stay up to date with analysis and insights on current news in Pakistan and South Asia.</i></span></div>

The land is eager to teach

<p>By: <a href="http://www.researchcollective.org/researchers_info.php?cat=author&amp;val=A_079" target="_blank">Kabeer Dawani</a>&nbsp;</p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgArYgD-9uqpouXwLh6flXix2nQChbpAIYX_eWNWiEljVGIWmwolAorDaeiqHJUQjF2e6N0LBswV5lTI8y1a-CEYGstEjI056y6A-B5iT0u_M9mAX7rOskCG5uwyrBRbzj0S9D360fX0qJb/s1173/pill-drugs-medicine-health-doctor-medical-pharmacy-emergency.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1173" data-original-width="880" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgArYgD-9uqpouXwLh6flXix2nQChbpAIYX_eWNWiEljVGIWmwolAorDaeiqHJUQjF2e6N0LBswV5lTI8y1a-CEYGstEjI056y6A-B5iT0u_M9mAX7rOskCG5uwyrBRbzj0S9D360fX0qJb/w300-h400/pill-drugs-medicine-health-doctor-medical-pharmacy-emergency.jpg" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><br /></td></tr></tbody></table><div class="separator" style="clear: both; text-align: center;"><br /></div><p class="MsoNormal" style="text-align: justify;">Earlier this month, the Federal Government of Pakistan <a href="https://profit.pakistantoday.com.pk/2020/07/08/govt-takes-away-drug-pricing-power-from-pharmaceutical-companies/?fbclid=IwAR34OqHEFCPg9WNCNeDUPnFY5v7NO8lzKZRLUNKt4Af568q4ztkY1codcjY">amended the Drug Pricing Policy of 2018</a> in a bid to reinstate the government’s control over medicine prices and end automatic, inflation-adjusted increases. This follows public outcry in January 2019 over price increases and ongoing debates around affordable healthcare in the wake of the COVID pandemic.</p> <p class="MsoNormal" style="text-align: justify;"><span lang="">Medicine pricing has long been a controversial issue in Pakistan. Currently all pharmaceuticals have strict price ceilings, which, combined with a policy of price rigidity, has incentivised manufacturers to set very high initial margins. As a result, consumers face overpricing, shortages of drugs that are no longer profitable to manufacture, as well as poorer quality and less effective substitutes. While the Drug Pricing Policy was welcomed by many in the industry as a way to regulate an otherwise ad-hoc process, medicine pricing remains a populist issue and politicians face pressure to keep prices low. <span style="mso-spacerun: yes;">&nbsp;</span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">For the past two years in partnership with the&nbsp;<a href="https://ace.soas.ac.uk/" target="_blank">SOAS Anti-Corruption Evidence</a>&nbsp;research consortium, I have researched the Pakistani pharmaceutical sector, with a focus on rent-seeking related to pricing. In two papers coauthored with Asad Sayeed, I discuss the <a href="https://ace.soas.ac.uk/publication/anti-corruption-pakistan-pharmaceutical-sector/">political settlement of Pakistan’s pharmaceutical sector</a> and issues of <a href="https://ace.soas.ac.uk/publication/pakistans-pharmaceutical-sector/">pricing, procurement and quality</a>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">So, why is pricing of medicines so contentious in Pakistan? Do the strict price controls have positive or negative consequences? And can the pricing regime be structured in a way that benefits both the industry and the consumer?<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="">Populism in pricing <o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">Pakistan has implemented strict price controls and rigidity on medicines despite not having a clearly defined price-setting policy until 2015. From 2001 to 2013 there was a virtual price freeze on medicines. And even in 2013 when the Nawaz Sharif government increased prices, the decision was reversed within a matter of days due to public pressure. Pharmaceutical firms subsequently pursued a series of court orders until price increases were granted and a pricing policy was instituted, first in 2015, and then again in 2018. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">The <a href="https://www.dra.gov.pk/Home/Download?ImageName=Drug%20Pricing%20Policy%202018_new.pdf">2018 drug pricing policy</a> was formulated after due consultation with relevant stakeholders – nearly all of the people interviewed for our study supported it. The policy rationalises what was previously an ad-hoc process of price determination and increases, which one manufacturer termed as a ‘negotiation’ with the government. Under the new policy, increases were granted based on inflation – such as for essential medicines which could be increased by 70% of annual inflation once a year.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">However, early in 2019 there was public uproar over approved price increases that <a href="https://www.dawn.com/news/1479611/is-freezing-drug-prices-a-rational-health-policy">I have previously argued were largely legitimate</a>. At the time, the Imran Khan-led government came under considerable pressure by the media and the then-federal health minister, Aamir Kiani, was <a href="https://tribune.com.pk/story/1955960/1-amir-kiani-breaks-silence-denies-involvement-drug-price-hike">removed from office for alleged corruption</a> in granting the increases. In May 2019 the new health minister, Dr Zafar Mirza, was tasked with reducing these prices <a href="https://www.dawn.com/news/1482743">within 72 hours</a> and, by the start of 2020, the government had <a href="https://www.dawn.com/news/1524622">reduced the prices of 89 medicines</a> by 15%. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">This month the government has <a href="https://profit.pakistantoday.com.pk/2020/07/08/govt-takes-away-drug-pricing-power-from-pharmaceutical-companies/?fbclid=IwAR34OqHEFCPg9WNCNeDUPnFY5v7NO8lzKZRLUNKt4Af568q4ztkY1codcjY">revoked the inflation-based price increases</a> and has reinstated the Drug Regulatory Authority of Pakistan’s (DRAP) <a href="https://www.dawn.com/news/1568270">arbitrary powers</a> to decide increases – which must be seen in the broader context of strict price controls. Every government, across parties and systems, has continued with the populist policy of restricting increases because any change in the price of medicine – an essential good – is perceived as a failure of government and anti-poor. But populist debates often ignore the wider ramifications of the price controls.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="">What do price controls mean in reality?<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">The strict price controls increase the production costs of drugs, which means that pharmaceutical manufacturers employ multiple mechanisms to continue to grow and profit. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">Firms secure very high initial prices – sometimes with margins of 1000% – because they know that these will be squeezed over time. There are also inevitable shortages if a medicine is not profitable to produce (<a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063515">one study</a> found that only about a third of essential medicines were available in the market), while higher-priced substitutes may be introduced and produced that are more economical for manufacturers. Due to lax regulation, firms routinely compromise on minimum production standards (‘Good Manufacturing Practices’ or GMPs) too that are a necessary condition for quality medicines, in an effort to secure higher profits.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">Although hard to quantify, consumers will experience negative health effects from sub-standard drugs – they have to consume medicines for longer due to their lower quality and may not be able to access essential medicines at all due to their unavailability. Patients may also experience complications from the drugs shortages and slower treatment due to lower efficacy. Consumers have to spend more on medicines too – our research shows that for the poorest 10% of the population, expenditure on medicines as a share of total health expenditure nearly doubled from 45% in 2010–11 to 80% in 2015–16. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">So the stated aim of price controls – to keep prices in check so medicines are affordable for low-income households – is directly contradicted because of the incentives created for firms to circumvent the restrictions. And the consequences described above are harmful for the broader population, disproportionately affecting the poorest in Pakistan. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b style="mso-bidi-font-weight: normal;"><span lang="">Strategies for reform<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span></span></b><span lang=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">In the Democratic primary campaign in the United States, Bernie Sanders and Elizabeth Warren consistently <a href="https://www.commondreams.org/views/2019/02/02/bernie-sanders-and-elizabeth-warren-team-lower-prescription-drug-prices">highlighted exorbitantly high drug prices as an issue</a>. Left alone to capitalist forces, prices for medicines can skyrocket. However, at the other end of the spectrum, Pakistan’s strict price controls demonstrate harmful consequences in developmental terms. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">A balance needs to be struck of course, and Pakistan’s Drug Pricing Policy of 2018 as originally devised was a step in the right direction in establishing clear rules for rational pricing. As a result of the latest amendment this month, the current government may undo the beneficial aspects of the 2018 policy and they should seriously reconsider their decision.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">A large body of political economy research suggests that top-down policy changes are difficult to initiate and implement. Instead, successful improvements can be achieved through horizontal changes by industry or other players in the economy – policy-makers and industry stakeholders in Pakistan should take heed. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang=""><a href="https://ace.soas.ac.uk/wp-content/uploads/2020/07/ACE-WorkingPaper025-PakistanPharma-200701.pdf">Our study</a> suggests that a feasible way to seek improvements in pricing and access to medicines is if pharmaceutical firms and the media can work together. The media in Pakistan has significant power in shaping public discourse and opinion. But, due to the complexity of the pharmaceutical sector and the relationship between pricing and larger public health concerns, reporting has been inadequate and often misplaced. The media, in fact, reinforces the populist pressure on governments to suppress medicine prices. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">And so the onus is on the pharmaceutical sector to work <span style="mso-bidi-font-style: italic;">with</span>the media. One possible way to do this is through <i style="mso-bidi-font-style: normal;">independent</i> journalism schools who organize workshops to train journalists. The industry can finance these schools, who can then organize workshops for journalists on the impact of price controls on social welfare and the broader effects beyond populist debates. The trainings will be credible because they will be conducted independently and not the industry, who will not have any editorial input. This is crucial for the strategy to be successful, and some schools do presently organize journalists’ trainings through corporate financing, so it is not unprecedented. Thus, if the print and electronic media can report more critically and highlight the harmful impact of rigidity in medicine pricing and its ad hoc nature, it could be possible to decrease incrementally public opposition to price increases. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="">In turn, informed public attitudes will allow politicians to enforce consistent, rule-based price increases. Not only will this reduce drugs shortages, it will also reduce the high margins on medicines and the propensity for higher-priced substitutes. Although such efforts will take time, this is one <i style="mso-bidi-font-style: normal;">feasible</i> way for meaningful reform in the pharmaceutical sector and for improvement in access to medicines in Pakistan.<o:p></o:p></span></p> <p class="MsoNormal"><span lang=""><br /><i>This article is an output of a research programme (</i></span><span lang=""><a href="https://ace.soas.ac.uk/"><i>SOAS-ACE</i></a><i>) funded by UK Aid from the UK government. The views presented here are those of the author and do not necessarily represent the views of the UK Government’s official policies.</i></span></p> <p class="MsoNormal"><i><span lang="">This essay was first published by </span></i><span lang=""><a href="https://nayadaur.tv/2020/07/why-amending-pakistans-drug-pricing-policy-is-a-mistake/"><i>Naya Daur Media</i></a><i> and is reproduced here with the author’s permission.</i></span></p>

Populist Policy not Effective Reform: Why Amending Pakistan’s Drug Pricing Policy is a Mistake

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