The Role of Politics in Health – With Examples from Pakistan

Health is fundamentally influenced by politics. Political priorities shape health policies, budget allocations, access to care, and even life expectancy. In countries like Pakistan, where health indicators remain a major concern, the political system plays a decisive role in determining the quality and reach of healthcare services.

1. Political Determinants of Health in Pakistan

Political determinants refer to decisions made by policymakers that directly or indirectly affect people’s health. In Pakistan, political instability, corruption, and inconsistent policies have historically weakened the health system. Frequent changes in leadership result in poor continuity of health programs and underfunding.

For example, Pakistan’s National Health Vision (2016–2025) aimed to create a coordinated health strategy across federal and provincial levels after the 18th Amendment. However, implementation has been slow due to political fragmentation and lack of accountability.

2. Health Budget and Resource Allocation

Pakistan spends less than 2% of its GDP on health, which is far below the WHO recommendation of 5%. This low investment reflects the lack of political prioritization of health. While large sums are often allocated to defense or infrastructure, the healthcare system suffers from under-resourced public hospitals, lack of rural facilities, and brain drain of healthcare professionals.

The Sehat Sahulat Program, introduced under the PTI government, was a step towards Universal Health Coverage (UHC). It provided free health insurance to low-income families in KP and Punjab. However, political changes affected its continuity and expansion, showing how political will directly impacts health equity.

3. Political Responses During Crises

The COVID-19 pandemic revealed both the strengths and weaknesses of political leadership in health emergencies. While Pakistan was praised for its smart lockdown strategy and vaccine rollout under the NCOC (National Command and Operation Center), political rivalry often undermined collaboration between provinces and the federal government.

Additionally, vaccine hesitancy was worsened by mixed messages from political leaders and religious groups, highlighting the role of political influence in public perception and health communication.

4. Health Equity, Advocacy, and Gender

Pakistan faces significant health disparities based on income, gender, and geography. Rural areas have limited access to maternal health, while Balochistan and interior Sindh remain underserved. Political neglect in these areas contributes to higher maternal and infant mortality.

Despite this, strong political advocacy can lead to positive change. Laws on mandatory vaccinations, tobacco control, and reproductive health rights have been passed due to pressure from health activists and civil society—demonstrating that political engagement is essential for progress.

5. Global Health and Political Image

Pakistan’s participation in global health diplomacy, such as polio eradication efforts, is heavily influenced by its political image. While international partners like WHO and UNICEF have supported the mission, political resistance, attacks on vaccinators, and lack of security have hindered progress.

Conclusion

In Pakistan, as in the rest of the world, health is a political choice. Governments decide whether health will be a right or a privilege. Political instability, lack of commitment, and poor governance have long hampered Pakistan’s health outcomes. However, where there is political will—such as seen in the Sehat Card Program or COVID-19 response—positive change is possible.

To build a healthier future, Pakistan needs consistent, transparent, and inclusive political leadership that treats health as a national priority, not an afterthought.

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