Islamabad: A strong movement by the concerned citizens and civil society organizations is badly needed in the country for health to enshrined as a basic right in the Constitution as Pakistan is among countries which are ‘lowest spenders’ on health, healthcare experts, lawyers and representatives of civil society said on Friday.

They also deplored that health was not part of the manifestos of most of the political parties in Pakistan and called for exerting pressure on the political forces to make preventive, promotive and curative health as part of their agendas and manifestos.

Speaking at the roundtable discussion organized by the Human Rights Commission of Pakistan on the issue of right to health in Pakistan, former Special Assistant to Prime Minister (SAPM) Dr. Zafar Mirza deplored that state of Pakistan never gave priority to provision of basic health services to people and except for one occasion, less than 1% of the GDP is spent on healthcare in Pakistan.

“In some health indicators, we are even worse than Sub-Saharan African countries. Over 70 percent of our allocation for health is spent on establishment and running tertiary-care health facilities while less than 30 percent is spent on primary-care”, Dr. Mirza said and added that we don’t spend on preventive and promotive healthcare.

Dr. Mirza called for collaborative efforts and a movement to compel the state to enshrine health as a basic right in the Constitution and also called for approaching different political parties to include health as a basic right in their manifestos.

Another former SAPM Dr. Faisal Sultan Former SAPM on health Faisal Sultan said it was important to ensure that the right to health should not dissolve into platitudes. Unless underwritten by sufficient funds, the right to health cannot be realized, he observed.

Senator Walid Iqbal cautioned that introducing constitutional amendments was a long, often difficult process, adding that the courts had already articulated the right to health through the right to life.

Lawyer Sahar Bandial explained that, in international law, health is seen as an interdependent right, securing which depends on the provision of other rights, including the right to food, water, sanitation and a healthy environment, among others.

She added that the probability of successfully enforcing the right to health would increase if the scope of that right was clearly defined in the Constitution. Recognizing this right would also express the state’s moral and legal commitment to enforcing it.

Development practitioner and activist Zoya Rehman, who is working on a ‘people’s manifesto’ on the right to health for HRCP, reported that people had identified a range of concerns, including de-humanization of trans persons in the health sector, problems of healthcare provision based on a for-profit model, right to safe abortions, mental health and suicide among students, healthcare for victims of sexual violence and post-disaster healthcare support.

Discussing marginalized communities’ access to healthcare, Nabila Zaka from UNICEF cited the example of a pregnant sex worker whom hospitals had refused to treat when they learned she was HIV-positive.

Criticizing the recent bill that had effectively rendered gender dysphoria illegal, trans rights activist Mehrub Awan said, ‘Healthcare looks different for different people,’ adding that ‘gender affirming care is lifesaving care.’

Public health specialist Arif Azad underscored the need for collective action on health at the district level. ‘We see the right to health only when we fall ill’, he said, ‘but it should be seen in terms of the right to life, as preventive and promotive healthcare.’ Zainab Durrani of the Digital Rights Foundation said that the right to privacy was also linked to the right to health, explaining that health data leaks could have a catastrophic fallout for vulnerable groups.

Emphasizing HRCP’s commitment to the right to health, chairperson Hina Jilani said that there was a strong link between modern slavery and the right to health, explaining that HRCP had found that most bonded labourers took on debt servitude because of family health crises.