ishrat husain : the health challenge in pakistan - prognosis and prescription chief guest address by mr ishrat husain, governor of the state bank of pakistan, at the launch of the human development report of south asia, organised by mahbubul haq center for human development, islamabad, 30 may 2005. * * * there is a strong theoretical and empirical evidence that economic growth causes improvements in human development which, in turn, increases economic growth. the improvement in health results in enhancement of basic capabilities that adds value to human life. the transmission to growth takes place through impact on worker productivity, through demography and through trade and investment. health has a positive effect on poverty reduction too. poor households are hit by major illness and fall into poverty trap. lower earnings due to withdrawal from full time employment increases the risk of illness for the rest of the households. risk of falling below poverty becomes acute in case of death of the bread winner of the family. thus, investment in health, particularly preventive health such as availability of clean drinking water and sanitation can contribute to growth and minimize the risk of falling below the poverty line. there is no doubt that pakistan ’ s social indicators are not something we can feel proud of. pakistan ’ s competitiveness in the future knowledge based economy of the world will critically depend upon how well we are able to harness and increase the productivity of labor force for meeting future challenges. it is no longer a cliche that those lag behind in human development are going to become marginalized. it is all the more surprising to note this poor state of affairs at a time that there is almost unanimity on the intellectual front and broad consensus on the political front on the importance of human development in attaining national prosperity. both the economists and non - economists have converged their views on the critical role education and training, health and nutrition play in economic development. those on the left, those in the center and conservatives also have identical views though due to different reasons. all political parties in pakistan are committed to human development as a policy objective. why is it then that the progress in this area has been so unsatisfactory and what can be done to remedy this situation? in my view there are four cogent reasons for lack of progress in human development in pakistan. first, there is a structural ambiguity in the allocation of responsibilities between the federal, provincial and local governments in the whole endeavour of human development. the overlap and duplication in

elected representatives of an area should assume an active role as watchdog to make sure that the poor segments of the population are treated well at the government facilities. instead of focusing their attention on the postings and transfers of individual officials they will win popular support if they redress the grievances of their electorate in accessing basic services provided by the government. this vigilance will keep the officials on the right track while endear the elected representatives to their electorate. monitoring and evaluation of various programmes and projects will have to be carried out separately in a systematic way.