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The BMJ launches special collection on Health in South Asia

Apr 12, 2017

Over 60 contributors from South Asia and outside, including AKU researchers

​Fertility rates in South Asia are the highest in Afghanistan followed by Pakistan. Since the last 14 years, Pakistan’s fertility rate has not decreased even by 1%. It was 4.1% in 2004 and 3.6% in 2014, says the BMJ coveted collection Health in South Asia.

The compilation, containing 12 articles, was launched at a ceremony in New Delhi. Over 60 researchers, from South Asia and outside, including experts from the Aga Khan University, have contributed to the collection, stressing what should be the
Researchers from AKU in Pakistan participated in the launch ceremony in India via a video link
regional health priorities and recommending actions to improve public health.

Professor Zulfiqar A. Bhutta, Founding Director of AKU’s Centre of Excellence in Women and Child Health and Co-Director of SickKids Centre for Global Child Health, Toronto and Dr Samiran Nundy, Dean of the Ganga Ram Institute for Postgraduate Medicine and Research (GRIPMER), India have steered this initiative.

“In order to deal with the issue of high fertility rates, the priority should be to educate people and empower
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each country’s women. Take the example of Bangladesh that took initiatives and invested in education and female empowerment. Today Bangladesh is far ahead of Pakistan in many maternal and child health indicators,” said Professor Bhutta. He added that empowered women are more inclined to seek healthcare when in need, have improved health, education and long term outcomes.

Around 13 years ago, The BMJ published a review of the state of maternal and child health in South Asia and highlighted rampant poverty, malnutrition and lack of women empowerment as key barriers to change. The current update suggests that while there has been progress, it has been uneven and wide disparities persist. 

Professor Bhutta underscored the importance of scientific collaboration and partnerships in the region to address priority issues and gaps in public health.

Dr Nundy reinforced the need to foster stronger ties among the countries in South Asia. “We have the same problems – poverty, illiteracy, lack of access to health care. It's now time we get together and work out regional solutions. The BMJ collection is a start,” he said.  

Now the current collection focuses on public health of South Asia where gender disparities, malnutrition and social inequalities are widespread and over 300 million people live below the poverty line, according to Professor Bhutta. “The irony is that India and Pakistan are nuclear powers and invest immensely on arms and armaments while millions of people are deprived of basic facilities and human development indices are among the lowest in the world,” he pointed out.

According to the analysis, India, Pakistan and Sri Lanka, in South Asia, are the states that spend only 3-4% of their GDP on health.

Today, the region is at the brink of conflict, with massive deployment of armies on the borders of Pakistan and India. Terrorism is now a consistent threat affecting the lives and livelihoods of millions of people in the region. Conflict, civic unrest and insurgency have cost the region dearly. Despite continued economic growth and development, South Asia remains one of the poorest and underdeveloped regions of the world. Current generations are fed an incessant daily dose of jingoistic and nationalistic slogans and a highly selective and mutilated form of history. The growth of social media and communication technology may have increased contacts between people but it has also fuelled hysteria and war mongering, the publication contents stress.

Authors draw attention to the needs of people and set out priority actions for governments. People of South Asia deserve better, was basically the aim to publish articles on health issues in the region.

“The governments of our South Asian states should extend mutual cooperation in the health sector and also deal with the issues of public health but separately. They must keep aside politics as with better policies, political wisdom and public awareness the region can progress. Regional cooperation among the states is the need of the hour,” emphasised Professor Bhutta.

Dr Sajid Soofi, an associate professor of paediatrics at AKU, contributed to the paper on ‘Conflict in South Asia and its impact on health’. The paper has attempted to highlight the issues of mortality, sexual health, mental health, reproductive and child health, including gender based violence to improve health outcomes in the region.

One of the biggest challenges that needs to be addressed in the region is high consumption of cigarettes and smokeless tobacco – betel nut, gutka, main puri and paan masala. Dr Javaid Khan, a professor of medicine at AKU, said that 30% of men and 4% of women above the age of 15 smoke in South Asia. The consumption of smokeless tobacco is the highest in the region and its use leads to head and neck cancer, he added.

“The governments in the region should consider raising taxes on cigarettes, tobacco and smokeless tobacco products. This is the most effective intervention to curb smoking. Smoking should also be banned in public places,” he said.

The collection was launched by Dr Kamran Abbasi, Executive Editor, The BMJ. AKU researchers, including Zulfiqar Bhutta, Ather Enam, Javaid Khan, Tazeen Jafar, Sajid Soofi, Shehla Zaidi and Ashar Malik participated via a video link.

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