PAKISTAN 2020 | A Vision for Building a Better Future
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Transcript of PAKISTAN 2020 | A Vision for Building a Better Future
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PAKISTAN 2020
A Vision for Building a Better Future
ASIA SOCIETY PAKISTAN 2020 STUDY GROUP REPORT
BY HASSAN ABBAS
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PAKISTAN 2020A Vs F Bg a
B F
Hassan abbas
My 2011
ASIA SOCIETYPAKISTAN 2020 STudY GrOuP rEPOrT
AsiaSociety.og/Pakistan2020
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I the word of the legedry poet, Fiz ahmed Fiz, whoecetery i beig celebrted i 2011:
We shall see / certainly we, too, will see /
that day that has been promised us
When these high mountains
Of tyranny and oppression / turn to uff
And evaporate
And we oppressed
Beneath our feet will have
this earth shiver, shake and beat
And heads of rulers will be struck
With crackling lightening and
thunders roar.
When from this Gods earths (Kaaba)
All falseness (icons) will be removed
Then we, of clean heartscondemned by zealots those keepers of faith,
We, will be invited to that altar to sit and Govern
When crowns will be thrown offand over turned will be thrones
We shall see / certainly we, too, will see
that day that has been promised us
Then Gods name will remain (Allah will remain)
Who is invisible and visible too
Who is the seer and is seen
Then will rise one cheerI am God!
Who I am too
And so are you
Then the masses (Khalq e Kuda) people of God will rule.
Who I am too
and so are you
Hm dekhenge
(trltio y Miz nqvi)
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Poject diecto
Hassan Abbas, Bernard Schwartz Fellow, Asia Society; Quaid-i-Azam Proessor, South Asia
Institute, Columbia University
Poject Manage
Robert W. Hsu, Assistant Director, Global Policy Programs, Asia Society
Membes
Samina Ahmed, South Asia Project Director, International Crisis Group
Graham Allison, Douglas Dillon Proessor o Government and Director, Beler Center or Science
and International Aairs, Harvard University
Peter Bergen, Journalist; Director, National Security Studies Program, New America Foundation
Christopher Candland, Associate Proessor o Political Science and Co-Director, South Asia
Studies Program, Wellesley College
Stephen Cohen, Senior Fellow or Foreign Policy Studies, 21st Century Deense Initiative,
Brookings Institution
Suzanne DiMaggio, Vice President, Global Policy Programs, Asia Society
Asad Durrani, Lieutenant General (Ret.), Pakistan Military, and Former Director General o
Inter-Services Intelligence; Former Pakistan Ambassador to Germany and Saudi Arabia
C. Christine Fair, Assistant Proessor, Center or Peace and Security Studies, Edmund A. Walsh
School o Foreign Service, Georgetown University
Asher Hasan, Founder and CEO, Naya Jeevan
Andrew Hess, Proessor o Diplomacy and Director, Program or Southwest Asia and IslamicCivilization, Fletcher School o Law and Diplomacy, uts University
Pervez Hoodbhoy, Chairman and Proessor, Department o Physics, Quaid-i-Azam University
Mir Ibrahim, Founder and CEO, Geo V
Pasa 2020 S Gp
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Asma Jahangir, President, Supreme Court Bar Association o Pakistan
Jehangir Karamat, General (Ret.) and Former Chie o Pakistan Army; CEO, Spearhead ResearchInstitute
William Milam, Senior Policy Scholar, Woodrow Wilson International Center or Scholars; FormerU.S. Ambassador to Pakistan
Adil Najam, Director, Frederick S. Pardee Center or the Study o the Longer-Range Future,Boston University
Nigar Nazar, Cartoonist; CEO, Gogi Studios Ltd.
John D. Negroponte, Vice Chairman, McLarty Associates; Former U.S. Deputy Secretary o State
Sania Nishtar, Founder and President, Heartle
Amir Rana, Director, Pakistan Institute or Peace Studies
Ahmed Rashid, Journalist and Author; Former Correspondent, Far Eastern Economic Review
Eric Rosenbach, Faculty Aliate, Beler Center or Science and International Aairs, Harvard
University
Babar Sattar, Founding Partner, AJURIS Advocates and Corporate Consultants
Ayesha Siddiqa, Political Analyst; Author,Military Inc.: Inside Pakistans Military Economy
Shirin Tahir-Kheli, Former Senior Advisor or Womens Empowerment, U.S. Department o State,
and Senior Director or Democracy, Human Rights, and International Operations, U.S. NationalSecurity Council
Frank Wisner, Foreign Aairs Advisor, Patton Boggs, LLC; Former U.S. Ambassador to India and
U.S. Undersecretary o Deense or Policy
Moeed Yusuf, South Asia Advisor, Center or Conict Prevention and Analysis, United States
Institute o Peace
Mariam Abou Zahab, Lecturer, Institut National des Langues et Civilisations Orientales
Mosharraf Zaidi, Columnist, Te News; Policy Analyst
Nasim Zehra, Director, Current Aairs, and Host, Policy Matters, Dunya V
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Foreword |7
Given ever-increasing concerns about Pakistans stability and its impact on the region and beyond, it
is not surprising that there has been a urry o studies on Pakistan in recent months and years. TeAsia Society Pakistan 2020 Study Group seeks to contribute to the thinking about Pakistans uture
by oering three unique and mutually reinorcing dimensions. First, this Study Group is the rst in
recent years to include a signicant number o leading experts rom Pakistan andthe United States,
representing a range o sectors in both countries. Second, rather than viewing Pakistan exclusively
through a security lens, the Study Group set out to examine the crises in Pakistan in a broader and
more comprehensive context. A myopic ocus on security challenges is problematic, as economic
challenges, perennial political tussles, and resource scarcity problems in Pakistan are o equal, i notgreater, concern to the uture o the country. Finally, rather than dwelling on what is going wrong
and resorting to quick xes, the Study Group ocused on generating pragmatic and durable policy
recommendations aimed at improving Pakistans uture prospects with a long-term vision.
Tis report, however, is not meant to represent a consensus among all the members o the Pakistan
2020 Study Group. It presents the ndings and conclusions reached by the project director and thereports principal author, Hassan Abbas, through consultations with Study Group members. While
individual members may disagree with some parts o the report, the Group broadly supports theoverall set o recommendations.
Tis report went to print as the news o Osama bin Ladens death suraced. As the United States and
Pakistan ace an extremely dicult moment in their bilateral relationship, our hope is that the recom-
mendations provided here will help policy makers in both countries and in the broader international
community to ormulate the best and most eective decisions to set Pakistan on a progressive path
by 2020. Moreover, the ideas or reorm contained in this report are directed at civil society actors inPakistan, who in recent years have started to play an increasingly important role.
On behal o the Asia Society, I would like to thank the members o the Pakistan 2020 Study Group or
dedicating their experience and expertise to this enterprise. I am especially indebted to Hassan Abbas
or ably directing the project and or bringing his deep knowledge o Pakistan to bear in penning this
report. My thanks go as well to Suzanne DiMaggio, Vice President o Global Policy Programs at the
Asia Society, or skillully overseeing all aspects o this initiative, and project manager Robert W. Hsuor supporting the many moving pieces rom the initial stages to the nal product. Special thanks are
due to Shahan Muti or his help in writing this report, imothy Orr or coordinating meetings with
Study Group members, and Yasser Kureshi, Kinza Hasan, and Cynthia Lee or providing research
assistance.
During the course o this project, valuable insights were gained rom interviews with senior Pakistani
government ocials, including ariq Pervez, ormer Director General o the National Counterterrorism
Authority; ariq Khosa, ormer Director General o the Federal Investigation Authority; KhawajaMohammad Asi, Member o the National Assembly o Pakistan; Ambassador Nazar Abbas; Amjad
Bhatti, Advisor in the Ministry o Inormation, Islamabad; and Owais Ahmed Ghani, ormer Governor
o Khyber Pukhtunkhwa Province. I grateully acknowledge their valuable insights. Useul eedback
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8|PAkiStAn 2020: A ViSion For BuildinG A Better Future
or the report was also gained rom interviews with students at Government College University in
Lahore, Pakistan and the School o International and Public Aairs at Columbia University in New
York. I also wish to thank the Lotte Group or generously supporting this eort.
Finally, this eort began under the keen eye and passionate commitment o Asia Societys ormer
Chairman, the late Richard C. Holbrooke. Asia Society dedicates this report, and our ongoing work
and programming on South Asia, in his memory, with deep gratitude or his legacy in international
relations and his service in this region in particular.
Vishakha N. Desai
President, Asia Society
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i n recent years, Pakistan has stumbled rom one crisis to another. A number o political andsocioeconomic challenges threaten to urther destabilize a country that already is reeling rominsurgencies along its northwestern border. Pakistans newest democratic government is struggling to
maintain control over parts o its territory where militant religious groups are intent on challenging
its authority and legitimacy. Te countrys conict with India over Kashmir, now in its seventh de-
cade, appears as intractable as ever, and the war in neighboring Aghanistan has deepened instabilitythroughout Pakistan. Te transition rom a near-decade-long rule under a military dictatorship is
slow and complicated, as rampant corruption and politicization o the bureaucracy present huge
obstacles to the state-building process.
Although Pakistans vibrant civil society, relatively open media, and the rise o an independent higher
judiciary provide some glimmers o hope, poor economic and development indicators coupled with
worrying demographic trends pose serious challenges to the well-being o millions o Pakistanis.
Energy shortages have worsened in recent years, and the destruction caused by the oods o 2010
has exacerbated the countrys many strains. In short, how Pakistan manages these challenges in the
coming years will have great consequences or its uture prospects.
While recent reorm eorts in the higher judiciary and constitutional amendments to strengthen
democratic institutions and expand provincial autonomy signal a positive trajectory or the country,
sustaining democratic governance is complicated by radicalization and violence perpetrated by an
intolerant and extremist minority in the country. errorist attacks on respected and cherished Su
shrines throughout Pakistan and high-prole assassinationsincluding the January 2011 killing
o Salman aseer, the governor o Punjab, and the assassination o Shahbaz Bhatti, Pakistans only
Christian cabinet minister, in March 2011illustrate the lengths to which religious extremists inPakistan will go to silence opposition voices in the country. And rather than condemning these acts o
vigilante justice as un-Islamic, the governments slow and timid response to the violence has allowed
voices o intolerance to gather strength.
Preventing Pakistan rom urther deterioration will require a sustained, long-term commitment rom
the government o Pakistan, the United States, and other international stakeholders to promote genu-
ine reorm in the coming decade. Tis commitment must be enshrined in a comprehensive package
o policies aimed at promoting sustainable constitutional democracy, credible and eective rule o lawand law enorcement, a signicant expansion and improvement o the education and health sectors,
ecv Sa
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exeCutiVe SummAry |11
their leaders, limit the areas where candidates can contest an election to their home constituen-
cies, and establish a transparent mechanism by which unding can be provided to low-income
candidates.
rle of Law an the JiciayTe weaknesses o Pakistans judicial system not only pose a serious challenge to access to justice, butalso hinder the ght against terrorist groups. In the most basic sense, the rule o law in Pakistan must
aim to protect the rights o citizens rom arbitrary and abusive use o government power. A unctioning
judiciary is a undamental element o any societys rule o law. Expanding reorm eorts rom higher
to lower judicial levels o the system will be critical or Pakistan in the coming years. Te ollowing
measures should be carried out to strengthen the rule o law in Pakistan over the coming decade:
e2002BangalorePrinciplesofJudicialConductwhichstipulatethat,inadditiontoinde-
pendence, the values o impartiality, integrity, propriety, competence, diligence, and equal treat-
ment o all beore the courts are essential to proper judicial conductmust be ollowed.
Respectingtheseparationofpowersenshrinedintheconstitution,aswellasplacingreasonable
limits on the Supreme Courts use osuo moto powers, will contribute greatly to the enhancement
o the rule o law in Pakistan.
Securityforjudges,especiallyforthoseinlowercourtshearingsensitivecasessuchasthosecon-
cerning blasphemy and terrorism, must be enhanced.
eUnitedNationsConventionontheEliminationofAllFormsofDiscriminationAgainst
Women needs to be ratied without delay.
eNationalJudicialPolicyshouldbeimplemented,withanemphasisonprovisionscallingfor
oversight, disciplining corrupt and inecient judicial ocers, setting a timeline and establishingspecial benches or prioritizing cases that can be ast-tracked, and unding courtroom construc-
tion and the hiring o judicial ocers and administrative sta.
IntheFederallyAdministeredTribalAreas,thePakistangovernmentandSupremeCourtmust
establish as a matter o priority a unctioning judicial system with civil and criminal courts and a
reormed legal code to replace the outdated and irrelevant Frontier Crimes Regulation.
Hman developmentPoor governance and weak institutions have eroded the Pakistani publics condence in the govern-
ments capacity to address their everyday needs. Pakistan currently ranks 125th (out o 169 countries)
on the United Nations Development Programmes Human Development Index. Te governmentis investing little in socioeconomic development, which also is hindering the growth potential oPakistans economy and depriving people o opportunities to live a satisying lie.
Ecation
Given the dire crisis in education in Pakistan today, the country will not achieve universal primary edu-
cation by 2015, as set orth in the United Nations Millennium Development Goals. Te ocus should
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be on getting as close to the goal as possible by 2015, with a renewed commitment to achieve universal
primary education by 2020. As a rst step, Pakistan must immediately raise its public expenditures on
education rom less than 1.5% to at least 4% o gross domestic product, and by 2020, the expenditures
should be set to at least 6%. Without making this minimal commitment, a reversal o the worrying
trends in the education sector is unlikely to occur. An immediate increase in public expenditures on
education to at least 4% o gross domestic product should target the ollowing priority areas:
Devisingandimplementinganaccountableandpredictablesystemofteacherrecruitment,
hiring, payment, retention, and training, as well as promotion based on merit, achievement, and
outcomes will greatly improve the quality o education and teacher perormance in Pakistan.
eintroductionofcurriculumreformfocusingonalife-skills-basedapproachtoeducationwill
promote real-world applications o creative thinking and analytical reasoning.
Developingarobustcentralregulatorysystemwillcontributetothemaintenanceofstandards
and the collection o timely data on service delivery, operations, inrastructure availability, scal
fows, learning achievements, teacher perormance, and school outcomes in the education sector.
Adynamicsetofinstitutionalizedrelationshipsshouldbeestablishedbetweenthecentralregula-
tory mechanism and the autonomous and independent subnational government units responsible
or service delivery.
Separatingthehighereducationfunctioncompletelyfromtheprimaryeducationfunction
and enacting legislation to provide specialized management and authority over higher education
institutions will ensure greater regulatory control.
Madrasareformcanbeachievedthroughstrategiesforcurricularimprovement.Publicschool
curricula should be devised, designed, and monitored by provincial governments and combine
religious and secular education.
egovernmentofPakistancanfulllitseducationreformplansifforeigndonorsandinter-
national agencies ocus their aid eorts on establishing a single coherent approach to providing
signicant budget support in this sector.
Health
Pakistan is in need o deep-rooted reorm in its health care system, which must include systems o gov-
ernance outside the public health sector that aect the perormance o health systems. While universal
access to basic public health acilities is an ambitious goal that many Pakistanis desire, investments
now must begin to build a strong inrastructure by 2020 to make this goal attainable. Immediate
action in the ollowing priority areas should begin to address health needs in Pakistan:
Proactivestepstoimprovehealthgovernancewillbegreatlyenhancedbythedevelopmentofa
national consensus on a health reorm agenda.
Inadditiontodevolvingservicedeliveryresponsibilitiesfromthefederalleveltotheprovincial
and district levels, capacity building at the provincial level will allow or the planning, evaluation,
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exeCutiVe SummAry |13
and implementation o alternative service delivery and nancing mechanisms. Key national
unctions or health should be retained by the ederal structure.
Collecting,analyzing,andswiftlyscalingupsuccessfulbestpracticesfromexistingexamplesof
public service delivery reengineering at the primary health care and hospital levels will contributegreatly to health sector improvement in Pakistan.
Separatingpolicy-making,implementation,andregulatoryfunctionsinthehealthsector,aswell
as adopting market-harnessing regulatory approaches, will lead to an improvement in service
delivery.
Concretestepsforincreasingpublicnancinginhealthmustbeginalongsidemeasuresto
improve utilization and limit pilerage. Strengthening essential services, enhancing social
protection or the inormally employed, and pooling insurance or the unemployed are priority
areas or any increase in revenues in the health sector.
Aninnovativesystemofprivatepublic,employer-andsponsor-subsidized,andpooledgrouphealth insurance can be introduced nationwide, especially or low-income groups.
Investmentsmustbemadetoleveragethefullpotentialofhealthinformationtechnologyin
mobile health systems, with the aim o improving transparency in procurements, increasing
philanthropic subsidies, enhancing quality assurance, and promoting access to medical education.
echnology such as telemedicine can help bridge the gap between rural and urban access to
quality health care.
Collecting,analyzing,anddisseminatinghealthinformationforshapingpolicyandplanning
at the decision-making level can be achieved through the development o an apex institutional
arrangement.
Byadoptingmarket-harnessingregulatoryapproaches,therstpointofcontactinprimary
health care will be broadened while enabling equitable access and the purchase o health care or
many Pakistanis.
Strengtheninggovernmentoversightandregulationsinprivatesectorhealthcaredeliverywill
prevent and check problems such as malpractice and acilitate publicprivate collaborations in
health delivery.
Enegy InfastctePakistan aces chronic inrastructure challenges when it comes to energy sources. In addition to
nurturing social and political instability, Pakistans poor energy inrastructure imposes enormouseconomic costs in the orm o unemployment and loss o revenue. An uninterrupted supply o energy
to uel the nations economy should be the highest priority or Pakistans economic managers. o
meet its current and uture energy demands, the government o Pakistan should invest a minimum
o $5 billion in energy production by 2020. Additionally, the ollowing measures in the energy sector
should be implemented:
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Pakistanmustenhanceitscapacitytocultivatemorepowerfromrenewableenergysources,particularly by improving its ability to harness wind energy along its southern coast and by
making use o solar power.
Alongwithproperupkeepandmaintenanceofexistinghydropowerdams,moredamsareneededto meet current and uture energy requirements in Pakistan. Tis can be achieved by directing
investments toward the construction o a very small number o large dams (Kalabagh dam is one
project that has been stalled) or a larger number o small reservoirs. At the same time, these plans
must be integrated into a broader strategy to improve water resources management throughout
the country. Additionally, Pakistan can dispel the impression that big dam projects will benet
only larger provinces by exploring ways to reach a consensus among all the provinces on its water
inrastructure and providing provinces with legally binding guarantees.
EnergyeciencyinPakistancanbeimprovedifgovernment-ownedpowergeneration
inrastructure is reurbished technologically and power inrastructure is upgraded with a modern
ecient grid.
ForeigndonorscanplayakeyroleinbuildingPakistansenergycapacitybyprovidingexpert
advice to the public and private sectors in Pakistan on energy development and management.
Te United States, in particular, should explore investing in a large energy inrastructure projectin Pakistan, which will not only deepen strategic ties with Pakistan but also create goodwill in the
country.
The Floos of 2010Te massive oods in Pakistan during the summer o 2010 set back all development indicators in the
country. Te enormity o the humanitarian crisis caused by the oods requires concerted planning
and a seamless transition to the rehabilitation and reconstruction phase. Securing resources or thepost-relie phase continues to be a challenge, but every eort should be made in the next two to
three years to ensure that reconstruction in Pakistan proceeds eectively. Te ollowing steps shouldbe taken to ensure that Pakistan ully recovers rom the ood and is adequately prepared or uture
disasters:
Pakistansvulnerabilitytodisasterscanbeaddressedbyimmediatelyimplementingsoundbuild-ing regulations, starting land rehabilitation, de-silting canals and waterways, and constructing
dikes.
IntegratingclimatechangescenariosintothePakistangovernmentsannualdevelopmentplanswill help develop a well-coordinated strategy to address the impacts o global climate change in
the country while ensuring progress toward meeting the Millennium Development Goals targetsor poverty reduction.
Regionalaswellasglobalsupportforreconstructioninood-hitareasiscritical.Toimproveits
credibility and potentially attract more unds or reconstruction, Pakistan must be ully transpar-
ent about the use o international unds.
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Baluchistan, where reports o abductions o political activists by security orces are common,must end.
Arobustwitnessprotectionprogramthatalsoprotectsinvestigators,prosecutors,andjudges
particularly in major criminal and terrorism casescan be created through amendments in theCriminal Procedure Code.
Rigidandimpartialenforcementofthelawwillhelpameliorateethnicstrifeandsectariankill-
ings in cities, especially in Karachi. Tis strategy will require revising the curriculum in publicschools, as well as in madrasa networks, in ways that encourage pluralism and deter any dissemi-
nation o intolerance.
CurricularimprovementinPakistanalongscienticlinescanbemodeledonsimilareortsinIn-donesia and other countries. In this context, progressive religious scholars who challenge violent
extremists must be provided ull security as well as state support or their independent research
work and publications.
Internalsecuritycanbeachievediftheinternationalcommunitydirectlytargetsitsassistance
toward helping Pakistan in this area. Hal o U.S. unding allocated or counterterrorism and
counterinsurgency support in Pakistan, or example, can be directed toward supporting scientic
investigations and enhancing orensic capabilities in law enorcement. Additionally, the rules o
engagement o coalition orces and policies on drone attacks should be reassessed.
relations with Inia an NeighbosPakistans development is almost impossible without regional cooperation, and China and India play
a very important role in this context. An optimistic scenario in the next 10 years would be orPakistans economy to grow at a rate o approximately 5% annually, which would provide a cushion so
that the country could begin investing in long-term human capacity development. However, withouta sustainable peace deal with India that includes an amicable resolution o the Kashmir dispute, this
is unlikely to happen. Tere is a growing realization in India that a ailed Pakistan is not in its best
interest. Peace in South Asia is attainable i Pakistan, its neighbors, and international stakeholders
ocus on the ollowing measures:
PakistanmustsetagoalofincreasingannualdirectbilateraltradewithIndiatomorethan$5
billion by 2020, as increased economic interactions will expand the space or peace constituencies
in both states. As a rst step, India should unilaterally lower nontari barriers to trade with
Pakistan. In turn, Pakistan can accord India most-avored-nation trade status.
Reformingthevisaissuanceprocesswillhelpsupportandstrengthenpeople-to-peoplecontactrom both countries, as will urther encouraging contacts between civil society groups and
student exchange programs in both countries.
EnhancingenergycooperationbetweenIndiaandPakistanisapotentialavenueofdialogue
between the two countries. Cooperative energy projects, such as joint natural gas pipelines,
joint electricity-generation projects, and the development o a common grid system, will go a
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exeCutiVe SummAry |17
long way toward demonstrating that the people o both countries can benet rom improved
relations.
egovernmentsofPakistanandIndiashouldplaceamoratoriumontheexpansionoftheir
nuclear weapons programs. Pakistans military leaders must realize that more nuclear weaponswill neither improve the countrys nuclear deterrence capabilities nor help in its ght against
terrorism. Furthermore, Pakistan must ensure the saety and security o its nuclear materials.
ByreposturingmilitarilyandbecominglessPakistanfocused,IndiacanhelpeasePakistans
insecurity. War doctrines such as Cold Start should be reviewed and Pakistans apprehensions
about Indian intererence in Baluchistan need to be addressed. At the same time, Pakistan must
dismantle all armed groups ocused on Kashmir.
Pakistan,India,Afghanistan,andotherexternalpowersmustrecognizethatterrorismisbyno
means a state-specic problem; the entire region will have to conront it together. Cooperation
between civilian law enorcement agencies in South Asia should be institutionalized.
eUnitedStatescannotpromoteanamicableresolutionofthedierencesanddisputesbetween
India and Pakistan by supporting one side or the other; it must remain objective. In the case o
Aghanistan, a more proactive role or the United States must include bringing all the regional
stakeholders to the table, ideally under a United Nations umbrella and with the aim o endingthe IndiaPakistan rivalry and proxy war in Aghanistan.
Pakistan aces enormous challenges in the years ahead. But the people o Pakistan have shown a
remarkable resilience in addressing some o these challenges, and there is a high potential or reorm
and development in the country. Progressive and constructive policy shits, as suggested here, are
what truly matter in the long term. Moreover, internal and regional actors will dene and drivePakistans path toward reorm, and the international community, especially important allies such as
the United States, must play a supportive role.
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For much o the past six decades, the Pakistani military has been the dominant player in nationalpolicy making, especially in ormulating oreign policy in the region. Ater the all o GeneralPervez Musharra s military regime in 2008, the army restrained itsel rom interering in government
ormation in the center and in the our provinces. However, one o the most important challenges
acing Pakistan is the militarys dominance o the countrys scal priorities and strategic calculus.
Te military consumes the lions share o state resources and continues to ocus on its ear o Indian
regional hegemony. In this context, one o the biggest challenges or the democratic government is tobuild, consolidate, and strengthen civilian-led democratic institutions.
Te promise o bold political reorms in the
Federally Administered ribal Areas (FAA),
reconciliation eorts with secessionist groups in
Baluchistan Province, economic reorms in the
shape o a newly negotiated National FinanceCommission award involving all provinces
and the ederal government, as well as a major constitutional amendment to enhance provincial
autonomy in critical areas are positive steps toward comprehensive political reorm. Yet it remainsto be seen whether these decisions will be implemented to the satisaction o all local stakeholders.
In this context, corruption in the bureaucracy and political arena is a serious obstacle to democratic
reorm in Pakistan.
Te militarys inuence in the political arena remains pervasive, albeit inconspicuous. It continues to play
an important and inuential role in the countrys internal security policy while retaining its vast business
interests in the country. Financially, the Pakistani military is one o the most opaque in the world. Te
relationship between the civilian government and the military is reminiscent o earlier governments,
many o which eventually ell into conict with the military. Te current government led by the Pakistan
Peoples Party initially made bold gestures to exert its supremacy over the military, although some o
those steps were not well thought-out. For instance, an attempt to bring Pakistans premier intelligenceservices, Inter-Services Intelligence, under civilian control ailed, as this was done in an unduly hurriedand conused manner, causing the army to react and orcing the government to retreat.
Te civilian political orces clearly are not nearly as powerul or united enough to bring about a
sea change in the civil-military power dynamic in Pakistan in the short term. Many in the country
view the prime ministers decision to extend General Ashaq Kayanis tenure as chie o the army or
Cv-ma ras a
dcac
The militarys inuence in the
polcal aena emans pevasve,
albe nconspcuous.
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CiVil-militAry relAtionS And demoCrACy |19
another three years as an indication that the military chie retains his prominent place in governmentand in relations with the United States. Tis unprecedented step possibly was meant to ease tensionsbetween civilian and military leaders, which began in 2009. Te WikiLeaks disclosures on this subjectsubstantiated strong rumors about this civil-military tension.1
In regional policy making, the Pakistani armys General Headquarters is still oremost in deciding andimplementing security and geostrategic policy or the country, especially in regard to its neighborsIndia, Aghanistan, and, to some extent, Iran. op Western civilian leaders, especially rom Washington,D.C., and the European Union, continue to meet with top military commanders in Pakistan in one-on-one meetings, apparently without the involvement o ocials in Pakistans Ministry o Deense.Tis serves to strengthen the role o the Pakistani military in the policy-making arena.
All o this eclipses the act that the military now must contend with a newly empowered judiciarythat has risen in Pakistan through a popular street movement. Historically, all military takeovers o
government were sanctioned or at least rubber-stamped by a compliant judiciary. oday, however,the Supreme Court, which is led by a powerul chie justice who rose to power on the promise tobury the doctrine o necessity that had been used in the past to justiy military takeovers, is unlikelyto sanction a military takeover o the government in Pakistan. Te increasingly popular televisionnews media also has made clear its position that military rule is not the way orward. While a hand-ul o ultranationalist newspaper columnists continue to suggest that the militarys role in politics isneeded, the overall prospects or a military takeover in Pakistan are quite remote under the prevailingcircumstances.
Vision 2020 Objectives and Recommendations: Expecting the military to completely withdrawrom civilian politics within a couple o years o civilian rule is unrealistic. ransition rom military
to civilian rule takes timeas is evident rom previous occasions in Pakistans history, and is shownby experts who have analyzed the urkish and Indonesian experiences. Over the next decade, it ishoped that civilian orces will be able to unction in a way that will strengthen democratic institutionsand that the military will realize the damaging impact it has had in the country through its directinvolvement in governance. Pakistans armed orces are well resourced and largely well organized andcan contribute eectively to national building, provided they remain within their constitutionallyprescribed domain. Te ollowing course o action should be pursued to strengthen democratic rulein Pakistan:
Astrictadherencetotermappointmentsforarmedforcespersonnelbythecivilianleadership
will support the proessionalization o the Pakistani military. Retired or serving generals should
not be appointed to lead civilian institutions.
MakingtheexpendituresofthePakistanimilitarymoretransparentiscriticalandwillrequire
enacting parliamentary legislation through a legislative process similar to those ollowed by many
governments worldwide.
1 ahfq Kyi Mulled Topplig aif ali Zrdri Who Hd nmed succeor: WikiLek, Daily News and Analysis, Decemer 1, 2010
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CiviliansupremacyinthePakistaniarmycanbeestablishedthroughthedevelopmentofinternal
mechanisms, or example, by emphasizing the importance o democracy in military academies,
making the Pakistani militarys budget transparent, and involving civilian leaders rom Pakistans
Ministry o Deense in strategic decision-making processes.
einterestsoftheUnitedStatesandotherimportantalliesofPakistanwillbebetterservedby
giving priority to strengthening relations with the democratic leadership and institutions o the
country.
AchievingstabilityinPakistanandstrengtheningdemocratictraditionsinthecomingdecadewill
require all major Pakistani political parties to be internally democratic and transparent. Strength-
ening democratic traditions will require taking the ollowing steps:
Every political party must hold regular elections or all leadership positions in the party and
enact term limits or oceholders.
No candidate should be allowed to contest an election in any constituency, except in theconstituency where the candidate and his or her amily normally reside.
All parties must establish central and provincial party unds to enable low-income party
workers to contest elections. Allocations must be made through a transparent mechanism.
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Pakistans judicial system has a checkered history. Corruption and ineciency, as well asdeerence to military rule and extraconstitutional interventions, have dened the Pakistanijudiciarys reputation with its citizens.2 Access to justice always has been a problem, particularly in the
countrys peripheral regions. However, in recent years, the judiciary has gained popularity and stature
by deying authoritarianism and by taking on a populist agenda o social justice. In this regard, the
lawyers movement o 20072009, which led to the restoration o the chie justice o the Supreme
Court o Pakistan, Itikhar Muhammad Chaudhry, and helped bring an end to military rule, hasplayed the most signicant role.
Te overall judicial system in Pakistan, however,
aces grave problems, including ineciency, a
judicial backlog, high levels o corruption in
lower courts, lack o training, and insucientaccess to justice in most parts o the country.
In peripheral regions o the country, there is an
absence o any real judicial system. For instance,
1.1 million cases were pending with the countryslower courts as o May 2010, while 150,000 cases remain pending in the High Courts. Te Supreme
Courts backlog o cases in July 2010 was about 17,500. 3 Tis staggering backlog causes signicant
delays. According to a report by the International Crisis Group (ICG), it can take anywhere rom 10to 20 years beore a nal judgment is given in civil cases. A major reason or this backlog is the very
limited resources available to the judicial sector and understang. In 2008, a judicial ocer in Punjab
Province, on average, had to deal with a case list o 1,668 cases a day. Te ICG report calculated that
in Sindh alone, 250 more judges were needed to manage the backlog.4
Insucient government investment in the judicial sector has resulted in corruption and ineciencywithin both the courts and the police, particularly in criminal cases. As a result o inadequate pay
and resources, the criminal justice system is characterized by limited investigation and prosecutioncapacities and long gaps between the ling o charges and trial dates, during which evidence oten
r f la a Jca
in ecen yeas, he judcay
has ganed populay and saue
by defyng auhoaansm and
by akng on a populs agenda of
socal jusce.
2 For hitoricl perpective, ee Itertiol br aocitio, a Log Mrch to Jutice: a Report o Judicil Idepedece d Itegrity i Pkit,Hum Right Ititute Report, septemer 20093 see Kmr Hider, Court Ce bcklog, suffer Commo Pkiti, Dawn, July 21, 2010, for dt o lower d higher court well thesupreme Court4 Itertiol Crii Group, Reformig the Judiciry i Pkit, ai Report o 160, Octoer 16, 2008; ee lo secretrit of the Lw d Jutice
Commiio of Pkit, ntiol Judicil Policy: 2009, http://wwwidhhighcourtgovpk/jp2009/jp2009pdf (cceed Ferury 7, 2011)
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disappears. Criminal cases can take more than ve years to process, except when tried by special
courts such as accountability courts, where cases oten are politically motivated. As a result, Pakistan
has a critically low arrest and conviction rate.
Prisoners on trial oten are not brought to the court on trial dates because o simple deciencies such
as the unavailability o transportation. Prison personnel also seek bribes rom prisoners to ensure ac-cess to a judge. Fearing indenite detention, many detainees are orced to plead guilty to obtain lesser
sentences, or they might bribe police ocials to avoid going through the courts. Te huge backlog
o cases provides opportunities or corruption within the subordinate judiciary, as many judges seek
bribes to x an early hearing. Women are especially disadvantaged in this environment.
Access to justice is even worse in the peripheral regions o the country. For instance, the lack o accessto justice and public rustration over the existing legal system in Swat Valley in Khyber Pukhtunkhwa
Province contributed to an increase in support or the ehrik-e-Niazi-Shariat-e-Mohammadis brand o
brutal but decisive law.5 Ater the brie takeover o Swat by local militants in 2009 and the establishment oa parallel judicial system, the civilian government realized the need or improvement in judicial services.
In FAA, the national judicial system essentially
does not exist because o the outdated and re-pressive colonial laws o the Frontier Crimes
Regulation, which still is enorced. Moreover, the
all-powerul Political Agent makes all judicial
decisions, including arrests and punishments that
cannot be appealed in any court. Te absence o
a real judicial system and the diminishing impor-
tance o tribal leadership, along with the increasing isolation o FAA rom the rest o the country,
have helped bring FAA under the control o religious extremists and militants.
Lately, concern has been growing over the conrontational tone between the judiciary and the executive,
as the judiciary has been seen as encroaching on the powers o the executive and legislature. Meanwhile,
the political leadership is being criticized or ailing to implement judicial decisions. Moreover, the
newly empowered and active Supreme Court has been criticized or not building the capacity and
inuence o district courts, which are the ace o justice or many ordinary Pakistani citizens.
Clearly, the judicial system is in urgent need o drastic reorm, and has been or many years now. In
2009, the newly reinstated chie justice announced the National Judicial Policy, which was intendedto transorm the judiciary into a cleaner, more ecient, and more accessible system.6 A host o reorm
measures were planned, some o which have been initiated. For example, to prevent the politicization
o the judiciary, judges are prohibited rom taking executive oces, and special courts were brought
under the control o the judiciary rather than the executive. Furthermore, placing undue stress on
in FAtA, he naonal judcal
sysem essenally does no exs
because of he oudaed and
epessve colonal las of he
Fone Cmes regulaon.
5 Judicil Reform i swt, Dawn, Mrch 25, 20106 For the full text, ee secretrit of the Lw d Jutice Commiio of Pkit, ntiol Judicil Policy: 2009
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rule oF lAw And the JudiCiAry |23
disposing o court cases rapidly should not compromise procedures or ensuring justice. Tere must
be a distinction between timely as opposed to hasty delivery o justice.
Vision 2020 Objectives and Recommendations: In the most basic sense, the rule o law is a system
that aims to protect the rights o citizens rom arbitrary and abusive use o government power. A unc-
tioning judiciary is a undamental element o any societys rule o law, and expanding reorm eortsrom higher to lower judicial levels o the system will be critical or Pakistan in the coming years. Te
provision o justice in a timely manner will go a long way toward stabilizing Pakistan and, indirectly,
strengthening democracy in the country. In recent years, disenranchised segments o the population
at times have adopted vigilante tactics to mete out justice, which has created a space or extremists
and criminals to assert themselves. Curbing this trend also will check the rise o militant groups in
the country. Te ollowing measures should be carried out in the next decade i improvements in the
rule o law are to be established in Pakistan:
e2002BangalorePrinciplesofJudicialConductwhichstipulatethat,inadditiontoinde-
pendence, the values o impartiality, integrity, propriety, competence, diligence, and equal treat-ment o all beore the courts are essential to proper judicial conductmust be ollowed.7
Respectingtheseparationofpowersenshrinedintheconstitution,aswellasplacingreasonable
limits on the Supreme Courts use osuo moto powers, will contribute greatly to the enhancement
o the rule o law in Pakistan.
Anincreaseinfundingfortheexpansionofcourtsandforagreaternumberofjudgesatalltiers
is needed, and the judicial arms nancial autonomy must be greatly enhanced over the next
decade.
Securityforjudges,especiallyforthoseinlowercourtshearingsensitivecasessuchasthose
concerning blasphemy and terrorism, must be enhanced.
eUnitedNationsConventionontheEliminationofAllFormsofDiscriminationAgainst
Women needs to be ratied without delay. Moreover, police and judicial training must include
sensitization to issues aecting women and minorities.
eNationalJudicialPolicyshouldbeimplemented,especiallyprovisionsthat:
Call or disciplinary action against corrupt and inecient judicial ocers implemented
through the mechanisms outlined in the National Judicial Policy;
Require superior judges to carry out vigorous oversight and conduct surprise checks o lower
courts;
Prohibit judicial ocers rom being posted in a home district or in a particular district beyondthree years, which would prevent judges rom developing close ties, biases, and corrupt rela-
tions within a district; and
7 For the complete text of the 2002 bglore Priciple of Judicil Coduct, ee http://wwwuodcorg/pdf/crime/corruptio/judicil_group/bglore_priciplepdf (cceed april 23, 2011)
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Set a timeline and constitute special benches at the Supreme and High Courts to begin pri-
oritizing cases that can be ast-tracked. Funding or inrastructure, such as the construction o
courtrooms, and or the hiring o more judicial ocers and administrative sta also should be
increased. At the same time, salaries or court sta must be raised and made equal in the our
provinces.
IntheFederallyAdministeredTribalAreas,thePakistangovernmentandSupremeCourtmust
establish as a matter o priority a unctioning judicial system with civil and criminal courts
and a reormed legal code to replace the outdated and irrelevant Frontier Crimes Regulation.
Additionally, legislation is needed to address the role o jirgas and other orms o traditionaljustice and to regulate their use and relationship to the ormal justice system. Extending the
Political Parties Act to FAA will ensure that political parties there can participate in elections so
that these areas can be brought into the mainstream.
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rule oF lAw And the JudiCiAry |25
EcationPakistan currently ranks 125th (out o 169 countries) on the United Nations DevelopmentProgrammes Human Development Index, and the government is investing little in socioeconomic
development, which also is hindering the growth potential o the Pakistans economy and depriving
people o opportunities to live a satisying lie. Poverty and illiteracy rates are among the highest in
the region: almost one-quarter o the population lives on less than $1.25 per day, and more than hal
o all Pakistani adults are illiterate. A 2010 review conducted by the Pakistan Education ask Force,
which was ormed by the Pakistani government, highlighted the severe challenges in the countrys
education system. According to the ask Forces report, government expenditures on education as ashare o gross domestic product are estimated to be less than 1.5%. As a result, approximately 1 in 10
o the worlds children not in primary school live in Pakistan, making the country second in the global
ranking o out-o-school children. (See Figure 1). Moreover, 4.2 million girls are out o primary school
compared with 3.1 million boys, highlighting the gender disparity in education in Pakistan, and 30%
Pakistanis have received less than two years o education.
Poor acilities also contribute to Pakistans edu-
cation crisis. Only 36% o public schools are insatisactory condition, with many schools lack-
ing basic acilities. For example, approximately
two-thirds o Pakistans schools have adequate
water and sanitation acilities, while only 39%
have electricity. Blackboards, textbooks, and desks are oten in short supply.8 Te ask Force makesa strong case or education reorm and ocially acknowledging the countrys crisis is a positive
sign.
Pakistans educational system is a battleground or competing political and ideological claims. Even
worse, Pakistans ailing education system potentially has opened the doors or the radicalization o
many young people who lack the skills necessary to participate in Pakistans modern economy. In
2007, the total number o school-aged children (519 years o age) in Pakistan was approximately 60
million, but only 37 million were enrolled in school. O the total number o children enrolled, more
than 21 million studied in public-sector or government schools, and 12 million studied in private-
ha dvp
Appa 1 10 f s c pasc v Pasa.
8 For dt d lyi, ee the Pkit Eductio Tk Force pulictio t http://eductioemergecycompk/pulictio/ (cceed april 23,2011); ee lo Uited ntio Developmet Progrmme, The Rural Wealth of Nations: Pathways to Human Development (new York: UnDP, 2010)
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sector schools. Mosque schools and madrasas accounted or approximately 1.6 million, or about 5%,
o total enrollment.9 Such religious schools operate privately, and, peculiarly, their curricula remain
unregulated by the government.
Poor recruitment, promotion, and retention policies or teachers make matters worse. Increasingly,
teachers are recruited as contract employees on a political basis, but within a ew years, they are
made permanent employees o the government, either at the provincial level or at the ederal level.In most cases, these promotions are awarded without any clear criteria or merit system. As a result,
any increased budgetary burdens on the education sector are not complemented by an enhancement
in the quality o education. Students who attend public schools are at a severe disadvantage when
they enter the job market compared to their peers who attend expensive, elite private schools, where
the curriculum is up to date, teachers are well paid, and English is taught. One study estimates that
wealthy Pakistani citizens typically receive seven more years o education than the poorest. Curriculum
development in Pakistan also suers rom serious problems. Historical misstatements and religiousbias in textbooks continue to exist, and despite eorts by scholars and education specialists to x these
problems, the results have been mixed at best.10
8
7
6
5
4
3
2
1
0
India *Pakistan Bangladesh Philippines Cambodia Malaysia * Korea, Rep.
Female
Male
Total
*Data for 2007
Fige 1: Chilen Ot of Pimay School (millions), 2008
9 Tleemi Chowk, Pkit Eductio sttitic: 20072008, prepred y acdemy of Eductiol Plig d Mgemet, ntiol EductioMgemet Iformtio sytem, Pkit Miitry of Eductio, 2009, http://wwwmoegovpk/Pkit%20Eductio%20sttitic%2007-08pdf(cceed april 23, 2011)10 see, eg, a H nyyr d ahmd slim, ed, The Subtle Subversion: The State of Curricula and Textbooks in Pakistan (Ilmd: sutileDevelopmet Policy Ititute, 2003), http://wwwdpiorg/wht_ew/reporto/stte%20of%20Curr&Textbookpdf (cceed april 23, 2011); dbel Rz Jmil, Curriculum Reform i Pkit: a Gl Hlf Full or Hlf Empty? pper preeted t the semir o school Curriculum Policie
d Prctice i south ai Coutrie, new Delhi, augut 1012, 2009, http://wwwitcecorg/documet/ep09/nCERT%20Pkit%20pper%20bRJpdf (cceed Ferury 7, 2011)
source: World bk, World Developmet Idictor, http://dtkworldkorg (cceed april 11, 2011)
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humAn deVeloPment |27
Vision 2020 Objectives and Recommendations: Given the dire crisis in education in Pakistan today, the
country will not achieve universal universal primary education by 2015, as set orth in the United Nations
Millennium Development Goals. However, the ocus now should be on getting as close to the goal as
possible by 2015, with a renewed commitment to achieve universal primary education in the next 10
years. As a rst step, Pakistan must immediately raise its public expenditures on education rom less than
1.5% to at least 4% o gross domestic product, and
by 2020, the expenditures should be set to at least
6%. Without making this minimal commitment,a reversal o the worrying trends in the education
sector is unlikely to occur. Tis immediate increase
o public expenditures in education to at least 4%
o gross domestic product should target the ollow-
ing priority areas over the next decade:
Devisingandimplementinganaccountableandpredictablesystemofteacherrecruitment,
hiring, payment, retention, and training, as well as promotion based on merit, achievement, and
outcomes will greatly improve the quality o education and teacher perormance in Pakistan. As
part o this system, teacher employment, pay, benets, and pensions should be de-linked rom
the basic pay scale regime, which currently guarantees permanent employment and providesvirtually no accountability.
Teachingprofessionalsshouldbeseparatedfromschoolmanagementandadministrationand
rom the education sector administration and management system. Without specialization, thebest teachers stop teaching mid-career and enter the bureaucracy as managers, which is both
highly inecient and ineective. Pakistan also must invest in more teacher training acilities.
eintroductionofcurriculumreformfocusingonalife-skills-basedapproachtoeducation,asopposed to rote memorization o esoteric inormation that has little or no vocational relevance,
will promote real-world applications o creative thinking and analytical reasoning
Developingarobustcentralregulatorysystemwillcontributetothemaintenanceofstandards
and the collection o timely data that can be made available to the general public on servicedelivery, operations, inrastructure availability, scal fows, learning achievements, teacher
perormance, and school outcomes in the education sector.
Adynamicsetofinstitutionalizedrelationshipsshouldbeestablishedbetweenthecentralregula-tory mechanism and the autonomous and independent subnational government units respon-
sible or service delivery. Greater eciency will also be achieved by reducing the size and scope o
the ederal Ministry o Education and divesting ederal schools to the jurisdictions in which they
exist. Whenever possible, ederal employees should be transerred to the province o their choice.
Asystemofincentivesisneededtobringteacherstounderservedlocationsandtopreventthe
concentration o teaching talent in the big cities. Legislation providing ree transportation or
women teachers to schools within their districts that require emale teachers also will strengthen
education in underserved areas.
As a rst step, Pakistan must
a as s pbcps ca fss a 1.5% a as 4%f gss sc pc.
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Anovelsystemofpartnershipsintheeducationsectorisneededtoinvolvethepublicandprivate
sectors and nongovernmental organizations. Tese partnerships will promote the active sharing
o knowledge, as well as the sharing o human capital and resources through peer-to-peer student
exchange programs, which will promote social cohesion and bridge the quality gap in educationacross the socioeconomic divide. Te private sector is especially important in this regard, as it will
help stimulate scientic and technological exchanges and create new opportunities or improving
Pakistans education system.
Separatingthehighereducationfunctionallcollegeanduniversity-leveleducationbeyond12
years o schoolingcompletely rom the primary education unction, and enacting legislation to
provide specialized management and authority over higher education institutions, ideally central-
ized within Pakistans Higher Education Commission or by province, will ensure greater regula-
tory control.
Madrasareformcanbeachievedthroughstrategiesforcurricularimprovementandappropriate
changes in public school curriculum. In this regard, a school curriculumdevised, designed, andmonitored by provincial governmentsthat combines religious and secular education, as sug-
gested by both religious scholars and educationists, will oer some advantages.
egovernmentofPakistancanfulllitseducationreformplansifforeigndonorsandinter-
national agencies ocus their aid eorts on establishing a single coherent approach to providing
signicant budget support in this sector. Tis aid must be conditioned on the Pakistani govern-
ments achievement o unding benchmarks (e.g., education expenditures as a percentage o the
countrys gross domestic product).
Health
Pakistan has a mixed health system. Te public inrastructure comprises three tiers o service deliveryunder the Ministry o Health. Public nancing covers only one-quarter o the population, and medical
impoverishment as a result o catastrophic health expenditures is very common. Low remuneration
in the public system leads health providers to hold dual jobs and oten contributes to absenteeism
and a propensity to reer public patients to their private practices. As a result, public acilities are
woeully underresourced, suer rom poor maintenance and administrative ineciency, and routinely
underperorm. Te situation is urther complicated by corruption in procurements and preerentialtreatment in sta deployment, which engineers the health system to provide benets to a select ew.
In such an environment o poor public health service provision, market mechanisms have arisen to
meet the ever-growing demand o a burgeoning population. Te extensive market system is made up
o a diverse range o nonstate actors, including hospital trusts, nongovernmental organizations, social
enterprises, and or-prot health insurance companies. Private-sector service provision is predominant,
but the lack o regulatory oversight o private acilities has resulted in poor standardization o qualityo care. Malpractice is also a common occurrence.
While Pakistan has excelled at producing graduates o both public and private medical colleges and
universities, a large number o these graduates opt to study abroad or postgraduate medical training
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humAn deVeloPment |29
and live abroad (primarily in the United States and the United Kingdom) because o a perceived lacko nancial incentives and quality o lie in Pakistan. Tis has created a massive medical brain drain,
which is urther complicated by low nancial remuneration or general physicians in Pakistan, urban
saturation, and an urbanrural mismatch in human and inrastructural resources.
Overall, the health system in Pakistan perorms poorly with respect to six key perormance assessment
yardsticks: access in rural and peri-urban areas, airness in nancing, preventive health awareness, health
improvement, ormal training o ancillary health workers (e.g., nurses, paramedics, occupational therapytechnicians), and equity in outcomes and responsiveness. Te determinants o poor perormance are
rooted in the interplay o what has been described as a triad o determinantsinadequate state und-
ing, an unregulated role o the private sector, and lack o transparency in governance.11 aken together,
these actors greatly compromise the quality and equity objectives o public health care delivery. Deep-
rooted reorm is needed with actions at several levels to address this systemic distortion.12
More importantly, Pakistans poor health care system has had a proound impact on human develop-ment in the country. Rates o inant mortality in Pakistan are high at 70 per 1,000 births, compared to
a regional rate o 55 and a global rate o 43. (See Figure 2). More than one-third o the deaths among
children under the age o ve in Pakistan are caused by treatable illnesses such as pneumonia and
diarrhea, and 60% o child deaths in Pakistan are the result o water- and sanitation-related diseases.
In the FAA alone, 135 out o 1,000 children die rom curable illnesses every year. Approximately
260 in 100,000 women die rom childbirth,
compared with 25 per 100,000 in Organisationor Economic Co-operation and Development
countries.13 At the same time, reproductive health
services in Pakistan are lacking and the ertility
rate in the country is 3.9 children per woman.Te doubling o the population in a little more
than a generation will not be sustainable.
Government investment in the health sector is low, and more than 75% o health nancing is out
o pocket. Primary research indicates that monthly expenditures on routine, primary, and secondary
care are as high as 20% per capita income in major urban centers.14 Te silver lining is that public-
sector expenditures on health as part o overall public expenditures have increased recently, and the
government has started to give greater priority and allocate relatively more resources to the health
sector.15
11 For detil, ee si nihtr, The Mixed Helth sytem sydrome, Bulletin of the World Health Organization 88 (2008): 7475, http://wwwwhoit/ulleti/volume/88/1/09-067868/e/ (cceed april 23, 2011)12 si nihtr, Choked Pipes: Reforming Pakistans Health System (Oxford Uiverity Pre, 2010) acceed t http://wwwiihtrifo/choked-pipephp13 World bk Dtk, http://dtkworldkorg/ddp/homedo?queryId=189 (geerted april 11, 2011)14 see ny Jeev t http://wwwjfkorg for dt15 For exmple, the Pkit govermet expediture o helth icreed from 06% of it gro dometic product i 2005 to 16% i 2006 For helthstatistics, see World Health Organization, Pakistan Health Prole, August 13, 2010, http://www.who.int/gho/countries/pak.pdf (accessed February 7, 2011);
d idem, Pkit, i Country Cooperation Strategy at a Glance, april 2008, http://wwwwhoit/coutryfocu/coopertio_trtegy/ccrief_pk_epdf(cceed Ferury 7, 2011) see lo Uited ntio Developmet Progrmme, The Rural Wealth of Nations; d Us agecy for ItertiolDevelopmet, MCH Progrm Decriptio: Pkit, July 2008, http://pdfuidgov/pdf_doc/PDaCn952pdf (cceed Ferury 7, 2011)
m a - f as ag c
the age of ve in Pakistan arecas b aab sss.
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Fige 2: Matenal an Infant Motality rates in Pakistan, 2008
Since 1950, Pakistan has received $58 billion in oreign aid or the health and population sectors,
but the country has little to show or it. One reason may be that many Pakistani ocials associated
with oreign aid programs have beneted privately and personally rom the programs that they were
supposed to supervise and implement in the public interest.16
Vision 2020 Objectives and Recommendations: Pakistan is in need o deep-rooted reorm in its health
care system, which must include systems o governance outside the public health sector that aect healthsystems perormance. While universal access to basic public health acilities is an ambitious goal that
many Pakistanis desire, investments now must begin to build a strong inrastructure by 2020 so that this
goal is attainable. A social protection system or health should bring improvements in the existing system,
rather than reinventing the wheel. Much can be achieved by reorganizing existing nancing arrange-
ments to increase access to quality private health care or large, low-income, and vulnerable populationsthat currently are at the mercy o a dysunctional public health care system. Immediate action in the
ollowing priority areas should begin to ensure that all Pakistani citizens health needs are provided or:
Proactivestepstoimprovehealthgovernancewillbegreatlyenhancedbythedevelopmentofanational consensus on a health reorm agenda.
Inadditiontodevolvingservicedeliveryresponsibilitiesfromthefederalleveltotheprovincialand district levels, capacity building at the provincial level will allow or the planning, evaluation,and implementation o alternative service delivery and nancing mechanisms. Key national
unctions or health should be retained by the ederal structure.17
300
250
200
150
100
50
0South AsiaPakistan OECD World
Maternal Mortality (per 100,000)
Infant Mortality (per 1,000)
source: World bk, World Developmet Idictor, http://dtkworldkorg (cceed april 11, 2011)
16 Khlid H, Pkit Helth, Popultio sector Hve Regreed, Daily Times, July 11, 200817 For more detil, ee si nihtr, scrppig a Miitry of Helth, The Lancet, o 9775 (377), My 5, 2011; d idem, Ce of the VihigMiitry, The News, December 25, 2010, http://www.heartle.org/pdf/92_The_vanishing_ministry.pdf (accessed April 23, 2011).
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humAn deVeloPment |31
Clarifyingtheroleofdistrict-levelhealthsystemswillstrengthenlocalaccountabilityand
ownership alongside local community social responsibility.
Collecting,analyzing,andswiftlyscalingupsuccessfulbestpracticesfromexistingexamplesof
public service delivery reengineering at the primary health care and hospital levels will contributegreatly to health sector improvement in Pakistan.
Separatingpolicy-making,implementation,andregulatoryfunctionsinthehealthsector,aswell
as adopting market-harnessing regulatory approaches, will lead to an improvement in service
delivery.
Concretestepsforincreasingpublicnancinginhealthmustbeginalongsidemeasuresto
improve utilization and limit pilerage. Strengthening essential services, broadening the base o
social protection or the inormally employed sector, and maximizing pooling through insurance
or the ormally employed are priority areas or any increase in revenues in the health sector.
Aninnovativesystemofprivatepublicandemployer-andsponsor-basedsubsidies,alongwith large cooperative pooled insurance or low-income populations, can be provided through
aordable access to private health care networks.
Investmentsmustbemadetoleveragethefullpotentialofhealthinformationtechnology
in mobile health systems. Tis will have a positive, catalytic eect on a range o health care
challenges, including improving transparency in procurements, enabling health care conancing
through philanthropic subsidies, enhancing quality assurance through electronic medicalrecords, and promoting easy access to continuous medical education. Additionally, innovations
in telemedicine, such as the introduction o point-o-service diagnostics in rural primary care
settings with skilled paramedics, can dramatically bridge the gap between rural and urban access
to quality health care.
Collecting,analyzing,anddisseminatinghealthinformationforshapingpolicyandplanning
at the decision-making level can be achieved through the development o an apex institutional
arrangement.
Byadoptingmarket-harnessingregulatoryapproaches,therstpointofcontactinprimary
health care will be broadened while enabling equitable access and the purchasing o health care
or many Pakistanis.
Apriorityshouldbeplacedonhealthsystemsresearchbymakinglinkageswiththerightagencies
both within and outside the health sector. Linkages with agencies outside the health sector must
consider the social determinants and the intersectoral scope o health.
Strengtheninggovernmentoversightandregulationsinprivatesectorhealthcaredeliverywill
prevent and check problems such as malpractice and will acilitate publicprivate collaborations
in health delivery.
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Pakistan aces chronic inrastructure challenges when it comes to energy sources. Te countrysenergy woes are clear or everyone to seemost o all or Pakistanis o every class and region, who have experienced long periods o load shedding or power outages across the country over
the past ew years. In addition to nurturing social and political instability, Pakistans poor energy
inrastructure imposes enormous economic costs in the orm o unemployment and loss o revenue.
As Charles Ebinger and Kashi Hasnie aptly remarked, Even i the aliban and its Pakistani allies
were to disappear tomorrow, Pakistan in the absence o a plan to deal with its energy crisis will remain
in darknessliterally and guratively.18
Pakistan ranks 38th in the world in terms o
energy use, but current per capita energy con-
sumption is low (14 million British thermal
units against 90 million British thermal units or
Malaysia, or example), at only one-th o the
world average.19 According to the government
o Pakistan, the mix o primary energy supply in
20042005 was gas (50.3%), oil (29.8%), hydro(11.0%), coal (7.6%), and nuclear (1.2%), with
current installed electricity-generation capacity at 19,400 megawatts. (See Figure 3). Pakistan depends
heavily (50%) on its reserves o natural gas or industry, power generation, and commercial and
household use. Tese reserves will start declining within the next decade i no new major discoveries
are made.20
Te current energy shortall in the country is estimated to be between 4,000 and 5,000 megawatts.
Pakistans proven coal reserves are the worlds sixth largest, and the government plans to increase the
share o coal in the overall energy mix rom 7% to 18% by 2018a necessary policy choice rom
an energy standpoint, though it is not without negative environmental implications. Ocial gures
rom Pakistan warn that demand or energy will be 22% more than the projected supply in 2015,
eg ifasc
i a g scaand polcal nsably, Paksans
p g fascpss s cc
coss n he fom of unemploymen
a ss f v.
18 Chrle K Eiger d Khif Hie, Powerle Pkit, Dawn, My 17, 201019 a meured y coumptio of petroleum, turl g, col, electricity, d reewle ource i britih therml uit see Eergy Iformtioagecy, Itertiol Eergy sttitic, http://wwweigov/cfpp/ipdproject/IEDIdex3cfm (cceed Ferury 7, 2011)20Govermet of Pkit, Eergy for Growth, i Pakistan in the 21st Century: Vision 2030 (Ilmbd: Plig Commiio, 2007), http://wwwpl-igcommiiogovpk/viio2030/Pk21tcetury/Chpter%20Wie/Ch%209,%20Eergy%20for%20Growth,%2081-90pdf (cceed april 23, 2011)
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enerGy inFrAStruCture |33
with energy shortalls reaching 64% by 2030.21 Tis is a sure recipe or increased unemployment,
economic stagnation, ewer growth opportunities, and turmoil on the streets.
Dam construction and the building o the countrys hydropower capacity also are raught with di-
culties. Water scarcity in Pakistan is already severe, and poor water resources management remainsan ongoing problem. For example, much o the countrys irrigation system, which dates to thecolonial era and is a ew hundred years old, is in desperate need o modernization, and meeting
current and uture water demands continues to be a serious challenge. In larger towns and cities,
water scarcity has led to the unregulated mining o groundwater, which is a highly unsustainable
practice. Because o these competing demands or water, increasing hydropower capacity to meet the
countrys energy needs remains a challenge. Moreover, any plans or the construction o new dams
or reservoirs are subject to long delays because o water disputes between the provinces and ethnic
politics surrounding it.
Pakistans ailure to meet its current energy needs is largely the result o poor planning, but other
actors also have contributed to the prevailing crisis. Heavy line losses o electricity are common as a
result o old and deective energy grids (e.g., transmission lines and power distribution centers), and
approximately one-third o these losses result rom thet. Moreover, Pakistans potential sustainable
and renewable energy resourceshydro, wind, and solar powerremain largely untapped.22
21 Pkit lrget exitig dm t Trel produce le th tht see noor-ul-Hq, ed, Energy Crisis in Pakistan, (Ilmd: Ilmd Policy
Research Institute, 2008), http://ipripak.org/factles/ff99.pdf (accessed February 7, 2011); and ibid.22 Eiger d Hie, Powerle Pkit
Gas
50%
Oil
30%
Hydro
11%
Coal
8%Nuclear
1%
Fige 3: Mix of Pimay Enegy Spply, 20042005
source: Govermet of Pkit, Plig Commiio
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Vision 2020 Objectives and Recommendations: An uninterrupted supply o energy to uel the
nations economy should be the highest priority or the countrys economic managers. o meet its
current and uture energy demands, the government should invest a minimum o $5 billion dollars in
energy production over the next decade. Tis is a very achievable target, and the investment could end
load shedding or power outages. Resorting to ad hoc measures to deal with Pakistans energy needs,
such as opting or rental power plants, must end, and deep-rooted structural problems in the energysector should be tackled head-on. Te ollowing measures in the energy sector should be implemented
over the next decade:
Pakistanmustenhanceitscapacitytocultivatemorepowerfromrenewableenergysources,par-
ticularly by improving its ability to harness wind energy along its southern coast and by making
use o solar power. One reason that countries such as Malaysia, China, and India can meet their
energy demands is that they have a better mix o nonrenewable and renewable energy sources.
Alongwithproperupkeepandmaintenanceofexistinghydropowerdams,moredamsareneeded
to meet current and uture energy requirements in Pakistan. Tis can be achieved by directinginvestments toward the construction o a very small number o large dams (Kalabagh dam is one
project that has been stalled) or a larger number o small reservoirs. At the same time, these plans
must be integrated into a broader strategy to improve water resources management throughout
the country. Additionally, Pakistan can dispel the impression that big dam projects will benet
only larger provinces by exploring ways to reach a consensus among all the provinces on its waterinrastructure and providing provinces with legally binding guarantees.
EnergyeciencyinPakistancanbeimprovedifgovernment-ownedpowergeneration
inrastructure is reurbished technologically and power inrastructure is upgraded with a modernecient grid.
ForeigndonorscanplayakeyroleinbuildingPakistansenergycapacitybyprovidingexpert
advice to the public and private sectors in Pakistan on energy development and management.Te United States, in particular, should explore investing in a large energy inrastructure project
in Pakistan, which will not only deepen strategic ties with Pakistan but also create goodwill in the
country.
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rule oF lAw And the JudiCiAry |35
the massive oods in Pakistan during the summer o 2010 set back all development indica-tors in the country, and the resulting gures are staggering. According to the U.S. Agency orInternational Development, approximately 2,000 people died as a result o the oods, and almost 2million homes were destroyed or damaged.23 Te United Nations estimates that the ood injured
or aected approximately 18 million people in Pakistan, a gure that exceeds the total number oindividuals aected by the 2004 Indian Ocean tsunami, the 2005 Kashmir earthquake, and the 2010
Haiti earthquake combined. At the peak o the ood, approximately one-th o Pakistans total landarea was reported to be underwater.24(See Figure 4).
Pakistans economy has been seriously harmed by extensive damage to the countrys inrastructure,
which is estimated to be around $4 billion.25 Additionally, Pakistans crop production has beenimpacted heavily, and the damage to the countrys sugar, rice, and wheat crops is estimated to be ap-
proximately $2.9 billion. In all, 17 million acres o Pakistans most ertile crop lands were submerged,and massive amounts o grain were washed away by the oods. Farmers were unable to meet the all
deadline or planting new seeds in 2010, which means a major loss o ood production in 2011 andpotential long-term ood shortages. Te damage to the agriculture sector includes more than 700,000
acres o lost cotton crops, 200,000 acres o sugarcane, and 200,000 acres o rice, in addition to theloss o more than 500,000 tons o stocked wheata primary ood item in Pakistan. Additionally,
more than 6 million heads o livestock (including poultry) were killed. According to an assessmentconducted by the Asian Development Bank and the World Bank, the total direct economic impact o
the 2010 ood is approximately $10 billion.26
Te foods also damaged an estimated 2,433 miles o highway and 3,508 miles o railway, with cost estimates
or this damage valued at $158 million and $131 million, respectively. Te countrys power inrastructure
also took a severe blow rom the foods, with 10,000 transmission lines and transormers, eeders, and
t Fs of 2010
23 Pkit Flood, Fct sheet o 9, Us agecy for Itertiol Developmet, Jury 10, 2011, http://wwwuidgov/pk/dowlod/d/012111-UsaID-DCHaPkitFloodFctsheet9-FY2011pdf (cceed april 23, 2011)24 See United Nations Ofce for the Coordination of Humanitarian Affairs, Pakistan Floods Relief and Early Recovery Response Plan, November 5, 2010,
http://ocholieuorg/humitrippel/webpgep?MeuID=14351&Pge=1903 (cceed april 23, 2011); ee lo C Chritie Fir, Wht
Pkit Did Right, Foreign Policy, Jury 18, 2011; d Urget Cry for Help Deth Toll Rie from Pkit Floodig, CNN, augut 16, 201025 Michel J Hick d Mrk L burto, Prelimiry Dmge Etimte for Pkiti Flood Evet, 2010, Ceter for buie d Ecoomic Re-
erch, bll stte Uiverity, augut 2010, http://ceriweuedu/reerch/PkitFloodpdf (cceed april 23, 2011)26 see Pkit Flood 2010 Dmge d need aemet, World bk, novemer 15, 2010, http://itereourceworldkorg/PaKIsTanEXTn/Reource/Dnayd-worldkPreettiopdf (cceed april 23, 2011); Uited ntio Food d agriculture Orgiztio, Pkit Iitil
Flood Emergecy Repoe Pl 2010, augut 10, 2010, http://wwwfoorg/emergecie/tce-ppfud/tce-ppel/ppel/emergecy-detil0/e/item/44701/icode/?uidf=19653 (cceed april 23, 2011); sugr, Whet, Rice Worth $29 billio Ruied y Pkit Flood, Bloomberg, augut12, 2010; Pkit Flood Cued $97 billio i Dmge: aDb/World bk, Reuters, Octoer 14, 2010; Fir, Wht Pkit Did Right; d
2010 Pkit Flood, New York Times, novemer 16, 2010
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powerhouses destroyed in food-hit areas. Floodwater inundated the Jinnah hydropower plant and 150
powerhouses in Gilgit. Te food damage caused an additional power shortall o 3,000 megawatts.27
Te inability o centralized institutions in Pakistan to respond immediately to the oods reects the
weakness o governance in Pakistan. Tis weakness was revealed ully by poor governance along theIndus River, especially the ailure to implement construction regulations around the river and its
canals. Financing disaster management is also a great challenge to the country. Te severe shortage
o paramedics to respond to emergencies and the water and sanitation crisis that emerged in the
atermath o the oods, or example, exposed a deciency in local social service inrastructure that isleading to a slow recovery process. Overall, the state o social services in Pakistan remains abysmal.
Rehabilitation eorts since the ood have been slow as well, and many victims still are living in camps
and cannot return to their homes.28
B a l u c h i s t a n
Pu n j a b
K h y b e r-Pa k h t u n k h w a
G i l g i t -B a l t i s t a n
A z a d J a m m u Ka s h m i r
F A TA
A r a b i a n S e a
Islamabad
National boundary
Line of controlLine of control
Provincial boundary
Maximum flood extent
Severely affected districts
Moderately affected districts
SOURCES: OCHA, NDMA, UNOSAT
0
0 100
100
200 300 km
300 mi
Karachi
Larkana
Bahawalpur
MultanQuetta
ParachinarPeshawar
Lahore
Sialkot
Gilgit
S i n d h
Rawalpindi
Faisalabad
Hyderabad
Fige 4: Aeas Affecte by the 2010 Floos
27 See United Nations Ofce for the Coordination of Humanitarian Affairs, Pakistan Floods Relief and Early Recovery Response Plan, August 2010July
2011, http://ftuochorg/pgeloderpx?pge=emerg-emergecyDetil&ppelID=905 (cceed april 23, 2011); d Power shortfll Rie to3,135 Megwtt, The Statesman, augut 13, 201028 See Waqar Bhatti, UN Ofcial Laments Post-Flood Conditions in Sindh, The News, Ferury 9, 2011
adpted from Relief We mp, http://reliefweit/txoomy/term/182 (cceed april 11, 2011)
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the FloodS oF 2010 |37
Moreover, competition or unding between the Pakistani state agencies and the United Nations
system are apparent, and unding tensions between the ederal and provincial governments also have
come to light. However, it is noteworthy that most o the rehabilitation work was managed by the
Pakistani military, which switly moved its orces and equipment into the ooded regions to evacuate
people and distribute supplies in the immediate atermath o the oods. Rapid support rom the
United States helped Pakistan in the initial weeksand months ater the massive oods, but support
rom Pakistans riends in the region, as well as
rom the Middle East, was slow and inadequate.
Indeed, the United States is the largest donor o
unding or ood relie eorts in Pakistan.29
Vision 2020 Objectives and Recommendations:Improving Pakistans lagging social and economicdevelopment indicators should be a top priority. Te enormity o the humanitarian crisis caused by
the oods requires concerted planning and a seamless transition to the rehabilitation and reconstruc-tion phase. Securing resources or the postrelie phase continues to be a challenge, but every eort
should be made in the next two to three years to ensure that reconstruction in Pakistan proceeds
eectively. Te ollowing steps need to be taken to ensure that Pakistan ully recovers rom the ood
over the next decade and is adequately prepared or uture disasters.
Pakistansvulnerabilitytodisasterscanbeaddressedbyimmediatelyimplementingsoundbuilding
regulations, starting land rehabilitation, de-silting canals and waterways, and constructing dikes.
IntegratingclimatechangescenariosintothePakistangovernmentsannualdevelopmentplans
will help develop a well-coordinated strategy to address the impacts o global climate change in
the country while ensuring progress toward meeting the Millennium Development Goals targets
or poverty reduction. Tis will require billions o dollars in medium-term investments in climate
change mitigation and adaptation measures. Mechanisms such as the Climate Investment Funds,or example, support low-carbon and climate-resilient development through scaled-up nancing.
Regionalaswellasglobalsupportforreconstructioninood-hitareasiscritical.Donorfatigue
in recent years resulted in slow nancial support or Pakistan initially, but this can be oset bysustained support or reconstruction. o improve its credibility and potentially attract more unds
or reconstruction, Pakistan must be ully transparent about the utilization o international unds.
Stabilizingandimprovingaccesstosteady,aordable,andnutritiousfoodsuppliesinPakistanis essential, especially or the 6 million people most aected by the foods. Te Pakistan gov-
ernment must continue to ensure adequate supplies o nutritious ood to inants, women, andyoung children in food-hit areas. Areas that are experiencing high levels o ood insecurity and
economic and social underdevelopment also have been associated with growing insurgencies.30
29 K al Krotdt, Pervze a sheikh, d bruce Vugh, Floodig i Pkit: Overview d Iue for Cogre, Cogreiol Reerch service,Report o R41424, novemer 18, 2010, http://wwwforg/gp/cr/row/R41424pdf (cceed april 23, 2011)30 Kier begli