Pakistan Human Development Forum January 24-26, 2002 Islamabad

Home , Amjad Saqib, Ehsan Mani, Ishrat Hussain, Shoaib Sultan Khan, Younis Khan

PAKISTAN HUMAN DEVELOPMENT FORUM JANUARY 24-26, 2002 ISLAMABAD

VOLUME I

PROCEEDINGS OF THE FORUM (KEY ISSUES, DISCUSSIONS AND STATEMENTS)

GOVERNMENT OF PAKISTAN

LIST OF ABBREVIATIONS

ADB Asian Development Bank AKDN Aga Khan Development Network AKHS Aga Khan Health Services AKUH Aga Khan University Hospital BHU Basic Health Unit CBOs Community Based Organizations CCB Citizen Community Boards CEDAW Convention on the Elimination of Discrimination against Women CPR Contraceptive Prevalence Rate CYP Couple Year Protection DFID Department for International Development DTCE Devolution Trust for Community Empowerment EMIS Education Management Information System ESR Education Sector Strategy EU European Union FATA Federally Administered Tribal Areas FBS federal Bureau of Statistics FPAP Family Planning Association of Pakistan GDP Gross Domestic Product GOP Government of Pakistan HFA Health for All HMIS Health Management Information System ICT Islamabad Capital Territory IDB Islamic Development Bank ILO International Labour Organisation IMF International Monetary Fund IMR Infant Mortality Rate IPRSP Interim Poverty Reduction Strategy IT Information Technology LHW Lady Health Worker MMR Maternal Morta lity Rate MOE Ministry of Education MOH Ministry of Health MSU Multi-Donor Support Unit NFBE Non-Formal Basic Education NGOs Non-Governmental Organisations NIPA National Institute of Public Administration NRMIS National Reconstruction Management Info rmation System NRB National Reconstruction Bureau NWFP North West Frontier Province PHDF Pakistan Human Development Forum PIHS Pakistan Integrated Household Survey PRSP Pakistan Poverty Reduction Strategy PTA Parent Teacher Association RHC Rural Health Centre SAP Social Action Programme SMCs School Management Committees TFHD Task Force on Human Development UNDP United Nations Development Programme UNFPA United Nations Family Planning Agency UPE Universal Primary Education USAID United States Agency for International Development WHO World Health Organization TABLE OF CONTENTS

I. FOREWORD i II. ADDRESS BY THE PRESIDENT OF PAKISTAN ii III. EXECUTIVE SUMMARY xiii IV. PROCEEDINGS OF THE SESSIONS 1. INAUGURAL SESSION 1 2. PAKISTAN POVERTY REDUCTION AND HUMAN DEVELOPMENT STRATEGIES 9 3. EDUCATION 20 4. HEALTH AND REPRODUCTIVE HEALTH 36 5. MAINSTREAMING GENDER 47 6. FINANCING SOCIAL SECTORS 56 7. CONCLUDING SESSION 67

IV. ANNEXURES 79 ANNEX I: AGENDA AND PROGRAMME 80 ANNEX II: STATEMENT BY THE MINISTER FOR FINANCE 86 ANNEX III: STATEMENT BY THE MINISTER FOR EDUCATION 92 ANNEX IV: STATEMENT BY MS. CLARE SHORT, SECRETARY 98 OF STATE FOR INTERNATIONAL DEVELOPMENT, UK ANNEX V: STATEMENT BY DR. AHMAD MOHAMED ALI, 103 PRESIDENT, ISLAMIC DEVELOPMENT BANK ANNEX VI: LIST OF PARTICIPANTS 106

FOREWORD

It is a matter of great pleasure for us to present a complete transcript of the proceedings of the first-ever Pakistan Human Development forum organized at the Islamabad Convention Center on January 24-26, 2002. The Forum provided an occasion for the Government of Pakistan to present its policies and strategies in the social sectors, such as Education, Health, Population Planning and Human Development, with a special focus on the current thrust towards devolution of government authority to the elected local representatives.

The Forum was attended by as many as twenty-two developed countries and thirty-eight multilateral agencies, including the World Bank, the Asian Development Bank, the Islamic Development Bank, the International Monetary Fund and the International Finance Corporation. Presentations were made at the Forum by Minister-level speakers and high ranking civil servants to explain Pakistan’s policies in the social sectors against the perspective of past experience and future aspirations, the strategies to be adopted to achieve the desired targets and goals and the availability of financial resources to launch and implement the programmes.

The importance of the Forum was particularly underscored by the active participation of the non government sector. The civil society speakers had enlightened presentations on the role of the private and informal sectors, particularly the NGOs in the social sector.

We must take this opportunity to express our personal gratitude to Pakistan’s bilateral and multilateral development partners for participating in the forum and ensuring its resounding success. While we appreciate the hard work put in by the Economic Affairs Division and the assistance provided by the World Bank’s resident mission in Pakistan in arranging the Forum, we are also grateful to the Multi-donor Support Unit (MSU) for preparing a record of the proceedings so that these can be shared with Pakistan’s development partners. Needless to add the transcription can also be used as a ready reference for the Government’s social sector policies.

Zobaida Jalal Shaukat Aziz Minister for Education Minister for Finance Government of Pakistan and Economic Affairs Government of Pakistan

Address

President of Pakistan

General Pervez Musharraf

at the

Pakistan Human Development Forum

Islamabad January 24, 2002

BISSMILLA HIR REHMAN -IR-RAHEEM

The Secretary General, United Nations, Mr. Kofi Annan:

President of Islamic Development Bank, Mr. Ahmed Mohammad Ali

Secretary of State for International Development, Ms. Clare Short

It is indeed my honour to welcome you in our midst. Secretary of State for International Development, Ms. Clare Short, we are extremely grateful that you joined us today. We are specially grateful for your concerns and for your understanding of Pakistani environment and for the support that you have always been giving to Pakistan and to my government, especially. We are extremely grateful to you.

I also would like to welcome Mr. Ahmed Mohammad Ali, the President of Islamic Development Bank, we remain extremely grateful to you, Sir, for financing specially our science and technology projects and also your funding by the COMSTECH, Science and Technology Project and all the miscellaneous projects that you yourself have mentioned. Thank you very much, Sir. It is our honour to have you in our midst. Besides that all other distinguished professionals who have worked extensively in the area of human development, human resource and development. It is my pleasure to have all of you here in Pakistan, trying to contribute, trying to understand our environment. This forum is taking place in a very turbulent time specially in the aftermath of 11th September, after the terrorist attacK on the US. This act has cast dark shadows over the global economic environment. The world economy is suffering through recession. The developing world, may I say, has suffered more on account of this terrorist act and Pakistan, being a frontline state, has also been doubly affected, through disruption of its trading activity through loss in revenue generation, through reduction in foreign investment and through a setback to its privatization programme.

As it is with this setback we were in an environment where the government was deeply involved addressing the after-effects of the “Decade of Disaster”, as I call it, the decade of the nineties where loot and plunder was the order of the day, where governance was at its worst, where probably hardly there was any strategic direction evolved and given to the nation, and, worse than that, there was no will to implement any direction that was, if at all, perceived, and may I also say there was quite an absence of focus on human development. So while we were grappling with all this environment, this catastrophic event of 11th September took place. So we have to address this reality and we are doing it. We are not daunted we will face the challenge. We are facing the challenge. We will face it boldly and with ingenuity. Our concern remains how to keep course on the overall development strategy that we have formulated and, also, certainly, how to protect the allocation that we have made to all the development projects that we have planned. Today now, I am going to take some time to give you an overview of the strategy that we evolved for our national development. Doing this at the fag end of the day, after so many speakers iii and at a time which is past lunch time, my main concern is certainly going to be to keep your attention focused towards me. May I also say that I haven’t timed myself but having this captive audience sitting in front of me I am motivated to speak my heart and mind out on the overall strategy as its over action level because that is where everything sources from. So I would like to explain to you the over action strategy that we are following because then only, with all that is being done in various sectors, will fall in place.

First of all, let me tell you that it is my belief that in bringing about change there are three gradations. One is improving. The other is reforming and the third is restructuring. I personally feel improving means that everything is going all right and you need to do a little bit of tinkering in improving an organization. By reforming, I mean when things are bad but you could do a denting and painting job and improve. But, restructuring is when the structure is decayed and collapsing. You need to create a new structure. Pakistan needs restructuring. That is my belief and we are involved in restructuring.

Now, within this restructuring I lay a lot of emphasis on human development. I would like to start with a quote:

“Human development is the anchor of my economic revival policy which will focus on health, education and poverty alleviation”.

This was given some time back and Zobaida Jalal has put my name under it. Yes, I did say this some time back and I mean every word of it and I am here to implement exactly this focus.

In human development we have to alleviate poverty, we have to improve quality and develop capacity. So I would like to start by giving you an overall strategic focus. Soon after taking over we focused on what is required for restructuring Pakistan and we identified four areas. Number one: economic revival of Pakistan which is the basis of any activity. Nothing can proceed unless the economy gets revived.

Then poverty alleviation we identified as the second area. It works hands in glove with the economic development, of course. The third is bringing good governance in its entire complexity. And all embracing sectors of education, health, law and order, corporations improvement, government functioning improvement was all inclusive in this improving of governance in Pakistan.

And lastly, political restructuring. Because I thank it was political structure of the nation which needed a re-do to eliminate whatever Pakistan was suffering from. So, these four areas from the basis of our strategy to move forward and I would like to explain to you that each one of these areas has a focus and it contribute directly or indirectly to human development.

Now I would like to give you our achievements and our future directions in each one of these four areas and that these four areas were visualized by us early in 2000, soon after my government came into place. So this is the strategy we had to start then. This is exactly the strategy that we are following even now. We have iv been developing our tactics on the basis of this over action strategy, and I will explain how exactly everything falls in line.

I take on economic revival, first of all. As I said it is at the heart of all development activities. Real poverty alleviation is only possible through economic development. So, therefore, the source of human development is economic revival.

We suffered, when we took over, from two dilemmas. And I would like to tell you about these two dilemmas that the nation was suffering. The Debt Dilemma and the Investment Dilemma.

Debt dilemma; when we saw our economic financial condition we saw the debt servicing that we were doing and the debt trap in which we were, we saw that we must never borrow because it increases our debt liability. But, we must borrow to develop. So this was the dilemma. The investment dilemma was that we had to attract foreign investment to increase our foreign exchange reserves. But, the foreign investment looks at our foreign exchange reserves to come and invest in Pakistan.

So these were the two major dilemmas that we were facing which needed to be addressed. And the very broad strategy, finance strategy, that would evolve economic strategy in simplest way of putting it, we thought we had to acquire a breathing space from our debt liabilities and we bring this breathing space, acquire money, acquire fiscal capacity to invest in development activity which will give us greater returns than the debt service liability that we will incur on our servicing. That was the overall economic strategy that we thought we must follow.

We selected, then, the areas of focus for the economic strategy that we were supposed to follow. And in selecting the areas of focus we saw Pakistan’s requirements, requirement of the population or the distribution of the population. If I may very briefly tell you that the majority of the Pakistani population, 65 to 70 per cent, is rural. Its an agrarian society. Land and villages. So they are affected by agriculture. The remaining is urban and we can divide urban into two groups. Urban educated, unemployed and second, urban uneducated, unemployed. So we have to address these three categories of the people, the rural mass, the urban educated unemployed and the urban uneducated, unemployed. So what was the area of focus that we developed, let me tell you.

Number one. We thought agric ulture has to be our focus in the immediate future. May be we change strategy in the long term future. And within agriculture we thought we have to concentrate on water resources. We need to concentrate on water reservoirs, distribution of that water and bringing more land under cultivation and irrigation. Through this we are addressing poverty at the rural level, 65 to 70 per cent of the Pakistanis. And not only that when we address the issue of making small dams and canals, we are talking of job creation. This is an activity where maximum jobs are created. And therefore, we undertook this intensive activity of building small dams and canals and through this we hope that in the next four or five years we will bring two millions acres of land under cultivation and irrigation. I don’t want to go into the details of the small dams and the number of canals that we have already initiated. I have performed their opening ceremonies and I know that they are going v strictly on schedule. I keep taking feedback. And a number of projects I have still to launch within these coming few months which I will do myself.

So this was in the area of agriculture which addresses the dual purpose of poverty alleviation in the 70 per cent of our population. It gives us the fastest economic returns. So this has the dual purpose and, may I say, that we are doing extremely well on this in spite of the drought by which we were affected last year.

The second area we thought we should address is the urban educated unemployed. And we saw that information technology is, can be, the main focus to address this issue. And we took on this as the second area of our focus.

In Information Technology we thought this will create maximum jobs in shortest time period and we have a tremendous potential of growth in information technology and telecommunications which is included in it.

I would like to tell you that in NADRA which is our database and registration authority at the moment there over 10,000 young boys and girls are employed who were unemployed and they earn about Rs.5,000 to 8,000 per month which is an excellent achievement. There is immense potential and we are progressing very well on information technology. This is just to quote a few. I would like to commend the efforts of Dr. Attaur Rehman, my Minister of Science and Technology in this field.

In this short time-frame of just over one year we have extended Internet facilities from 29 cities to 550 town and cities, the smallest towns have Internet connection. We have increased the bandwidth capacity from 30 megabits to 265 megabits. We have reduced the cost of bandwidth from $85,000 for 2 megabits per month to only $6,000. It is one of the cheapest in the world. We have given fibre connections increased from 100 cities to 200 cities of Pakistan. We have opened 7 universities of computer sciences, including one virtual university. Last year we trained 25,000 information technology skilled children and this year we are going to increase this number to 50,000. And this figure is from the previous figure of 3 to 4,000 per year.

Mobile telephones have risen from 235,000 in the last ten years. Last year we had 850,000, 400 per cent more. So this is the growth in information technology and this is addressing the area of urban educated unemployed.

The third area was the urban uneducated unemployed and our third focus in economic revival then, after agriculture and information technology, is the small and medium industry. Because we thought this will address the unemployment of the uneducated also through labour. This is being done through revival of sick industries, through CIRC which is doing a good job and also, through new investment and opening new industrial units. We are trying hard in this field. We haven’t made big success as yet but I think things are looking far better and moving well now.

So this will address the issue of uneducated, unemployed in the cities and the fourth, the last area of focus is the Energy Sector. Other than exploring oil and gas, the strategic focus is to convert the thermal, oil based power generation towards hydro-electricity, gas and coal. This would give us import substitution because vi furnace oil costs us about one billion dollar per annum and the ratio of thermal, oil- based electricity production is 70:30 hydro at the moment which is a lop-sided organization. Because we have tremendous potential of hydro-electricity, in fact the total potential of Pakistan is double our requirement. We have the biggest coal reserves in the world in Thur but we haven’t developed it and we have not managed our hydro capacity at all. We need to switch this ratio from 70:30 to a better proportion with the passage of time. We are concentrating on generating hydro- electricity through a number of hydro-electric projects. We are trying to generate electricity based on the Thur Coal and we are trying to convert our thermal oil-based power units to gas because we have gas. With this transformation we will improve the ratio and this will give us import substitution. And may I add here, from the human development point of view, this does generate a number of jobs because, again, specially in the hydro-electricity generation area and the coal development area our coal industry which involved hundred of thousands of workers which was lying sick has got revived.

So this much for our economic revival activity that I spoke about, the four areas of focus and the rationale behind those four areas of focus because we were focusing on those deprived class of people who needed attention for development.

At the macro-economic level I just want to say that I would like to express special gratitude to our bi-lateral creditors through the Paris Club for the complete stop of debt-rescheduling that they have given us. I would also like to express our gratitude also to IMF for the PRGF that they have provided us. I would like to express gratitude to the World Bank and the Asian Development Bank for the enhanced financial support. I would also like to thank the EU specially for the market access that they have provided to Pakistan. At this has given us fiscal space and has made funds available to Pakistan for executing the economic strategy that I initially enunciated, gaining space gaining time and generating the funds putting it into developmental activity which will give us more and faster returns than the debt service liability that we will incur. And we are doing this for the economic revival of the four areas, agriculture, information, technology, energy and small and medium industry. This is the economic revival plan, overall.

Our foreign exchange reserves stand now at a record of $5 billion. It should be much more for a country of our size. But we never ever in our history achieved this. I would like to give credit to my Finance Minister. This is up from under $ one billion when we took over and if I may give some indicators, our fiscal deficit is at 5.2 per cent, reduced by over one per cent which is a great achievement because we showed fiscal discipline. We took a number of very bold and difficult decisions. We increased our oil prices five times and also the gas prices to improve the tariff structure of gas. We froze our defence budget, rather we reduced our defence budget. While our friend to the east increased its defence budget by 28 per cent one year, and 14 per cent, the other year. These were not easy decisions. We took them. Our Finance Minister every time used to say you have to bite a bullet. I used to ask him how many bullets do I have to bite you. So we have been biting bullets every now and then and we keep biting them as long as it is in the national interest.

vii Secondly, inflation is down at 4 per cent. We are maintaining it at 4 per cent. Our exchange rate is stabilized without manipulation. Market mechanism is operating and it is stabilized. We have followed a very prudent monetary policy. We have reduced our interest rates and lastly we have raised allocation to the development budget by 40 per cent. These are no mean achievements. This is the fiscal discipline and the strategic planning that we had right from the top and what we started implementing and the results are now in front of us.

So this much for the economic revival strategy and our achievements. As I said this falls the basis of all human development and I think we are on target, implementing the overall strategy of economic revival that we have formulated.

Now poverty alleviation; it is true that poverty alleviation is only possible through economic revival and that’s exactly what we are going. But, however, I am extremely conscious and I do understand that our focus cannot be on economic growth alone because that is not enough and we have to take direct measures for poverty alleviation. They are also to be addressed other than the economic revival and I would like to just quote a few.

We have taken several initiatives as a part of our direct intervention, but quoting a few, Zakat strategy. For those who don’t know about it Zakat is the percentage deducted as our religious obligation from our savings. Through this Zakat strategy we evolved a new Zakat strategy where with all money that we collect and we have already in the bank. We have identified areas for focus of economic activities in various parts of Pakistan and we start distributing Rs.50,000 to an individual to generate his or her economic activity and let me give you a small feed back. We have given an average of 20,000 Rupees to 100,000 people which mean multiplied by five, about half a million people have been affected because we issued this money to a house hold to one individual and one of the whom. I give 20,000 Rs. I asked her what she is going to do with it. She said she is going to buy 5 sewing machines. She knows sewing and she is going to earn money. I asked whether she has a husband. She did not. She was having three children. So four people affected by Rs.25,000 that I give her. This is not a single story. This is given average 20,000 to 100,000 people and every year we are making the allocation 5 million rupees and we have the fund. We will be giving this money in about three years time to roughly one million people which mean 5 million poorest of the poor will be affected by this zakat strategy.

The second is the Khushal Pakistan Project. We call it a poverty alleviation programme. This involves a number of project at the micro level identified by the people themselves, small projects of a few hundred thousand rupees, may be one million rupees. At the movement 5,000 projects are going on generating jobs for about 500,000 people. These are going on in all parts of Pakistan at district and at the grass root level.

Last year the same was done and we are increasing our allocations to this Khushal Pakistan Project. This has a tremendous contribution. We did not know how big a success it will be. A small bridge constructed in the Northern Areas which I launched myself linked two communities because this was upon a stream that connected two communities. This small bridge costing a Rs.600,000 linked the two viii communities. This is our planning. A number of market-to-farm roads, dispensaries, schools and brick lining and sanitation projects. All these have been lunched through Khushal Pakistan Project. Thirdly, is the Khushali Bank or the Micro Finance Bank which has been launched by us. This is going very well. This is going to the doorsteps of the poorest of the poor and giving them up to Rs. 30,000 loans, debts and this has a very positive feedback. The target we have set is 100,000 people per annum.

We are on course doing this. I have got a feedback. I have met so many people who took this money. They are all poor people and they are returning hundred per cent of these loans. The rich of the country who have plundered the country, never used to return their loans. So this is the Khushali Bank, Micro Finance Bank distributing money.

Food support programmes for the poorest of the poor there is a subsidy for food and lastly, of course, the job generation through the development projects.

These were the five direct intervention projects in poverty alleviation that we have addressed. So this much for poverty alleviation of the economic revival.

Now third one is good governance that was the third area of focus. We are taking good governance at its broadest context. But here from the human development point of view, I am going to address only a few issues. I will take on the education first. There is a tremendous focus on education by my government. Because the condition of education in Pakistan is dismal. There are three areas to address in education. Number one is madrassa education that is the religious schools.

Secondly, the primary and secondary level education and no. 3 is higher education. We focus on all three areas. I will briefly talk about each. Taking the madrassa education first. Madrassa is the greatest welfare organization. Let this be very clear to everyone. This gives free board and lodge to the poorest people who cannot afford money to feed children. An organization which gives free board and lodge to about 700,000 to 800,000 poor children. This is the biggest NGOs anywhere in the world. Having said that with this positive point there are some negative points also and they are that they give only religious education. There are several institutions which teach modern education with computer science and I visit the madrassas. So with them there is no problem because they are already learning many subjects with religious education. The problem is with those who are teaching only religious education. The strategy is to let them carry on running humanitarian part and financing themselves at the donations, may be reinforced through zakat fund that I spoke about and we have a lot of money there.

To improve the education we thought of subjects. They must teach English, Mathematics, Science, Pakistan Studies and Computer Education. We want to change the lives of the poorest of the poor. We want to absorb them in the mainstream of the society and that can be done through modern education and I convinced the religious scholars and many many of them agreed with me on this issue. I have interacted with all of them. I have told them that if a person, mullah in a mosque is educated with these four subjects, he will be more enlightened and ix acceptable to the society. If the boy wants to join a bank or if I want to pick up this boy and give him a scholarship in a university in Lahore why should not he get this opportunity. So let us absorb these children in our society in Pakistan. So we are following this strategy in letter and spirit.

We have created a new board. This is going to examine them. We have told them to introduce these subjects and teach these subjects. This is Madrassa education that we have addressed.

The second is the focus on primary and secondary education. There are three things that we need to do. We need to improve the primary level. We are illiterate nation in terrible condition. Secondly, we need to improve the quality of education. Our quality is poor. Thirdly we need to introduce third stream that is technical stream of education. This is the strategy in education. We need to improve the syllabus and curriculum, and educate the teachers who are teaching and the examination system. New syllabus have been made. I will give credit to my Education Minister, Mrs. Zobaida Jalal for that.

They have evolved the new syllabus. They evolved this new strategy. The third is the technical stream of education. We have decided that down to the sub- division level 300 technical schools will be opened. In the public -private partnership where those schools in the private sector are going well were encouraged to be adopted by government schools and they have adopted a number of government schools and they are maintaining these schools which were in poor shape of management. They are adding classrooms to them. They are undertaking teacher’s training; they are also providing, willing to provide additional teachers and also issuing free text books (If there is anything left). So this is the public-private participation in adopting government schools and several private schools are undertaking the adoption scheme and I know this is also going on in the other provinces I thought these are very innovative ideas and I give full credit to the education managers who are doing this. So, this bring to the second tier of education. The third tier is higher education which needs to be addressed after Madrassa and primary, secondary and higher education. Unfortunately, we have been focusing more on primary education and ignoring higher education. This is not the correct attitude. I formulated two independent groups one working under Dr. Atta -ur Rehman and the other under Mr. Shams Lakha who is sitting here, and these two groups did the wonderful job of presenting their strategy for grooming the higher education in Pakistan. I won’t go in detail but what that brought out was that we have to have a balanced approach to education and we have to develop appropriate linkages between the primary, secondary and higher education. You can’t do one at the cost of the other. In fact higher education is essential for capacity development and also improving primary education. Because improving the higher education will provide the staff and teachers for the primary and secondary education. So, therefore, there has to be deep interaction between them. We have created a higher committee which is meant to improve the quality of education and develop focus on higher education. It will look after all the universities and focus on science and technology. We have decided to create linkages between industry and the university education through strengthening sc ience and technology and we have also decided to concentrate on engineering sciences for value addition in industry, bio -tech for agriculture improvement, information technology for job creation, and foreign x exchange earning. These are the four areas that we have to concentrate on in the higher education at the university level. We want to increase our PhDs from 60% per annum to 400 to 500. This is our plan.

The conditions of health sector are also dismal. We were concentrating on core issue of health level. There is 70% of population in villages. That is not being addressed so far. Therefore, the focus on rural areas.

We have worked out the organization and equipment for each hospital at the sub-division level. This is not enough. We have to implement it now. We need funds obviously and that is being done. A very interesting, innovative idea by Dr. Attiya who is sitting right in front of us, is the nutrition programme for girls. She is one for maximum rights for women and girls and I really appreciate it and we all are with her, the whole Cabinet is with her.

So in this I would like to say that this grand idea is again an idea of community participation and this will give money at school level asking the mothers to come to the school and cook for their daughters who are studying in the school. Now this is going very successfully because had we given the money or the stipends to the father they would have squandered it. But the mother will never. Mother will feed their daughter. Obviously they will be very successful. This is going to be introduced in 20 districts and 5000 schools, girls should be healthier because then the generations will be healthy. This is the logic and Dr. Attiya is following that. We will like to expand the schem e. But I would like to highlight a special feature in this area and that is the task for of human development that we have established. This task has been established under Dr. Nasim Ashraf who is a Dr. from the United States. He brought with him the expertise and involvement of the number of other doctors from United States. I made him the Project Director and he wanted me to be the Patron-in -Chief so I am with him. We have created a National Commission on Women Development and the Chairman of this Commission is Dr. Nasim Ashraf, who will operate directly under me. We intend opening social or human development incubators in all districts, I have asked them to change the name of incubators, we have to decide for a more simple name for the public of Pakistan, but for the audience here incubator will be developed in each district. And the national commission, in fact, will operate through these incubators at the district level. And will execute an integrated national programme for education, health, poverty alleviation and good governance at the grass root level. We have to generate government capacity at the grass root level and it is through these incubator, through this national commission interacting with the public sector, with the linked department, as you called them and ensuring capacity with development at the grass root level and focusing on, poverty alleviation, education and health that this would become possible. This is an extremely useful idea which we have to pursue with full vigour.

Ladies and gentlemen, we have decided to set up a trust fund of the public- private partnership. The task force which has come with Dr. Nasim Ashraf has raised 100 million rupees as a feed property from all expatriate Pakistanis and local philanthropists into this trust fund that we have set up. The government is chipping in, we have decided to chip in Rs. 2 billion into this target fund. I have done this without informing the Finance Minister so I am presenting this as a fait accompli. xi This is emotional black mail that I am doing. So he has to give Rs. 2 billion in this fund. This fund will be totally transparent. It will be managed by an independent board of trustees of very eminent people. If I have to name them, Abdus Sattar Edhi, Begum Zari Sarfraz, Moin Qureshi and a number of others.

In my humble capacity as Patron-in -Chief of the board of trustees, I appeal to all Pakistanis through this forum, in Pakistan and abroad, to donate generously to this fund so that you will be donating to a noble cause, you will be a participant to this noble cause.

I know they will contribute in this philanthropic cause. I am giving the focus to concentrate on this idea. I will also like to appeal to foreign donors to donate to this fund. And also, may I say, allow us the flexibility of using this fund because my personal observation is that donation that comes to us is binding to the special project, but give us some flexibility to utilize it. The assurance and guarantee, I am to give, is that, whatever is given in this fund will be utilized in education, health and poverty alleviation. This is my guarantee, allow me and my government to utilize the fund.

Briefly, the fourth area is the political restructuring. We are ushering in real democracy in Pakistan, which was non-existing earlier, in essence. I will have elections and an elected government. We are functioning in the most decent manners, but I personally feel that more important to me is the “essence” that is the functioning of government, less important is the elections. However, please do not misunderstand me. Elections will be held in October, democratic system has been put in place through the local bodies system which has been done on August 14. This is a silent revolution. I give credit to General Naqvi. All development activities will start from bottom and village level and will not be decided in Federal/Provincial capitals. That, corruption and mismanagement which was being done earlier by the members in collusion with the bureaucrats will cease to exist. This is a revolution, that we will bring. This is going well. This is a measure of upheaval. Let me add here that 30% seats have been reserved for women because I have found them more efficient than their male partners. This is the real empowerment of the people of Pakistan and is human development. We have also empowered and emancipated the women of Pakistan. In the national and provincial assemblies we have tripled the seats. I will ensure the continuity and sustainability of the reforms. There will be checks and balances of the leadership and national interest will be held supreme.

I would like to say, that democracy is not a constant feature. Every country has its own environment. I am a great believer in democracy. We need assistance of the world in this regard.

I am thankful to Kofi Annan and all the delegates for patient hearing.

xii

EXECUTIVE SUMMARY

While poverty alleviation is central to the development agenda of the Government of Pakistan, the strategies to achieve this agenda include a series of structural reforms and programmes. The strategies and reform programmes are fuelled by lessons learnt from the past, one of which is the linkage between poor human capital in Pakistan and the slow dow n of economy leading to increasing levels of poverty. It is against this background that one of the major strategies for poverty alleviation being pursued by the Government is human development. This is to be achieved mainly through improved social services in the country.

This evolving human development agenda was shared with development partners in the Pakistan Human Development Forum (PHDF) organised by the Government of Pakistan in Islamabad from January 24-26, 2002. The objective of the Forum was to discuss the key dimensions of the delivery of social services in a decentralised governance environment, share experiences of alternate approaches to service delivery that had been developed in partnership with non-governmental organisations and the private sector, seek the views of development partners based on their country experiences, and reach a broad consensus on new mechanisms for donor support to decentralised services in the social sectors.

The Forum was attended by the Government, donor com munity, non-governmental organizations and representatives of civil society. It was organised as a series of presentations conducted by federal and provincial cabinet level officials and the heads of the visiting donor delegations. There were eight separate sessions in the Forum beginning with the Inaugural Session, and followed by separate sessions on the following key themes: Pakistan’s poverty reduction and human development strategy; education; health and reproductive health; mainstreaming gender; financing social sectors; and the concluding session was designed for donors to present their statements and comments. Volume II of this report contains a complete text of all presentations.

The President of Pakistan, General Pervez Musharraf, delivered the Inaugural address and Ms Claire Short, Secretary of State, Department for International Development, Government of the United Kingdom and Northern Ireland gave the keynote address. Mr. Ahmed Mohammad Ali, President of the Islamic Development Bank also addressed the Forum. Mr. Kofi Annan, Secretary General of the United Nations who was in Pakistan on the morning of the Inaugural Session, was invited to make an impromptu address that was greatly appreciated. Mr. Shaukat Aziz, Minister for Finance, and Ms. Zobaida Jalal, Minister for Education, Government of Pakistan, were the Co-Chairpersons for the Forum.

The Forum provided the Provincial Governments the autonomy and leadership to present their own perspectives and reform plans. A novel feature of the event was the participation of selected representatives of local government, the newly elected Nazims representing the district tier of government who contributed richly to the discussions and added an important perspective to the Forum. The NGO and private xiii sector perspectives were also vigorously voiced and gave the Forum a very distinct participatory flavour.

An open door policy encouraging free and frank discussions was adopted in the Forum. The discussion on policies and strategies was followed by presentations of case studies of innovative models. The experience and perspective of the provincial governments and non-governmental organizations in this regard was equally highlighted. This was particularly appreciated by the development partner agencies, many of whom remarked that the manner in which the Forum had been organized and the discussions conducted had made their attendance worthwhile.

The tone of the Forum was set by the President of Pakistan who, in his inaugural address, had emphasized that Pakistan needed restructuring as improvements or reforming the existing system were not going to be sufficient in addressing the needs of a structure that was decaying and collapsing. Within restructuring, the emphasis would be on human development which was the anchor of the President’s economic revival policy and would focus on health, education and poverty alleviation. The President referred to four areas of strategic focus that included economic revival, poverty alleviation, good governance, and political restructuring. The presentations by senior government officials took this discussion forward and provided details on how these objectives would be achieved.

The Interim Pakistan Poverty Reduction Strategy (IPPRS) laid out the policy framework and the devolution plan formulated by the National Reconstruction Bureau provided the implementation framework within which social and economic development in Pakistan would proceed. These documents had been prepared after extensive consultations with ke y stakeholders. The framework of the poverty reduction and human development strategy had a multi-pronged approach that aimed at fostering growth through economic reforms, physical and social asset creation for the poor, development of social safety nets, good governance through devolution of power, civil services reform, access to justice, and police reform. It was stressed that the IPRSP was an evolving document that needed to be reviewed periodically.

The broad direction in which the Government of Pakistan was moving was indicated by the following key areas of emphasis:

Ø Reconstruction of the institutions of State to establish genuine and sustainable democracy for durable good governance for an irreversible transfer of power to the people of Pakistan;

Ø Stress on economic development was critical for laying the foundation for human development;

Ø Redirect focus and emphasis from expense management to outcome based development in order to follow through on the impact of development;

Ø The process of devolution had created a major sea change in Pakistan and had created opportunities and greater challenges. It entailed focus on the district level and a redefinition of the role and responsibilities of the different tiers of government; xiv

Ø Effective implementation was key to the success of the reforms. The ownership and validation by district governments was critical and would be undertaken through a broad range of options and innovative mechanisms such as those illustrated by the agreements in the education sector;

Ø Public -private partnership in social and economic development was critical in order to capitalize on the capacity and experience of the large array of stakeholders such as NGOS, voluntary organizations, civil society and the private sector;

Ø The focus of regulatory mechanisms would be on providing an enabling environment within which the private sector and non-governmental organizations would thrive and contribute effectively to the task of social and economic development;

Ø Stress on community participation was essential for the success of all grass roots initiatives. For ensuring ownership, a positive orientation towards self- development and a pro-active civil society effort would be critical. Community participation had the potential to reduce the deprivation that led to despair and served as an antidote to extremist mind-sets, organisations and activities. Community Participation, in this sense, was not only key to the success of devolution but also of Pakistan’s new insertion into the new world order.

Ø Capacity Building would be emphasized for effective implementation both within the government and of the other major stakeholders without which the desired impact would not be obtained;

Ø The President’s Task Force on Human Development was charged with the task of capacity development. It was engaged in out- of- the-box thinking in this regard. The approach of the Task Force was to focus on people rather than programmes, outcomes rather than inputs, systems rather than organisations, and incentives rather than punishments to elicit changes in behaviour;

Ø Stress on Gender issues and on development of women through a national policy for women, a strategic plan for women’s development and strengthening the institutional mechanisms, and capacity for dealing with the wide range of issues confronting women. Poverty in Pakistan had a female face and, therefore, women were an important part of the strategy;

Ø Stress by the Provincial Governments on resource sharing and allocation formulas that would enable them to address the wide variation in the socio- economic indicators of development at the district level;

Ø Monitoring mechanisms and systems were being enhanced through the development of management information systems and the development and identification of key indicators, and the strengthening of systems that would measure these indicators; xv

Ø The total requirements for the social sectors between 2001 to 2004 were projected at Pak Rs. 215.2 billion. The GOP’s planned allocations were anticipated at Pak. Rs. 110.5 billion, and the overall financing gap was projected at Pak Rs. 104.7 billion for 2001-2004;

Ø The allocation for social sector expenditures would be raised through greater efforts in raising revenues and restructuring the system of tax collection, and a greater effort at financial reform and fiscal discipline by the Provincial and Federal governments;

Ø Federal and Provincial Governments would be encouraged in ensuring fiscal discipline and restructuring of the tax system for creating the fiscal space within which the allocation for social sector spending could be enhanced as had been clearly illustrated by the presentations of the Provincial Ministers at the Forum;

Ø Pakistan’s preference was to meet the financing gap for its human development and social sector programme through grants followed by debt swaps, and only a small portion of the financing gap would be met through soft loans;

Ø Donor assistance that was forthcoming would be used within the framework of the IPRSP and would be used as an additionality; and

Ø Increased co-ordination between the donors and the governments at the federal level, the development of new mechanisms for donor co-ordination at the provincial and district levels, and a more efficient frame work for intra- government coordination would be instituted.

The donor community expressed its strong support and commitment to the Government of Pakistan regarding the plans and strategies that were presented at the Forum, and felt that the Government of Pakistan was proceeding in the right direction. The donors were particularly appreciative of the progress that had been made and it was inspiring to see the active involvement of the Federal and Provincial Governments in the process. The donors particularly remarked on the fact that the quality of the dialogue between the donor community and the government had been significantly enhanced.

There was broad acceptance of the IPRSP as the framework for the overall human development effort in Pakistan and appreciation of the devo lution plan as the framework for implementation. The donor community agreed that the document gave a holistic approach and should be the framework for use by all donors. The donor community also gave its endorsement to the sectoral strategies that were presented. While some donors had already pledged their assistance and specified the amount of funding that would be forthcoming, other donors felt there was a need for them to review the plans and strategies presented at the Forum.

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The overall feeling around the table was that the GOP plans enunciated in the IPRSP were overdue and appropriate and, although were ambitious, they had to be made doable. The greatest challenge that now lay before the Government of Pakistan was in implementation. Some of the major challenges that confronted the GOP in this regard were the human dimension issues and the formation of its social capital. There was a need for capacity building in terms of heightening the awareness of the people, involving communities, and creating the culture of working together with district and provincial governments and the donors. The donors stressed that economic revitalization was as important as human development. The GOP needed to focus on gender and regional disparities , fiscal discipline, good governance, ownership and participation of district governments, public-private partnerships, monitoring and measuring progress at the local level, etc. The donor community expressed its views that flexible mechanisms that allowed policy and resource allocations to respond to the challenges that lay ahead would be vital. The donors expressed a strong interest in seeing similar development forums at the provincial level in which district governments would have a strong presence.

The GOP reiterated the views expressed by the President of Pakistan at the Inaugural session. These were a demonstration of complete ownership of the reform agenda at the highest level and the strategies enunciated at the Forum were consistent with those. The GOP expressed its appreciation for the support of the donor community which had been very heartening, and the GOP assured the donors that this support would not lead to complacency. The GOP realized that it had a major challenge before it and undertook this challenge with a greater sense of commitment and realism. It was acknowledged that the Government had an opportunity to improve the life and lot of its people. In this connection, the Government reaffirmed that it wanted to build a moderate, vibrant and modern Pakistan and the support of the participants in this effort was highly appreciated.

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DAY ONE: JANUARY 24, 2002

SESSION I: INAUGURAL SESSION

Introduction:

The Pakistan Human Development Forum (PHDF) was organised by the Government of Pakistan to share with development partners its evolving human development programme in the context of the overall poverty reduction strategy. The objective of the Forum was to focus the discussion on the key dimensions of the delivery of social services in a decentralised governance environment, share experiences of alternative approaches to service delivery that had been developed in partnership with non-governmental organisations and the private sector, seek the views of development partners based on their country experience and reach a broad consensus on new mechanisms for donor support to decentralised services in the social sectors.

The Pakistan Human Development Forum was held in Islamabad from January 24- 26, 2002 and was attended by the Government, the donor community, non- governmental organizations and civil society representatives. The Forum was organised as a series of presentations conducted by federal and provincial cabinet level officials and the heads of the visiting donor delegations. There were eight separate sessions in the Forum beginning with the Inaugural Session and, followed by separate sessions on the following key themes: Pakistan’s poverty reduction and human development strategy; education; health and reproductive health; mainstreaming gender; financing social sectors; and the concluding session was designed for donors to present their statements and comments. Volume II of this report contains a complete text of all presentations, list of participants and list of publications distributed at the Forum.

The President of Pakistan, General Pervez Musharraf, delivered the Inaugural address and Ms. Claire Short, Secretary of State for the Department for International Development, Government of the United Kingdom and Northern Ireland gave the ke ynote address. Mr. Ahmed Mohammad Ali, President of the Islamic Development Bank also addressed the Forum. Mr. Kofi Annan, Secretary General of the United Nations who was in Pakistan on the morning of the Inaugural Session, was invited to make an impromptu address that was greatly appreciated. Mr. Shaukat Aziz, Government of Pakistan and Ms. Zobaida Jalal, Minister for Education, Government of Pakistan were the Co-Chairpersons for the Forum.

The significance of the Forum and the importance assigned to it by different development partners was signaled by the high level attendance of officials of the Federal and Provincial Governments, the high level presence of representatives of the donor community, the interest of the private sector, and the non-government organizations. All these constituencies had a significant presence at the Forum. The Provincial Governments were given the autonomy and leadership to present their own perspectives and reform plans. A novel feature at the Forum was the participatio n in it, for the first time, of representatives of local government, the newly 1 elected Nazims representing the district tier of government. The only regret was that not all the representatives of this newly elected tier who had been invited were present. However, those who were present contributed richly to the discussions and added an important perspective to the Forum. The NGO and private sector perspectives were also vigorously voiced and gave the Forum a very distinct participatory flavour.

The Forum had an open door policy, and free and frank discussions were encouraged. The discussion on policies and strategies was followed by presentations of case studies of innovative models. The experience and perspective of the provincial governments and non-governmental organizations in this regard was equally highlighted. This was particularly appreciated by the development partner agencies many of whom remarked that the manner in which the Forum had been organized and the discussions conducted had made their attendance worthwhile. The World Bank representative particularly appreciated the Forum’s open door policy. He felt that the Forum had been organized in the spirit of what had been noted by the World Bank President, Mr. James Wolfenson, at the time of the last World Bank meeting in Washington, when he remarked that “Gone were the days when development could be discussed behind closed doors.”

Summary of the Main Points Presented by President General Pervez Musharraf

The President of Pakistan, General Pervez Musharraf, thanked the distinguished guests who had come to participate in the Forum. In particular, he thanked Mr Kofi Annan, Secretary General of the United Nations, Ms Clare Short, the Secretary of State of the Department for International Development, and Mr Ahmed Mohammad Ali, the President of the Islamic Development Bank. While articulating his viewpoint, the President stated that the Forum was being held at a very turbulent time in Pakistan as a result of the aftermath of the terrorist attack on the US. This act had not only cast shadows on the global economic environment but had negatively affected Pakistan through the disruption of its trading activity, loss in revenue generation, reduction in foreign investment, and a setback to the privatisation programme.

The President referred the 1990s as a Decade of Disaster characterised by loot and plunder with no strategic direction given to the nation, and an absence of focus on human development. He explained that Pakistan was struggling with ways to deal with its current challenges when the events of September 11th happened. However, Pakistan was not daunted and was ready for the challenge. He emphasized that the government wanted to remain on course on the overall development strategy that it had formulated, and protect the allocation already made. He emphasised that Pakistan needed restructuring as improvements or reforming the existing system was not going to be sufficient in addressing the needs of a structure which was decaying and collapsing. Within restructuring, the emphasis would be on human development. The President stated that human development was the anchor of his economic revival policy which would focus on health, education and poverty alleviation. The President indicated that he had identified four areas for strategic focus. These were: economic revival, poverty alleviation, good governance and

2 political restructuring. The President outlined the achievements of his Government in each of these areas and outlined the future directions.

In economic revival, the focus would be on poverty alleviation. This was because of the understanding that real poverty alleviation was only possible through economic development. Pakistan suffered from the debt dilemma and the investment dilemma. In order to deal with these dilemmas, Pakistan had devised an economic strategy that would give it some relief from its debt liabilities and allow it to invest in development that would yield high returns, and eventually help to reduce debt and attract investments. The area of focus for economic strategy was identified based on a broad categorization of the socio-economic characteristics of the population. From this analysis, three principal categories emerged: the rural masses, the urban educate d unemployed, and the urban uneducated. For the large majority of the people, agriculture had been identified as the first area of focus in the immediate future with a particular emphasis on the development of water resources. Information Technology had been identified as a second area of focus for the urban educated, and small and medium industry was identified as the third area of focus for the urban uneducated. The Energy Sector had been identified as the fourth area of focus.

The President expressed his special gratitude to the bilateral donors for debt rescheduling through the Paris Club, to IMF for the PRGF that it had provided, the World Bank and the Asian Development Bank for the enhanced financial support, and to the EU for the market access that they had provided. This had enabled Pakistan to have some fiscal space and made funds available for its economic strategy. Pakistan’s foreign exchange reserves stood at US$ 5 billion which had never happened before. He expressed special gratitude to the Finance Minister for achieving this target. In addition, Pakistan had reduced its fiscal deficit, increased oil and gas prices, and reduced its defence budget. Also, inflation was brought down by 4 percent, the exchange rate stabilised without any manipulation, interest rates were reduced, and the development budget allocation was increased by 40 percent. The President explained that several direct interventions had been undertaken for poverty alleviation and these projects included a new Zakat strategy, the Khushal Pakistan Project, the Khushali Bank or Micro -Finance Bank, and a Food Support Programme for the poor. The projects had helped in employment creation, in providing funds to the poorest, and the development of infrastructure at the local le vel.

Pakistan had undertaken good governance initiatives in a broad context. However he wanted to elaborate on this aspect only in terms of its human development dimension. His government had placed particular focus on education, in particular on reform of Madrassahs, primary and secondary education and on higher education. The Madrassahs provided the greatest scope for social welfare as they provided free board and lodging to about 700,000 to 800,000 poor children. This made it one of the largest NGOs anywhere in the world. He indicated that there was need to support the positive aspects of the Madrassahs and address some of their weaknesses by mainstreaming their education system.

In addition, the Government would improve the quality of education and introduce a technical stream of education. He expressed his gratitude to the Education Minister 3 in helping to undertake important changes within the system. He also appreciated the public-private partnership that had helped the education sector in important ways. He stressed the need for a proper balance between primary and higher levels of education. Linkages would be created between industry and university education. In higher education, the concentration would be on engineering sciences, bio- technology for agriculture improvement, and information technology for employment creation and income generation. The President indicated that the conditions in the health sector were also dismal and the focus would be placed on the rural areas. He lauded the efforts of the Minister for Population Welfare and Women’s Development, and appreciated the efforts that had been made by her for the rights of women, and in particular, mentioned the nutrition programme for girls. He assured her of his support for women’s development in Pakistan.

The President briefed the participants about the creation of a National Commission on Human development under Dr. Nasim Ashraf which would provide support in human development at the district level and create needed capacity at the grassroots level. He indicated his plans to establish a trust fund for public-private partnership for which seed funds had been provided through private donations obtained by the Task Force on Human development. The President announced a contribution of Rs. 2 billion to this fund and appealed to all Pakistanis to contribute to this fund.

The fourth area of focus was political restructuring to usher in real democracy. He affirmed that there would be elections and elected government as per the schedule already known. However, the essence of the democracy was far more important than elections. He did not want to be misunderstood in this regard. He promised that elections would be held in October. The democratic system had already been put in place through the Local Bodies System. A silent revolution had taken place and for this he was grateful to the Chairman of the NRB. All development activities would be initiated from the village up and not decided in the Federal and Provincial capitals. He promised that corruption and mismanagement would cease to exist. He added that 30 percent of seats had been reserved for women as they were more efficient than their male partners. Women’s seats had been tripled in the national and provincial assemblies. The real empowerment of the people was through human development. The President felt that democracy was not a constant feature and every country had its own environment. The President emphasised that he was a great believer in democracy. However, Pakistan needed the assistance of the world in this regard. Finally, the President thanked Mr. Kofi Annan and all other dignitaries and delegates for a patient hearing.

A Better Future for Pakistan: Poverty Reduction and Human Development. Key Note Address by Ms Clare Short, Secretary of State for International Development, United Kingdom:

Ms Clare Short began by expressing her pleasure in being back to Pakistan and thanking the President for asking her to contribute alongside such distinguished speakers. She expressed her long-standing interest in Pakistan which was due to the fact that many families in her parliamentary constituency were originally from here and maintained their links with Pakistan. She explained that following the coup 4 in Pakistan, the UK Government had put their development work on hold and had observed the regime very closely. The clear signs that emerged were that this Government was committed to a crackdown on corruption, responsible economic management, pro-poor policy, and a transition to genuine democracy. She appreciated the fact that transition to effective democracy and sustainable development in Pakistan was an enormous challenge. She believed that there was a historic opportunity for Pakistan to institute the right policies and with support from the international donor community, Pakistan could make this transition and offer a better future to its people.

Ms Short emphasized that success entailed learning from the mistakes and missed opportunities of the past. She pointed to the fact that from 1988 to 2000 four successive governments failed in their democratic responsibilities and that the price of this failure had been high. A decade of political instability had generated economic instability. As a result, annual GDP gro wth in the 1990s averaged 4 percent compared to 6.2 percent in the 1980s, and poverty increased to the extent that a third of all Pakistanis today lived on less than US$ 1 a day. Per capita expenditures on health and education declined by more than 10 percent between 1997 and 2000. As a result, elementary school enrolment rates largely stagnated, infant mortality declined only slowly, and maternal mortality rates had not been reduced. People in poor rural areas and poor urban neighbourhoods had been largely failed by both the public and private sectors. In terms of human development and poverty reduction, the 1990s were a lost decade for Pakistan.

The current Government was grappling with this sorry legacy and Ms Short felt that real progress could be made. The Government had set out an ambitious reform agenda and the UK Government was committed to supporting this process of reform. There was need for inclusive economic growth and tougher action on corruption. There was a need for greater investments in education and healthcare to increase productivity and growth, and a special effort to include girls in universal primary education as educated girls had the potential to transform their country as they grew up. By investing in its human capital, Pakistan could make major progress in poverty reduction and development. This would also create hope for ordinary people and support the Government’s objectives of building a more tolerant, open and democratic society. This required political will and commitment at every level of government without which the pledges set out in the Poverty Reduction Strategy would not be delivered. Ms Clare Short stated that she was very encouraged to see the progress Pakistan had made since the last Forum. However, enormous challenges lay ahead.

At the national level, the Government had chartered a timetable for political reform. Local elections had taken place and she had been very pleased to see that special seats had been reserved for women and Pakistan appeared to be heading towards parliamentary elections in October 2002. The agenda for reform of the political parties, strengthening elected assemblies and the Senate, and providing greater freedom of information would help to improve the accountability of the political system and give the poor a more effective voice in safeguarding their interests. At the local level, devolution offered a unique opportunity to build a relationship of trust between the government and the citizens. A concerted campaign of action was required that gave the provinces and districts adequate resources and the capacity 5 and the authority to implement agreed policy. This was essential if Pakistan was to sustain the economic and social reforms necessary for growth and poverty reduction.

The interim PRSP and the recently agreed programme with the IMF mapped a provisional path for poverty reduction, and spending to support social services. However, spending under current projects were unlikely to be sufficient to achieve social sector targets and as such greater fiscal resources were likely to be required. The Government and donors needed to agree on how to increase resources to support social spending and ensure that allocated resources were actually spent. Institutional reform also needed to be undertaken to transform the bureaucracy. Ms Short emphasized that the unresolved conflict over Kashmir could endanger progress and needed to be resolved peacefully.

Ms Clare Short appreciated the role of the private sector in the social sectors and emphasized the need for partnership between the public and private sectors. She pointed to the experience with the Social Action Programme which had a limited impact due to a decade of interrupted political processes, failing governments and economic decline. The lessons from SAP needed to be learned. New targets for the social services had been fixed in the interim PRSP and these needed to be costed realistically. Donors and Government needed to find new mechanisms and instruments to support different tiers and functions of government to reach these targets. She pointed out that Pakistan needed a set of donors who worked well together. She confirmed the commitment of the UK Government, for the long-term, to build Pakistan’s capacity and work more collaboratively than in the past. She explained that she had spoken frankly as a friend of Pakistan and emphasized that it was imperative for the future of Pakistan that this time we succeeded.

Mr Kofi Annan, Secretary General of the United Nations

Mr. Kofi Annan, Secretary General of the United Nations spoke about the Millennium Summit targets that had been committed to by Pakistan as well as the other countries. Mr. Annan noted the significant convergence between the Millennium Summit targets and IPRSP such as reduction in poverty, ensuring food security, health, literacy, provision of safe drinking water, and elimination of gender disparities. He also highlighted the need to ensure that environmental concerns needed to be incorporated if overall develo pment was expected to be sustainable. He expressed his deep personal satisfaction in being able to be present in the Inaugural Session of the PHDF.

Mr. Shaukat Aziz, Minister of Finance

The Minister welcomed the participants and outlined the fact that the positive response and the support that were received at the first Pakistan Development Forum, held in Islamabad in March 2001, prompted the Government to organise a special forum on human development in Pakistan. Human development was central in Pakistan’s reform effort. The overwhelming support to this concept was illustrated by the presence of 400 delegates from 22 countries and 18 multilateral agencies at the Forum.

Under the current leadership, Pakistan had adopted an integrated approach that combined economic growth, social development and governance. As a result, there had been significant progress and the economy had been stabilized. There was a steady increase in GDP, and increase in exports. Foreign exchange reserves had increased and broad-based reforms had been initiated. Pakistan successfully completed the stand by programme of IMF and fulfilled its obligations to secure significant assistance from the World Bank and the Asian Development Bank. Pakistan’s performance under the SBA qualified it to secure a three-year medium term programme from IMF and an unprecedented rescheduling of its entire stock of bilateral debt from the Paris Club. Commensurate support was also forthcoming from the World Bank, the Asian Development Bank and the Isla mic Development Bank. However, Pakistan still had a long way to go and was fully cognizant of the challenges that lay ahead.

The Minister stressed that human development lay at the core of Pakistan’s reform effort and that the ultimate measure of sustainability of its development efforts would be its impact on human welfare. The poor state of human development not only constrained growth but cast a spectre of poverty and deprivation that led to social exclusion and made the poor vulnerable to exogenous shocks. The less stake the poor have in organized society, the more vulnerable they are to exploitation from forces that undermine the work of civil societies. Thus, a major challenge for Pakistan was poverty reduction and this was the focus of the Interim Poverty Reduction Strategy Paper.

The success of IPRSP would be determined by the availability of resources and their diversion towards poverty related expenditures and the quality of IPRSP monitoring. For this purpose, the Government hoped to have access to funds made available from debt relief and concessional financing. The most convenient mode of funding would be straight budgetary support as the government had made significant allocations to poverty reducing sectors where expenditures would rise from Rs. 119 billion (3.4 per cent of GDP) in 2001-02 to Rs. 230 billion (5 per cent of GDP) in 2003-04. A significant additionality to this effort would come from Zakat, private charities and philanthropy.

The monitoring framework developed under th e IPRSP would closely track not only expenditures but also the progress in intermediate, and final outcomes. A quick assessment of performance would be made by using intermediate indicators that could be measured at shorter intervals. However, the Government faced capacity constraints that would require technical assistance as well as innovative arrangements to achieve credibility. Donor support would be critical to establish this capacity.

The Minister explained that the Forum presented an opportunity to closely examine the strategies of the Government and the financing needs of the social sectors. A special focus of the deliberations would be the effective use of debt swaps for increased social spending. The Government hoped to improve its human development strategies in the light of feedback at the Forum. Pakistan’s aim was to forge a strong development partnership with the donor countries and enhance its understanding about best international practices in the area of human development. For Pakistan, it was important to fight the menace of extremism through poverty 7 reduction measures. Through the Forum, Pakistan hoped to make a stronger case for the renewed and expanded involvement of donors in the poverty reduction efforts of the government. The PRSPI was not cast in stone and would be reviewed annually. The scope of the IPRSP could be expanded in case additional resources were made available. The Minister hoped that the Forum would be a watershed in establishing a strong partnership between Pakistan and its development partners.

Ms Zobaida Jalal, Minister of Education

In her opening speech, the Minister of Education stressed the fact that a strong society was needed to create a strong state. The main challenge for the Forum was to revisit the facts and figures from a people -centered perspective. It was estimated that close to 32 percent of the people in Pakistan lived below the poverty line and this figure rose to 48 percent when the multi-dimensional definition of poverty was used. The Minister stressed that when basic entitlements were withheld from citizens, their support to the state and society also became fragile and as a result poverty bred extremism. In her capacity as the Chairperson of the Social Sector Co- ordination Committee of the Cabinet, she shared a profile of the social sectors. There was a demographic transition in Pakistan and the population growth rate had decreased from 3.1 per cent to 2.1 per cent. She outlined the main challenges in the area of education, health, water supply and sanitation facilities. In this context, she stressed the importance of education, particularly female education and the inter- linkages between the education sector and health and population. The current government was trying to address some of the existing anomalies and confront the factors that had led to exclusion. She outlined the need to adopt a more holistic approach that integrated economic and non-economic values. The Education Sector Reforms were also designed to correct some of the imbalance in the education sector that had stressed primary education to the exclusion of higher levels of education and the madrassahs. The Interim Poverty Reduction Strategy was seeking alliances for remedies within government and civil society. The role of the district governments was being highlighted in addressing the implementation gap and they were being provided with resources to address some of the challenges. She outlined some of the main changes that had taken place in the last year and felt that Pakistan stood at an important cross road. She felt that the Forum provided an opportunity for reflection and action, and outlined the specific challenges that lay ahead for Pakistan. The Government of Pakistan and its partners wanted to share the initiatives that they had undertaken and lay down a firm basis for social sector development in Pakistan for which there was strong commitment and an unprecedented political will.

SESSION II: PAKISTAN POVERTY REDUCTION AND HUMAN DEVELOPMENT STRATEGIES

Mr. Ahmed Mohammad Ali, President of the Islamic Development Bank chaired the session. He welcomed the participants and, after a few opening comments, invited the Chairman of the National Reconstruction Bureau to begin his presentation.

National Reconstruction for Sustainable Democracy and Durable Good Governance by Lt. Gen. (Retd.) Tanwir Naqvi, Chairman National Reconstruction Bureau

Main Focus of Presentation:

The Chairman of the National Reconstruction Bureau (NRB) began his address by referring to one of President General Pervez Musharraf’s earlier speeches in which he had clearly stated that the era of sham democracy in which only its label was used was gone. The Chairman also referred to the commitment of the President to an era of true dem ocracy in which the government would serve the people. The President had announced a seven point agenda. Lt Gen. (Retd) Tanwir Naqvi outlined that this was the background within which the National Reconstruction Bureau (NRB) was created with the explicit mandate to formulate policy and strategy options for the National Security Council. The NRB had, since its inception, pursued the national objective of reconstruction of the institutions of State to establish genuine and sustainable democracy for durable good governance ensuring an irreversible transfer of power to the people of Pakistan. The NRB had identified nine fields of focus that constituted the national strategy in pursuit of its strategic objective. These fields of focus included the following; political structure and system, law enforcement, public employment, economic development, information provision, education, primary health care and population Welfare.

The NRB had designed a three-phased strategic plan that included conception, development and establishment of a new local government system, a federal democratic governance system within the parameters of the Supreme Court judgement, and conducting elections for the establishment of democratic governments at the federal and provincial levels. The NRB was currently engaged in establishing genuine and sustainable democracy at the provincial and federal levels and in crystallising the constitutional and administrative changes necessary for devolution from the federal to the provincial levels in the political, administrative and financial fields, including the police and judiciary.

Proposals were being currently developed by the NRB on the following fundamental issues; (i) changes in the political structures and systems necessary for introducing genuine and sustainable democracy; (ii) devolution of power from the Federal Government to the Provincial Governments (iii) structural and systemic changes in the Provincial and Federal governments in order to introduce efficiency and transparency in governance; and (iv) changes in the structures and systems of the civil services to raise the quality of personnel.

The Devolution Plan elaborated in 2001 had been given the shape of a model local government law and a plan had been approved to demolish the colonial administrative system, and replace it with a system based on participatory governance. In addition, steps were taken to ensure direct communication between District and Provincial Governments, and separate the executive from the judiciary. A new Police Act of 2002 had been developed to replace the existing Police Act of 1861 that envisages the separation of the investigative functions from the prosecution functions, strengthen citizen’s rights, and improve police performance.

The Chairman emphasized that implementation of these changes required insurmountable one-time demands on the national exchequer that could only be met through international financial support in the short term. Major financial support was required to establish new institutions and transform systems. Timely financing was critical for the implementation to proceed as planned and for the people to see results and retain confidence in the new system. Finances were required in particular for reform of infrastructure and modernisation of the police and lower judiciary, training of elected representatives and government functionaries, creation of information technology, infrastructure for transparent e-governance, capacity building in critical areas like legislative drafting, spatial and town planning, municipal management, budgeting, planning, finance and gender issues. Particular attention needed to be paid to planning and development in the social sectors. Pakistan needed to reduce its illiteracy for positioning itself for the emerging post-modern knowledge age.

Community participation was essential for the success of all grass roots initiatives. For facilitating ownership, a positive orientation towards self-development and a pro- active civil society is needed. Only an active and empowered citizenry could make the new system of devolution fulfil its potential. Community participation had the potential to reduce the deprivation that led to despair and then to obscurantism, extremism, fanaticism, and finally terrorism, and it thus served as an antidote to extremist mind-sets, organisations and activities. Community Participation, in this sense, was not only key to the success of devolution but also of Pakistan’s new insertion into the new world order. It was important that the international donor community recognised this potential and identified the roots of the resistance to change, rather than risk becoming de facto apologists for corrupt institutions and officials who seek to impede citizen’s participation at all costs. It was suggested that the long-term good use of money should impel the donors rather than the short-term fiduciary risk of investment.

The Chairman further explained that Citizen Community Boards (CCBs) were the mechanism contemplated in the Local Government Ordinance 2001 to extend community participation to every neighbourhood and village of Pakistan. The experience of NGOs showed that there was capacity at the grass roots level to manage projects. To strengthen this capacity, NRB had contemplated practical capacity building through the Devolution Trust for Community Empowerment (DTCE) and the President’s Task Force for Human development which was designing social technology for the CCBs in the form of specific programmes that they may wish to opt for. There was scope for NGOs to participate further in training and capacity building and in the process to improve their current low level of coverage. The Chairman, however, stated that there was a risk that current financial constraints 10 may make the funding available for cost-sharing of local level projects insufficient to meet the expectations of the people in relation to CCB programmes.

The Devolution Trust for Community Empowerment (DTCE) was the mechanism designed by NRB to address the issue of additional financing and capacity building for the CCBs. The concept of the DTCE was based on a brilliant synergy that consists of the need of the international donor community to rapidly channel emergency assistance in the post-September 11th environment as well as their need to signal a long-term commitment, and the need of devolution that this assistance strengthen the new institutions. The Government of Pakistan and the United Nations Development Programme were co-sponsoring the DTCE, a quasi non-governmental entity.

The NRB had clearly demonstrated that its timeframe for national reconstruction was realistic through its objective track record that illustrated that the deadlines for every phase of the devolution process had been met. Pakistan needed very large sums of money to use the infrastructure of local government that had been established for raising the lot of the people through improved rights and service delivery. An Asian Development Bank team of consultants had worked in close conjunction with local institutions to devise a system that was operational at the local level and was compatible with the PIFRA project.

National reconstruction and devolution were the way to construct a democratic and moderate Pakistan and ensure that all of the programmes and projects produced a bigger bang for the buck. The world would spend its money well if it is invested into this epochal venture of the Government of Pakistan at this moment of historic opportunity that generally presents itself, at bes t, once a generation.

Pakistan Poverty Reduction and Human Development Strategy by Mr. Shahid Amjad Chaudhry, Deputy Chairman Planning Commission

Main Focus of Presentation:

The Deputy Chairman explained that he would provide the analytical framework that would build on the first presentation and provide the framework for the poverty reduction strategy. The Deputy Chairman showed the poverty trends using the indicators of food poverty and poverty as measured by the basic needs approach to demonstrate over the last three years. The Pakistan Poverty Reduction Strategy (PRSP) provided a series of measures to empower the poor through providing them with food security, access to basic social sector services, equal opportunities for income, employment and protection from vulnerabilities, and freedom of information and participation. The framework of the Poverty Reduction and Human Development Strategy had a multi -pronged approach that aimed at fostering growth through economic reforms, physical and social asset creation for the poor, development of social safety nets and good governance through devolution of power, civil services reform, access to justice and police reform. The Deputy Chairman outlined the goals and targets of the poverty reduction strategy and the instruments that would be used to achieve them. The major goals were to eliminate

11 food poverty, significantly reduce human poverty, achieve full literacy, eliminate malnourishment for the under five children, and provide clean water for all citizens.

The presentation outlined the employment statistics for Pakistan that showed a slight increase in the labour force and an increase in both the employment and unemployment figures. The current unemployment rate in the country stood at 7.8 per cent. The Deputy Chairman highlighted the employment elasticities of different sectors and outlined the strategy for employment generation and creation of physical assets. A series of development programmes had been launched including the Khushal Pakistan programme (public works) and a host of development programmes and projects for water supply, sanitation, katchi abadi regularisation and development, low cost housing, redistribution of land, and the development of farm to market roads. It was hoped that these programmes would help in creating physical assets for the poor.

Social sector strategies for education, health, nutrition, population welfare and women’s development were presented by the Deputy Chairman. The Education Sector Strategy aimed at an improvement in adult literacy and universal primary and elementary education, improvement in the quality of education, introduction of vocational and technical streams in secondary schools, establishment of polytechnics and vocational institutes, and increased ac cess to quality education through public-private participation. The Health Sector Strategy proposed to deal with staff absenteeism and positioning, availability of drugs, LHWs at the village level for community services, district health reform, introduction of Village Health Committees, provision of immunisation coverage, and prevention and treatment of a range of communicable diseases. The Nutrition Sector Strategy was aimed at improvement of maternal nutrition, encouraging breast- feeding, improving household food and nutrition security and a programme for micro-nutrient supplementation, fortification and diversification. Urgent action was also required to deal with the high rate of malnutrition among children. A wide range of programmes was planned fo r controlling the high rate of population growth in Pakistan. In order to deal with specific women’s issues, including issues confronting girls, it was planned to have a national policy for women, prepare a strategic plan for women’s development and strengthening the institutional mechanisms and capacity for dealing with the wide range of issues confronting women. The Deputy Chairman emphasised that poverty in Pakistan had a female face and therefore women were an important part of our strategy.

The Deputy Chairman highlighted the allocations for the social sectors between 2001 to 2004 indicating the planned allocations, financing needs and the financing gap. This analysis showed a total requirement of Pak Rs. 215.2 billion, an allocation of Pak. Rs. 110.5 billion and an overall financing gap of Pak Rs. 104.7 billion for 2001- 2004. A few areas like the Deeni Madaris and Special Areas Development Programme were introduced recently in view of their special needs. There was a need to broaden the scope of the education programmes of the religious institutions and the Special Areas Development programme was for the Tribal Areas adjoining Afghanistan. These areas had not been included under the Khushal Pakistan programme which was delivering public works at the local level. He also indicated the economic assistance currently committed for the period 2001-2004 from various donors. The total funds committed by donors so far was Pak Rs. 1709.04 million 12 which included grants worth Pak Rs. 1293.88 million and a debt swap of Pak Rs. 415.16 million.

The monitoring instruments which the Government of Pakistan would use to monitor its programme would be the gross primary and secondary school enrolment rates, malnutrition among pre -schoolers, low birth weight of infants, the contraceptive prevalence rate, total fertility rate, percentage of population with access to drinking water and sanitation services, and percentage of population in poverty using both the caloric and basic needs approach. Institutional mechanisms were being proposed for monitoring poverty indicators at the district, provincial and national level through Social Sector Co-ordination Committees at each level.

The Poverty Reduction Programme had benefited substantially from broad consultation with all stakeholders and the process was on-going. There had been a special effort at fostering partnerships between the public and private sectors and civil society in the delivery of social sector services, particularly education and health. The Planning Commission was planning, in the current year, to extend the process to fifty of the poorest districts facing serious problems due to the continuing drought conditions.

Role of Zakat in Poverty Reduction by Mr. Jamil Ahmed Bhutto , Secretary for Religious Affairs, Zakat and Ushr, Government of Pakistan

Main Focus of Presentation:

Mr Jamil Ahmed Bhutto, Secretary for Religious Affairs, made the presentation on behalf of the Ministry of Religious Affairs. The Secretary highlighted the fact that Zakat was one of the five pillars of Islam. It was an Islamic injunction, a constitutional requirement and a basic responsibility of an Islamic State. He outlined the current mechanisms for Zakat collection. Zakat deductions were made from term deposits and other savings schemes at the rate of 2.5 per cent and this system of direct deduction was a unique strength of the system. There were certain circumstances under which people belonging to a certain Fiqh were exempted from Zakat deductions.

He highlighted that the annual collections averaged between Rs. 4 to 5 billion and the collection for the year 2001-2002 was Rs. 4.480 billion showing an increase of 23 per cent over the previous year. All collections were remitted to the State Bank of Pakistan in th e Central Zakat Fund. Local Zakat Committees decide upon the eligibility for Zakat. The target beneficiaries of the system were the Mustahiq defined as needy, indigent or poor with preference being given to orphans, widows, the handicapped and the disable d. Zakat funds were also admissible to victims of natural calamities such as flood and earthquake.

The strategies for disbursing Zakat funds were aimed at providing Guzara or subsistence allowance for households, educational stipends, stipends for the students of religious schools, provision for health care, assistance for marriage of girls, rehabilitation for victims of natural calamities and small business opportunities

13 for the poor. Zakat funds were also distributed to social sector institutions and a large number of charitable institutions.

The estimated number of beneficiaries of Zakat funds in Pakistan ranged from 2 to 2.5 million people. It was estimated that Zakat contributes between 10 to 15 per cent to the Government’s endeavour to reduce poverty. Promoting human development was an important feature of the Zakat system and more than 40 per cent of the Zakat budget was spent on education and health. A strategy for human development was a composite part of the manner in which Zakat was distributed as it focused on improving access to education, health care, self reliance through establishment of micro-enterprises, permanent rehabilitation through training and improvement in skills, and reducing vulnerability against shocks. Zakat funds were administered with gender equality and special emphasis was given to skill development for women.

President’s Task Force on Human Development: Solutions for Social Transformation by Dr. Nasim Ashraf, Team Leader, President’s Task Force on Human Development.

Main Focus of Presentation:

The Team Leader of the Task Force on Human Development expressed his desire to dedicate his presentation to late Dr Mahbul-ul-Haq. He explained that the concept he would present was open to refinement and suggestions for improvement. It was a time for change and action. Change required change management with champions of change. It was this idea that he would be presenting today. The President of Pakistan established a Task Force on Human Development in June 2001 to contribute new perspectives and resources to development discourse in Pakistan. The principal objectives of the Task Force were to strengthen the system for efficient delivery of social services, support the government’s programmes in the social sectors by filling the unmet needs of Universal Primary Education (UPE) and Health For All (HFA), and develop public - private partnerships for programme implementation.

The approach of the Task Force was to focus on people rather than programmes, outcomes rather than inputs, systems rather than organisations, and to see how public -private partnerships could be used to elicit change in behaviour to support change in structures. There was a need to look at the system of incentives that motivated people and focused less on the punitive measures to elicit changes in behaviour. In order to meet its goals, the Task Force undertook an analysis of current realities to move to an analysis of gaps and options leading to an implementation plan. In this process, more than a 1000 individuals were interviewed and 50 workshops were held to map stakeholder needs and identify key system wide issues.

The key issues identified were lack of system wide capacity, competency and delivery capacity in current government programmes. In particular, lack of community participation, integration and co-ordination were identified as key gaps. The analysis revealed that most of the issues could be resolved if five guiding principles were incorporated into the strategy of the Task Force: 14

Ø Integration

Ø Community Participation

Ø Management Capacity

Ø Partnerships

Ø Accountability

The Task Force planned to establish Human Development Incubators in each district to ensure effective delivery of social services by supporting devolution, building capacity, and requisite competencies. These Incubators would strengthen the competencies of the line department officials, support newly elected representatives, facilitate change management, co-ordinate inter-sectoral initiatives across stakeholders, and build capacities of non-governmental service providers. The Incubators would provide services to line departments and NGOs to increase their success rates. The President had created a Trust Fund to support the Incubators and other social sector reform projects. Commitments had also been made to the Fund from the private sector. The Government of Pakistan would leverage the incubators to fill unmet needs in the UPE and HFA programmes. The Incubators would create public private partnerships to meet the targets ni non-formal basic education and adult literacy and targets of the National Health Policy in primary health care. The National Commission on Human Development established by the President would also contribute to the capacity building of the proposed institutional infrastructure. The proposed programme set the stage for continuous innovation in the delivery of social services.

MAIN FOCUS OF DISCUSSIONS ON POVERTY REDUCTION AND HUMAN DEVELOPMENT

Commitment from the Government of Japan: In view of the synergy between poverty reduction, human development and the broad programme of reform outlined in the presentations, the Government of Japan reiterated its commitment to provide grant assistance of US$ 300 million over two years starting September 2001. This assistance would be channelled through the sector programme in the education sector in accordance with the priorities outlined in the different presentations.

The Framework of the Interim Poverty Reduction Strategy (IPRSP): The representative from Norway was impressed by IPRSP’s work in the last ten months. The document gave a holistic approach and should be the framework for use by all donors. It should be seen as a major challenge for the donors to keep within this framework. The representative from Norway expressed the hope that as it was further developed, it would provide a good basis for co-ordination and trying to focus assistance in accordance with the priorities of the Government of Pakistan (GOP). The major implication was the cost implication and the implementation challenges as IPRSP was an ambitious document. The Minister of Finance highlighted that the IPRSP was an evolving document that needed to be reviewed periodically. The 15

Chairperson of the sessions and the representative of the Islamic Development Bank expressed his view that there was need for flexible mechanisms which allowed policy and resource allocations to respond to the challenges that lay ahead. He recognised the need for social capital development for success of the reforms and indicated that it was highly desirable to see the PRSP as an instrument which would provide this framework. For social capital formation, he outlined the Islamic concept of Haquq-ul- Ibad that entailed honesty and integrity in financial dealings, hard work and commitment and respect for human dignity. Wherever there was Haquq-ul-Ibad, there was likely to be greater social awareness and this would bring the prospect of success of the PRSP initiative.

Fostering Human Development: The representative from Japan stressed that in human resource development, local governments could play a key role and donors could assist in the process. The representative from Norway highlighted that thousands of new councillors would need training to retain the momentum in the system of checks and balances that had been instituted. The Government of Norway was very interested in supporting training through their collaboration with UNDP. The Minister of Finance stressed that one of the major challenges before Pakistan, as it moved towards local level empowerment, was capacity building which could then help to leverage its other investments for a bigger bang for the buck. Pakistan hoped to focus on training, process management and process improvement for the desired level of effectiveness. The Chairman of NRB explained that the National Institute of Public Administration (NIPA) would develop syllabi in accordance with manuals provided by the Bureau for institutionalising of capacity building. DFID had entered into an agreement with ADB and were investing close to UK £0.5 million exclusively for training of government functionaries and elected representatives in financial management.

Balance Between Micro-Planning by the Federal Government and District Level Planning by the Districts: The Nazim from Khairpur felt that the different presentations gave a sense of micro-planning for the districts at a time when the districts were being given the message that they were going to plan for themselves. There appeared to be too much planning from the top for the district level. The concept of Incubators seemed to go in two very different directions. The districts should be allowed to make plans and fix their own development targets. The Chairman of NRB responded that there was an apprehension that the Federal Government was getting into the sinews of local government. However, the idea was that now that the institutional infrastructure had been created, the structures had to be backed up by systems and for the systems to function, the people had to have the capacity which has to be built up and through the Task Force the void will be filled where required. The Team Leader for the TFHD agreed that the planning should be done and implemented at the local level and that the Inc ubators were being created to support the local level and build capacity in the social sectors, where required. The Minister of Finance pointed out that when the process of reform was started, Nazims were not in place, and although stakeholder seminars had been conducted, there was a need to get the ownership and support from the newly elected representatives. Although this was a complex task, it was an essential part of the process and had to be undertaken.

Balance between Human Development and Economic Revitalization: The Government of Japan felt that the emphasis on human development was justified as this area had been neglected in the past. However, it was important to remember that poverty was also a problem of job opportunities. Economic revitaliz ation was as important as human development. The development of agriculture, industry, including small and medium enterprises, and the development of infrastructure were also very important. Japan hoped to strike the right balance between these components. There was an interest in listening to the GOP’s strategy for agriculture and small and medium enterprises prior to the April forum. The Chairman of NRB responded by stressing that the link between human resource development and poverty reduction was in creating the potential for the individual to generate income through a combination of skills, finances and enterprise development thereby improving his level of prosperity. No matter how good the economy got for job creation, it was important to focus on the individual to enable him to utilise the economic opportunities. This would also lead to the growth of a service sector which was demand-responsive.

Redefinition of the Roles of the Federal and Provincial Governments: In response to a query about the roles and responsibilities of the Federal and provincial government, the Chairman of NRB elaborated that the basic principle underlying a redefinition of the roles and responsibilities of the different tiers of government was that when there was a citizen’s interface, it should be with the local government. Basic consumer services like electricity, gas and postal services were currently provided by institutions at the federal level. There was need for an interface at the local level for these federal level service providers. The provincial governments would be responsible for provincial policy, legislation, finances and for trans-district projects like highways, irrigation systems and other infrastructure. The Federal Government was the service provider for the nation as a whole. These were the underlying principles on the basis of which NRB was trying to reconstruct the relationships between the different tiers of government.

Accountability: The representative from Norway emphasised that accountability had to be the main focus when assistance to the social sectors was discussed. He was pleased to see that accountability had been taken seriously by the GOP and a clear signal had been given that corruption was not acceptable. Although the achievements in devolution and local government were very impressive, many questions could be raised. One of the main achievements was that the GOP had created checks and balances at the local level. The more transparent the budget process, the more likely it was for people to participate. The biggest challenge would be to see how the Nazims and the ordinary people perceived the benefits, how things worked in practice, how funds were channelled to the local level, and how they were being used. The Chairman of the NRB explained that instruments of accountability had been built into the system and all levels of councils and respective line departments would be monitored. There were plans to establish an office of an Ombudsman in every district, strengthening of the district courts system, placing magistrates at the local level, establishing small claims and minor offences courts and family courts. This would enable the existing courts to handle more cases promptly. An entirely new finance system was also being established at the local level in consonance with the Ministry of Finance that dealt with accounts, auditing, fiscal transfers, development of manuals, etc. 17

Mechanisms for Performance Monitoring: The Deputy Chairman of the Planning Commission explained that specific mechanisms had been put in place for monitoring. The Ministry of Finance was monitoring expenditures on a monthly basis and this information was available on a web-site in the interest of transparency. For physical monitoring of the social sectors, the Education Management Information System (EMIS), the Health Management Information System (HMIS) and the Pakistan Integrated Household Survey (PIHS) were now in place. A Poverty Reduction Monitoring System had also been established. The Chairman of the NRB informed the Forum that a complete National Reconstruction Information Management System (NRIMS), which was the citizen’s monitoring system, was being pilot tested in the district of Chakwal for transparency and information availability across the board. The software had been developed and the required finances were available to launch the system. The concept behind the NRIMS was that there was no better way to monitor than by the people to whom the service were going to be delivered. The Minister of Finance pointed out that while traditionally we had focused on expenditures, we were now focusing on outcomes. A minimal number of critical indicators would be measured very carefully in an independent manner.

The Nature of the Citizen Community Boards: Mr Shoaib Sultan Khan stressed that without organised citizenry, the devolution plan would not succeed. He expressed his concern that if the CCBs were envisaged as a representative body than community participation would not be forthcoming. As such, the CCB had to be a broad based organisation with a minimum membership of 75 per cent of the beneficiaries. The Chairman of the NRB explained that the CCB was nothing but a citizen’s body generic enough to cover School Management Committees or could be used for veterinary improvements. The CCBs were visualised as a group getting together for a doable project. It was not a representative institution in the technical sense of the term but it would be composed of citizens who would like to do a lot for the community without getting into the rough and tumble of politics.

The Size and Staffing of the District Incubators: Referring to the idea of District Incubators enunciated by the Team Leader of the TFHD, the representative from the ADB enquired about the size of the Incubators in terms of staffing, where the staff would be drawn from, and the relationship between them and District Councils. The Team Leader of the TFHD responded that the District Incubators would consist of a core team of technical staff as shown in the Organogram and consist of five key people. In case a larger number of organisations were being incubated, there would be need to recruit more people. This would depend upon the needs of the newly elected representatives. The relationship of the District Incubators to the elected representatives was that of a support organisation that would provide assistance with planning and social mobilisation.

The Financing and Sustainability of the Trust Funds: The representative from the United Nations Family Planning Fund enquired about the two Trust Funds that had been mentioned in the presentation by NRB and the TFHD, the relationship between these two trust funds, and the mechanisms for the donors to work with them. The Chairman of the NRB explained that there was a clear division of responsibility. NRB was not undertaking any piloting and were going directly to scale. The Trust 18

Fund of the TFHD is required to enable them to provide social technology transfer at the grass roots level. The NRB Trust Fund will provide money for actual projects by the community through the CCBs. It was expected that these funds would be a catalyst for activity to be generated and sustained. The Minister of Finance promised to clarify the roles even further to avoid confusion. The representative from UNFPA enquired that to the extent that these funds were an endowment, would they take on a life of their own and the experiences with such funds in other countries. The Chairman of NRB replied that although it was a good idea to have a time frame, the key question was to determine what was an appropriate timeframe. As such, he would be hesitant to put a life on it at this stage. He clarified that the Trust Fund of the NRB had two parts: one was an endowment and the other consisted of annual funds that had to be spent within the year. The Team Leader of the TFHD replied that his Trust Fund also had two parts: an endowment and a component to meet annual operational costs. In terms of the experience of other countries with endowments, there were two models that were used in practice: a sliding scale endowment and a perpetual endowment. The TFHD had not yet decided between these two models. It was explained that the donors would have a choice as to which component of the two Trust Funds they would like to contribute.

Preference for Meeting the Financial Gap: The representative from Germany enquired whether Pakistan would consider financing of its development needs through soft loans. The Deputy Chairman of the Planning Commission explained that the expectation was that most of the financing would be through grants and debt swaps, and only a small portion of the financing gap would be met from soft loans. The Minister of Finance stressed that Pakistan’s preference was to meet its financing gap through the flow of bilateral grants and some concessional financing from multilateral agencies.

The Impact of Zakat Collection and Decision-Making on Disbursements: The representative from the European Commission appreciated the presentation on Zakat but enquired about the impact of Zakat on savings and fund mobilization in the rural areas in view of the compulsory deduction from savings. He further enquired whether the local Zakat Committees were taking into account the democratic process and local decision-making. The Secretary of Religious Affairs clarified that Zakat had no impact on savings. He explained that there were 39,730 Local Zakat Committees and these were the lowest tiers of administration of the fund, and they determined eligibility at the grass roots level. These Committees functioned without any political or government pressure and determined the Istihqaq or eligibility for Zakat quite independently. At the Federal Level, the Federal Zakat Council oversees the system but does not interfere at the local level. The funds were distributed to the Provinces according to an agreed upon formula. The process of accountability was inbuilt into the system and there was public participation in the disbursement of the funds.

DAY TWO: JANUARY 25, 2002

SESSION III: EDUCATION

The leader of the USA Delegation chaired the session on education. She expressed her satisfaction at USAID being back in Pakistan. This was a very critical juncture in the history of the country and she was glad to be in Pakistan. The Chairperson recognized the role of education and the pivotal role it could play in Pakistan’s future. She was glad to be chairing the session on education which was also a subject very close to her heart.

Education Sector Strategy by Ms. Zobaida Jalal, Minister for Education, Government of Pakistan

Main Focus of Presentation:

The Minister for Education gave a comparative perspective of key education indicators in South Asia. Pakistan ranked lower than both Sri Lanka and India on each of the important education indicators with an adult literacy rate of 45 per cent, female literacy rate of 30 per cent, gross primary enrolment rate of 74 per cent, secondary enrolment rate of 26 per cent, drop-out rate of 50 per cent among children before grade five, and education expenditures of only 2.7 per cent of GDP.

The key institutional gaps in the education sector were resources, planning, information, staffing, and poor quality and low quantity of service re sulting in social gaps. In response, the Government of Pakistan had formulated the Education Sector Reforms Action Plan for 2001-2004 which was a doable plan integrated within macro -level shifts. This did not represent a new policy and the focus was on implementation. This plan represented a sector wide approach, with multi-level financing, with aspects of decentralisation and devolution, and a reform of institutions. She presented the macro-framework which would be used to address the delivery gap.

The Minister for Education presented Pakistan’s mission statement for the sector which was to develop human resources in Pakistan as a pre -requisite for global peace, progress and prosperity, and its vision which was quality education enabling all citizens to reach their maximum potential, produce responsible, enlightened and skilled citizens, and to integrate Pakistan into the global framework of human centred economic development.

The policy statement outlined that the IPRSP provided the policy framework for the ESR and the devolution plan provided the implementation framework. There would be a focus on public private partnership, increase in public expenditure to 3 per cent of GNP, cost sharing of education, and performance based audit to maintain transparency and accountability. She outlined the targets that the GOP wanted to achieve. This included: an increase in literacy rate to 60 per cent, gross primary enrolment to 100 per cent, net primary enrolment to 76 per cent, middle school enrolment to 55 p er cent, etc.

She outlined the seven thrust areas which included literacy in the non-formal sector, mainstreaming and up-gradation of Madrassahs, elementary education, addition of technical stream at secondary level, quality assurance, higher education reform and public private partnership. The ESR was envisaged as an inclusive, incremental and inter-sectoral plan. The plan would be implemented in a consultative manner and would be updated quarterly as a rolling action plan.

The financing framework for the ESR adopts a multi -dimensional approach. The sources of finances will be channelled from national, provincial and local resources, with soft loans from multi -laterals, grants and debt-swaps from bilateral sources as well as contributions from the private sector and the expatriates. The main challenge would be to create fiscal opportunity and changing allocation and budgetary patterns.

The current financial requirement was estimated at Rs. 55.5 billion, the current allocation was Rs. 30.32 billion, and the financing gap was projected at Rs. 25.24 billion. The gap did not include costs for mainstreaming Madrassahs, capacity building at district level, IT in basic education, and full cost of higher education reforms.

The Minister outlined the Public Sector Development Programme (2001-2002) which had an ESR allocation of Rs. 1.57 billion, with the provincial share at 90 per cent and 10 per cent as the federal share. She outlined the ESR allocations and the sub- sectoral allocations. New financing mechanisms with outcomes based agreements were being considered under which funds would be distributed as per NEC criteria and would allow the preparation and approval of projects at the district level according to the devolution plan.

There were special measures being considered to increase literacy and education. Some of such measures are: rehabilitation of existing facilities for optimum utilisation and implementing quality through a broad range of measures including deregulation of text books, publication of quality text books at district level, reorganisation of examination boards, revision of curriculum, national education assessment, implementing technical stream at the secondary school level, public–private partnership to encourage the participation of the private sector by restructuring the Education Foundations in order to regulate but not to control them, initiate an adopt a school programme, introduction of IT education in secondary schools, the provision of an incentive package for the private sector, and higher education reforms for which a task force had been set up and the private sector had been involved in the Task Force in the spirit of public private collaboration. The system will be fixed first through devolution and decentralisation in education. The education sector was a priority at the local level and needs had been identified by the Nazims at the local level.

The Islamabad Capital Territory was being used to pilot test the ESR. In describing the road ahead, the Minister of Education highlighted that the ESR was a catalyst for change in public policy and implementation. It would provide the framework for an outcome-based approach. It was expected that the new financing arrangements would be transparent and accountable. We expect that the sector wide approaches would be tested in 2002 for system revival and scaled up for sustainability. Quality assurance would be a key focus and would be undertaken through district based 21 capacity building for governance, amendments in recruitment and promotion policies, institution-based reform, and improved co-ordination. She emphasised that financial and technical support would be needed for all ESR programmes.

Provincial Perspectives: Vision for Delivery of Improved Education Services by Mr. Imtiaz Gillani, Minister for Education, Government of NWFP

Main Focus of Presentation:

The Provincial Minister of Education outlined that the main aim of education was to lay the foundation of an educational system the results of which would be apparent many years later. The dual umbrella of ESR and PRSP were being used in the education sector. He outlined some of the issues plaguing the education sector in NWFP. He felt that there was a misplaced focus on the education sector which was not on the schools and students but was on the teachers and the implementers. There was a serious ownership issue at every level. There was a gap between the policy makers and for whom the policy was being made. The Provincial Minister felt that there would be an immediate improvement in the system if a law was made that all Ministers and Secretaries children should go to public schools. He felt that inconsistent and shifting education policies and weak government were responsible for many of the problems in the sector. In the past, budget cuts had been imposed arbitrarily whenever there were resource constraints. Some special problems that plagued NWFP were low enrolment ratios, problems of access, quality, funding and cultural issues in which girls were less equal than boys although girl’s enrolment ratios had improved somewhat. The private sector had come up and was picking up the slack. A principal problem was that NWFP was dependent upon Federal transfers and smooth flow of funds was a particular problem. In addition, there were problems with monitoring and supervision, lack of dedication and a sense of responsibility, and problems with top-level management. The drop-out rate was high and completion rates were low, infrastructure was deteriorating and there was constriction at the middle level due to lack of investment. Poverty kept children out of the school system and there was limited capacity above the primary level.

The Provincial Minister emphasised that in NWFP, the first, second and third priorities were education. The Provincial Government spent 20 per cent on education, out of which 80 per cent went to primary education of which 70 per cent was allocated to girl’s primary education. The Provincial Minister felt strongly that education should be an equaliser. Unfortunately, Pakistan had created apartheid in the education system. There was a parallel stream of education: one for the haves and one for the have-nots. The Government wanted to bridge this gap. The Provincial Government wanted to shift the focus from the implementers to students. In the past, we had focused on the tools of education and not measured the ends or the strategic objectives. Education had to be the central plank otherwise no development was possible. It was also assessed that the return on investment was the highest in education. The Minister applauded the private sector but our real challenge was the public sector. NWFP had a huge Education Department which could not be wished away and we had to get it to perform better.

The Provincial Minister outlined plans to get teachers on contract who would have to perform and if there was any dissatisfaction with their performance, then the Department would have the autonomy to remove them. In the past, complacency had set in. The NWFP would also institute a Post-specific contract recruitment policy and would undertake redeployment of staff at the district level to create district cadres, merit based promotion, result-based reward, and punishment system. An Education Testing and Evaluation Agency (ETEA) Ordinance has been promulgated which was helping NWFP revise its examination and testing system. The private sector was performing well but some schools were not providing the type of education they should provide. An authority had been created to regulate the private institutions. In addition to the existing arrangements, BI & SE had been established at Mardan and Kohat. The NWFP would utilise funds through the PTAs, delegate authority and responsibility to district levels, and would create a separate Department of Schools and a Department of Higher Education.

For quality improvement, a series of steps had been taken including improving textbooks, district based teacher training, and a selective introduction of English as a medium of instruction for Mathematics and Science. A system was being established through which a school based system for purchase of consumables and petty repairs was being instituted. There would be periodic student assessments at the primary level. To improve access to schools, boys schools had been made co- educational, school infrastructure had been offered to private schools for the afternoon, computer education had been introduced, fifteen new degree colleges had been opened, three universities were opened in the public sector, four universities were established by the private sector, computer science programmes started in 26 colleges and MA classes in 3 colleges.

The Minister explained that for better governance, there needs to be a separation of teaching and management cadres in the Education Department. Management capacity had been strengthened at the district and provincial level. NWFP had not had much success with the “Adopt a School Programme”. PTAs had been established in middle and high schools. EMIS and PMIS had been established for all schools and colleges including FATA. Capacity building of the Directorate of Education had been undertaken, and discussion had been initiated with the media on education policies.

The future agenda of NWFP was not to spend on brick and mortar but to consolidate the infrastructure that the government currently possessed. There was a need to consolidate existing institutions, improve quality education in FATA, undertake proper student assessment in NWFP and FATA, rewrite text books, continue in- service training and expand it to the middle and secondary levels. Post specific teacher recruitment was required to combat absenteeism. There was a move for transferring teacher’s casual leave to vacations, rationalise and redeploy teachers, emphasise girls education, give priority to primary education but shift towards elementary education and expansion of secondary and post secondary schools, continue collaboration with the private sector, start afternoon classes, open m osque schools, open primary schools in rent free building, and implement the Compulsory Primary Education Act.

The Minister elaborated that Pakistan was a highly indebted country and was a signatory to the EFA. Pakistan needed debt relief, special dispensation for Afghan refugees, and a development package for FATA. Pakistan was at a crossroads. Basic education was a fundamental human right and a global responsibility. In Dakar, this statement was repeated. The World Bank and UNICEF had provided assistance in this regard. Afghanistan imposed special costs on NWFP. The province had a long border with Afghanistan. FATA consisted of seven tribal agencies and there were people on both sides with historical, cultural and family ties. In this context, any fall out of Tora Bora fells directly on NWFP. There has been little development in the Tribal Areas in the past. The Pathans were easy prey to propaganda as they had a very clear and traditional value system in which family and tribal ties were important. The best defence against such dogma was education and more education. There was need for a special package for FATA to bring it at par with the rest of NWFP. This would be a strong bulwark against terrorism. The world had changed after the lethal sting of September 11th. The breeding ground for terror is helplessness and despair which is nurtured by poverty. The world had contracted into a global village. Although this was understood in the context of trade and commerce, it needed to be understood ni the context of terror. This Forum presented a unique opportunity to deal with these difficult challenges. The Minister informed the Forum participants that they would find more than an ally in Pakistan. He invited the Forum to engage with Pakistan in the social sectors, to be colour blind to the complexion of our government, and to be a fellow traveller on Planet Earth. The Minister reminded the gathering that the nations were inextricably linked. When one nation walked on the moon we all triumphed; and when terror strikes one, we all suffer and bleed. He quoted John Dunn and reminded the audience that the bell tolled for thee. Pakistan needed an intense and deep engagement with its friends in the social sectors; otherwise, we might witness another horror.

ALTERNATIVE APPROACHES TO DELIVERY OF EDUCATION SERVICES:

Experiences of NGO and Foundation Schools by Professor Anita Ghulam Ali, Minister for Education, Government of Sindh

Main Focus of Presentation:

The Sindh Minister for Education outlined the idea behind the Adopt A School Programme and outlined its basic tenets. She emphasised that they did not want donations but wanted participants to adopt a school in order to oversee and nurture the school. The mobilisation of the private sector led to the improvement of public schools and increased the involvement of parents and communities in the educational processes. Marked achievements of this programme had been the adoption of 191 schools, a major upliftment of school facilities, strengthening of pedagogical activities, and quality education. This had led to regular school monitoring and increased involvement of parents and communities by establishing active and functioning SMCs through democratic practices. There had been a wide range of adopters including retired educationists, the armed forces, prominent citizens, etc. Through this programme, a strong linkage and partnership had developed between the private sector agencies and the Education Department.

The Minister outlined the tangible and intangible benefits of this partnership which included increased efficiency in school management and administration, improvement in infrastructure, improved efficiency and motivation of school staff, substantial increase in enrolments and a decrease in drop-out rates, a better relationship between the school, the Department of Education, and the communities, and the creation of a pressure group which had drawn the attention of the private sector towards public sector education and its issues. This had also led to policy shifts by the government towards greater recognition of public-private partnerships in the field of education. The Sindh Minister outlined her future plans regarding the Adopt a School Programme. These would include an effort to enhance the role of the Sindh Education Foundation and the expansion of the programme to rural areas. However, lack of financial resources, paucity of educational expertise in the adopters, lack of awareness of the DOE at the grassroots level, and the weaknesses in the monitoring and administration of the programme had to be dealt with in the future.

The Minister next outlined her experience with the Fellowship and Community School Programme. She outlined the Fellowship Schools Programme sponsored by DFID, and the World Bank/IDA for community schools. As a result of the support, 120 Fellowship Schools were established in seven districts of Sindh. The Sindh Education Foundation provided financial incentives for teacher and student attendance and provided funds for ensuring the sustainability of the community schools. She outlined the benefits of these schools which included a marked increase in female literacy, development of local level capacity, community ownership, increase in value of female education amongst rigid communities, and capacity development of private sector/NGOs for sustained public-private partnership. The model of community supported schools and the conditions under which support was provided to these schools through the World Bank/IDA financing would be expanded. The support was for enhancing the capacity of communities in the areas of school management. Under this scheme, 100 schools had been established in five districts of Sindh. This had also helped to improve the female literacy level of the province and provide income and job opportunities at the grass roots level. For the future, there were plans to research the model for possible replication as it was a cost-effective model.

In highlighting the achievement of the Sindh Education Foundation, the Minister informed the Forum that the Foundation had started with an initial allocation of only Rs. 17 million which was the lowest allocation when compared with the National Education Foundation and the other provincial foundations. However, a dedicated team of youngsters had been at the forefront in ensuring that these funds were leveraged properly. The SEF had now spent Rs. 95.5 million between Rs. 1993-94 and 2001-2002. The Minister gave an overview of the Sindh Education Foundation’s infrastructure and projects. The SEF included a home school project, a working children’s centre, the Manchar Lake project, a Women’s literacy Project, a Quality Support Unit, and a data processing and research cell.

Experiences of Private Education – Low Cost Service by Dr. Shahid Hafiz Kardar

Main Focus of Presentation:

Dr. Kardar highlighted the importance of private sector in fostering the agenda for education. There had been a rapid increase in private schools in urban areas. He emphasized that financing was not an issue. The real issues were institutional and lack of accountability. There was a lack of space restraining government ability to expand education in urban sector where the latent demand for education was the strongest. Even low-income households were sending children to private schools, perceiving them as providing better quality education. An informed debate on alternative solutions to expanding better quality schooling at lower costs, than being provided by the public sector, was missing, even though Federal and Provincial Governments recognised the importance of private schools.

A census of private educational institutions had revealed that 20 per cent of total enrolment and 53 per cent of urban enrolment were in private schools although only 17 per cent of the total number of schools were in the private sector. The overwhelming majority of private schools (95 per cent) were providing co-education indicating the degree of social acceptability of mixed schools at the primary level. In addition, a survey of 2,500 households conducted in 1996 showed that nearly 50 per cent of households earning less than Rs. 3,500 per month were sending their children to private schools. About 87 per cent of these households were paying less than US$ 2 per month. Households sending their children to government schools were spending twice the amount that households sending their children to private schools were spending.

Turning to the regulatory framework, Dr. Kardar specified that schools were the exclusive mandate of the provincial governments. Although government neither provided funding nor incentives to the private sector, it wanted to regulate them. He explained that the focus on school registration requirements was on inputs and not on outcomes. The information that was sought in the registration form was generally irrelevant to the delivery of education. To illustrate his point, Dr. Kardar read out some registration requirements. There were no standards prescribed for applicants to assess levels reached, and in some cases the penalties proposed for non- compliance were disproportionate. The survey of schools showed the long period was required in registering. The regulatory framework had a predatory nature. Registration had an intrusive intent but was enforced in a benign manner because, mercifully, the enforcement mechanisms were weak and cost of compliance low.

The vast majority of private schools were running scholarship programmes for able students and were offering concessional rates of school fee. The salaries of teachers in private schools were about one-third that of teachers in government schools. Average annual recurrent cost per student at primary level in private schools were almost half that for government schools. With the same allocation of funds in the private sector, twice the number of children could be educated through private schools.

Tax policies and structures discriminated against schools catering to less privileged households. There was tax on incomes of teachers and school buildings were liable for property tax. The private schools were in need of a proper incentive package that should include matching grants, reduction in property tax, domestic rates of tariff for utilities, and assistance in in -service teacher training. There was a need to support assessment of outcomes through performance of students in government organised tests. Dr Kardar felt that the following changes needed to be implemented in the education sector. There was need to reduce the emphasis on provision of immaterial information and dismantle requirements to maintain a host of registers, reduce number of processing steps for registration, establish an independent regulatory body, provide grants for schools in slums and low income settlements, and support education progression through the system of education vouchers. The State Bank needed to consider a special credit line on concessional terms for schools and soften the associated prudential regulations. The public -private partnerships should involve leasing out of poorly functioning institutions in the public sector. There should be no fee regulation for the private sector. The answer to private schools charging high fees was government schools providing good quality education. Annual fee increase in private schools was lower than the annual rate of inflation. The market should be allowed to determine fee levels except that such fee should not be increased during the currency of any academic year. For complete transparency and informed choice, the fee structure of a school should be available at the time of admission including information on trends in fee increases in the last three years. The private sector presents a major opportunity and the regulatory framework should not unnecessarily burden the cost of service provision which could price out less affluent segments of society. The principal responsibility of the government was to ensure free education, not provide it itself.

Education Development through Voluntary Services by Lt. Gen. (Retd.) Sabeeh Qamar-uz-Zaman, Director, Citizens’ Foundation, Karachi

Main Focus of Presentation:

General(R) Zaman explained that Universal Primary Education seemed to be an elusive goal in Pakistan. No Government had demonstrated a commitment to education. The jury was still out for the present Government. The question was one of priorities, not paucity of funds. The education sector had been plagued by misplaced priorities. The task of redesigning the education sector was an enormous task. General Zaman outlined current realities which included a high drop out rate, low net enrolment rates, staff absenteeism, poor capacity, and low quality. He estimated that nearly 4 to 5 million children would be added very year and 40,000 additional schools were required to keep pace with current needs.

Keeping in view the fact that there was no second chance for the young child, the concerned citizens decided to act. It was his belief that if the concerned citizens were not willing to invest for a better future, then they had no right to such a future. It was from this emotion that the idea of the Citizen’s Foundation and the Quality Schools Foundation was formed. These two non-profit corporate entities presented opportunities for disadvantaged children in rural areas and poor income urban areas. The Foundation started its operation in 1995 with five primary schools in Karachi. 27

Currently, the Foundation had 80 functioning schools in 9 towns of Pakistan. Of these, 20 were secondary schools and one was a teacher training institution. The medium of instruction was Urdu and official curriculum was taught in these schools.

The Quality School Foundation was established for girls with English as a medium of instruction. The schools would become operational next year. In these schools, the sciences would be taught and modern facilities would be established. The estimated Rs. 20 million cost had been raised through donations. The idea was to deliver quality education with emphasis on teacher training. However, there were experiences of harassments due to disproportionate discretionary powers enjoyed by levels of decision makers. It was very difficult to register such schools. The tax incentives were inadequate. In this context, it was important to learn from the experiences of other countries. The US experience showed that tax deductions had a substantial multiplier effect. Government could encourage individuals to contribute voluntarily for social services (including education) by ensuring tax deductions. There was a need to make procedures for registration simple and reasonable, and introduce lower tariffs on private schools for consumable services.

MAIN AREAS OF DISCUSSION ON EDUCATION:

Statement of Support from USAID: The Chairperson of the session and the head of the US delegation recognized the role of education and the pivotal role it could play in Pakistan’s future. She informed the Forum that USAID was returning to Pakistan even though the full scope of its programme was not determined. As such, this was a timely dialogue for them and they had heard the challenges that Pakistan faced with great interest.

Statement of Support from the Government of Japan: The representative from the Government of Japan fe lt that there were clear signs of will emerging from the GOP and the private sector to invest in quality education. He suggested that donors should use all their means to help these efforts on the part of Pakistan. The Japanese Government could provide assistance through technical co-operation, grants and concessional loans. The Government of Japan had decided to extend US$ 40 million to the education sector. He outlined the previous experience of the Government of Japan with technical co-operation and felt that investments in both formal and non-formal education were important, and there was a need for bridge building between the two. JICA also had experience with the previous Pakistan Literacy Commission and was interested in concrete steps to reduce the drop-out rates. The Japanese Government was also keen to pursue the concept of community schools and would like to see this expanded to the district and provincial level. JICA could provide experts for teacher training and secondary education, and was considering personnel training and supplying materials for Information Technology training for higher education. The JICA experience also indicated that grass roots small-scale grants through NGOs and CBOS were an effective way of involving civil society. JICA has provided assistance through its grass roots programme to 140 projects of which 50 were in the field of education. The Japanese Government also had a successful experience with public-private partnership. The Japan Bank for International Co-operation had financed the Balochistan Middle Level Education Project. Some problems had been encountered in implementation, such 28 as counterpart contribution; however, such issues were being discussed with the Government of Pakistan. The kind of lessons that Japan had learnt can be shared to explore how best the education system can be improved

Statement of Support from the Government of Norway: The representative from Norway felt that change in culture in the field of education was a principle challenge. What they had heard from the GOP was very interesting and there was a clear demonstration of a sense of ownership which was appreciated by the Government of Norway.

Statement of Support from the Government of Canada: The representative of Canada commended the authors of the Education Action Plan. However, the proof would be in the implementation. The GOP had improved efficiency in the sector and the Government of Canada was currently negotiating debt swaps worth Canadian $ 447 million in support of transparent, auditable and additional government financing.

UNESCO’s Pledge of Support: The representative of UNESCO commended the GOP for its renewed focus on education. The President of Pakistan and the Ministry of Finance had clearly indicated their commitment to the education sector and, as such, UNESCO wanted to strongly pledge its support to the Ministry of Education (MOE).

Endorsement by the Informal Working Group of Donors on Education: The representative from UNICEF spoke on behalf of the informal working group of donors on education and commended the GOP for its commitment to improve education outcomes and addressing the various bottlenecks. She especially welcomed the commitment to girl’s education. She recognised that the sector was complex and felt that the analysis should address broader reform issues. Many of the concerns expressed by the Government of Pakistan were also the concerns of the informal donor group on education. It was very encouraging to see that the Government was cognizant of these concerns and had mentioned many of these areas in their presentations

Framework of Co-operation between Donors and GOP: The representative of UNICEF, speaking on behalf of the informal group of donors on education, reiterated the need for a framework of collaboration between the donors and the GOP. It was important to incorporate the lessons from the Social Action Programme and to determine the most effective manner for future donor collaboration. Such overall framework for co-operation needed to move beyond projects. The lead for this collaboration should be taken by the Ministry of Education and should include the provinces. The representative from Norway also enquired how the government- donor dialogue would proceed at the provincial level.

Public-Private Partnership: The representative from UNICEF outlined the need for support for public and private partnership as there was a clear desire to work together. The GOP was trying to put in place an education friendly environment which was appreciated. The representative from the United Kingdom stated that he was interested in public-private partnerships and he thanked the GOP for the variety of examples that were shared indicating the diverse ways in which this collaboration could take plac e in practice. The Minister for Education stressed the need for public 29 private partnership. She reiterated that the GOP was envisaging that the private sector would supplement the efforts of the public sector. In this connection, she advised the Forum participants about the survey of private schools undertaken by the FBS recently.

The Potential for Mainstreaming Madrassahs: The representative from Norway said that some lessons had emerged from pilot projects regarding Madrassahs, and these had some potential, if used properly. The Federal Minister of Education explained that even prior to September 11, the GOP had taken an initiative concerning the mainstreaming of Madrassahs. Under this initiative, the GOP had provided textbooks for Science, Mathematics and English along with teacher training to about 100 Madrassahs. There was a demand for religious education, and if the GOP wanted to mainstream education, it would have to pay the cost. This programme had now become a large programme after the President’s speech at the inaugural session, and there was a lot of work that had to be undertaken. In accordance with the Madrassah Ordinance Board, all Madrassahs had to be registered by the end of March 2002. Last year, the MOE had sent forms to the Madrassahs indicating that these could be filled on a voluntary basis in case Madrassahs wanted assistance. The MOE had received 11,000 registration applications. The GOP is also offering the Madrassahs the Equivalency Certification if they introduce certain changes in their educational programme. However, resources were limited. The President had indicated that this was a welfare initiative. As the Madrassahs were providing free textbooks, food, lodging and free education, they mostly cater to the needs of the poorest. Where the GOP did not provide primary schools, the gap was generally filled by such Madrassahs.

The Positive Role of Regulation in the Education Sector: The representative from the United Kingdom stressed that regulation should be seen as part of the enabling environment to improve access and quality. He suggested that regulation should be undertaken to ensure quality for the more disadvantaged. He felt that regulation could provide a supportive and productive mechanism to improve the quality of education for the poorest. The representative of IFC felt that in view of analysis on the low cost of delivery by the private sector, he would urge the government to improve the enabling environment for the private sector in education. He indicated IFC’s support for any such effort by private sector. The Federal Minister of Education informed the Forum that the MOE was improving the enabling environment for private schools, especially for areas which the GOP had not been able to serve. The package of incentives would be placed before the Cabinet and submitted to the Ministry of Finance for approval. The MOE had no desire to control the private sector and private schools had themselves signaled a need for support and an enabling environment.

Balance Between Resource Allocation and Good Governance: The representative from Germany felt that the SAP experience made it clear that adequate resource allocation had to be combined with better governance mechanisms in order to achieve the desired results. The GOP had undertaken to meet the UPE goals by 2015. The German Government wanted to know how the GOP would ensure that these goals would be achieved. The experience of SAP showed that good governance was as important as the allocation of resources.

Balancing the Different Needs of the Education Sector: The representative from UNESCO specified that the UN gave particular importance to recognizing the comprehensive approach required to deal with the education sector. There was a need to focus on technical and vocational education for recognizing the importance of the world of work and at the same time investing in higher education for creating a critical mass of intellectual power. However, at the same time, it was important to place the major focus on the primary level in order to enable all children to develop their potential. The representative of the European Commission reiterated that the education sector would be the backbone of their co-operation. Although it was clear that the GOP was committed to the sector, EU would like to see where the focus on education would lie. Although the percentage of funds committed to the education sector would increase from 2.7 per cent to 3 per cent of GDP, it was important to see where the GOP visualized its foc us in relation to the private sector. The basic infrastructure in the education sector had been deteriorating and the development effort had come down to zero. The investment in elementary education currently represented only 1/3 rd of the total commitment to the education sector. Higher education was very often only for the privileged. The private sector could be given tax incentives for contributions to higher education. It was also important to assess where the geographical focus of education investments would be? Where would the GOP really put the focus in relation to the more backward areas? The Federal Minister of Education highlighted that while Elementary Education was very important, it could not be said at the same time that Secondary education was not important. She felt that it would be best to leave the choice to donors and let them decide where they wanted to focus. The ESR gave a framework and focused on areas which the donors were traditionally not interested in. However, 75 per cent of PSDSP was for elementary education.

Implementation of the Education Sector Reforms: The representative from the Asian Development Bank congratulated the Federal Minister for Education on the Education Sector Strategy and the reform program. The ESR provided a comprehensive plan but the real test would be in implementation. In order for effective implementation to take place, there was need for a major change in the culture of the education institutions and need for a shift in philosophy. There was need to infuse the people involved with a greater sense of commitment and service mentality. There was need for new managerial training as well as the annual in- service training. He enquired about the institutions that would be in the best position to underta ke this training and whether they had the capacity to undertake such training. The representative of the IMF noted with satisfaction that the budget of the GOP had been amended as a result of the grant contribution and that allocations for education and poverty alleviation programmes had increased. However, the key would be implementation. The Minister of Education emphasized that the ESR was not new. It was simply strengthening the ideas and concepts that were being used for making schools actually work. Even in the area of early childhood education, the Katchi class had always existed but it had never been properly institutionalized. The MOE was experimenting with a pilot with ten thousand schools.

Ownership of District Governments: The representative of the World Bank enquired about the ways of creating accountability that tended to cascade down. He enquired about the role of the districts in forming the letters of agreement that

Minister for Education referred to in her presentation. Did the lower levels agree to the goals that the higher levels were agreeing that they would be accountable for?

The Minister of Education informed the Forum that the modus operandi of the MOE was securing agreements through consensus and there was no element of coercion in the implementation of the education strategy. She outlined that two letters of agreement were being presented for securing commitments at the district level. One agreement was for the transfer of funds to the districts under the President’s programme of rehabilitation and second was for monitoring. She emphasized that it was a transitional and learning stage for all. The mechanisms for implementation were still being evolved in a consensual manner and were not being imposed.

Capacity Building in Education: The representative from UNICEF highlighted the need for investment in capacity building in view of the emphasis on participatory approaches in the strategy outlined by the Government of Pakistan. This capacity had to be developed for a wide range of stakeholders including the community, the PTAs, teachers, school principles, etc. The representative from UNESCO felt that it was important to ensure that the GOP could provide free, compulsory and relevant education. The teachers had a primordial role for learning to take place and as such there was need for commitment to meeting the training needs in the sector

Variation in the Competence Level at the Districts: The representative from Norway expressed his concern about the delegation of responsibility to the district level where there was likely to be a wide divergence of competence at the district level. There was a need to first ensure that there was equal quality and level of competence. He enquired whether the incubator idea was the tool that would be used to develop the level of competency and skills at the district level or whether there would be other mechanisms to ensure this. The Minister of Education explained that one of the principal mistakes of SAP had been micro-management. The present government did not want to micro -manage at the school level. The stress would be on institutionalising the changes so that each school council would take decisions and implement them through a framework of social responsibility.

Financial Framework for Supporting Education Investments: The representative of the IMF expressed the hope that a more attractive financial framework for the delivery of private education would be formulated. Some of the suggestions that had come forward could be grouped into three categories: (i) reducing the regulatory burden and accepting the levying of market fee rates; (ii) grants for private sector participation; and (iii) lower than market rates of interest for provision of utilities, tax exemptions and income tax. He suggested that PRSP had the provision to provide the third category of incentives not only for the education sector, but for everybody.

Financing of the Education Sector: The representative from UNESCO stressed that financing of the education sector was a major topic. The proposal for a Trust Fund had been finalized for financing the education sector. The debt swap mechanism could also assist the GOP to achieve the EFA goals and a commitment of US$ 50 million had been made to assist the GOP in achieving its EFA goals. Pakistan was the first country to prepare a National Plan of Action for achieving EFA objectives after the Dakkar conference. The Trust Fund would support some of the following activities: strengthening of basic education, universalisation of primary 32 education, improve retention levels, establish a culture of school maintenance, promote adult literacy with a focus on women, improve quality of education, mainstream education in Madrassahs. and train teachers. The Minister of Education outlined the idea for the Fund for the debt swap. This was intended to be a fund for Education. The Minister acknowledged the help of Canada and EU for help with the ESR.

Effective Utilization of Funds and Absorptive Capacity: The representative from UNICEF pointed out that it was critical to ensure the improved utilization of funds through a more timely distribution of fund, more efficient administrative procedures, appropriate budgetary procedures, and budgetary timelines.

Equity Issues in Improved Access to Education: The representative from UNICEF felt there were critical equity issues regarding the socio-economic features of those who gained access to education. Concern was expressed about whether the gains were shared equitably by girls, the poor and those in rural areas. In terms of geographical equity and the special needs of the Federally Administered Tribal Areas (FATA), the representative from Norway indicated his interest in seeing how the integration of FATA could be achieved in concrete terms.

Monitoring and Evaluation: The representative of UNICEF highlighted the importance of school monitoring, data management and collection, and consistency in the data collected from various sources. It was important to identify who could use the information. In addition, it was important to conduct impact assessments in the education sector. The representative from Norway stressed that the issue of monitoring was integral and there was need for some research to be undertaken in parallel to the programmes. The results of this research should provide feedback to the policies so that there could be learning by doing. The Federal Minister of Education indicated that an allocation of five per cent had been set aside for logistics under monitoring heading. It was important to ensure the mobility of the EDOs and other education sector managers for monitoring. The Minister of Education also explained that through District EMIS, local level data would be obtained.

Floaters and Incubators for Multiplier Effect: The representative of the European Commission said that the idea of Incubators had been introduced by the Task Force on Human Development and the EU would like to propose the idea of Floaters. Where in remote and isolated areas it was difficult to have permanent staff, Floaters, who understood the key issues, could be sent to strengthen the systems thereby yielding a multiplier effect. The team Leader of the Task Force appreciated the good suggestion regarding Incubators from the floor. Although the idea of Floaters was welcomed, but the idea was to have a core team available.

The Concept of School Maintenance: The German Government had invested DM 60 million in primary education in NWFP. The results of the evaluation showed success in some aspec ts but weakness in institutional development and the maintenance concept. The GOP needed to allocate the appropriate level of recurrent budget to demonstrate its commitment. The experience of GTZ in NWFP showed that school maintenance was a matter of concern.

The Negative Impact of Development Interventions: A representative from the Balochistan Rural Support Programme outlined the very negative experience of women from Balochistan who had taken micro-credit from the Pakistan Poverty Alleviation Fund and urged that the negative impact of such interventions should also be focused upon when development interventions were designed.

Ownership of the Concept of Community Mobilization: An NGO worker with experience in Balochistan outlined the successful experience with mobilization of communities for the promotion of girl’s education in Balochistan. This experience had been successfully replicated from Balochistan to the rest of the country. Despite this success, the ownership of the community participation idea was often lacking at both the community and government levels.

The Role of the School in Improving Education: The representative of the World Bank thanked the Minister for the impressive Education Strategy. However, one of the key questions was how to make the schools work and identify the responsibility and the role of the school in actually improving the education of children.

Implementation of the Policy of Compulsory Education: A participant from the floor expressed her concern regarding the soft implementation of the compulsory education policy as was indicated by the provincial Minister of NWFP. She stated that only those children who were disadvantaged were forced to work. As such there had to be a clear commitment by GOP for enforcing compulsory education. The Provincial Minister of Education from NWFP explained that it was unfair to prescribe punitive measures unless there was ample opportunity provided to ensure that the facilities for obtaining primary education were universally available.

The Minister of Finance reiterated the following points:

Ø There was need for leveraging the public sector’s installed capacity in the education sector. It was important not to allow the existing institutions to be destroyed;

Ø There was a need to build public -private sector partnership, more vigorously through leveraging public sector investments;

Ø There was a need to build capacity either through PTAs or the Pakistan Army or by recruiting floaters largely in the public sector;

Ø The private sector had to be unleashed into the education arena either through regulation or de-regulation or a happy medium of the two. The Finance Ministry would support such incentives;

Ø Education needs cannot be met by GOP alone. There was a need to look for innovate ways and involve the private sector, citizens and NGOs;

Ø Financial impropriety was only one aspect that led to the failure of SAP; the other was the lack of focus on outcomes;

Ø Donor co-ordination would get more complex as the education sector moved to the district and more people would have to be involved for effective co- ordination at that level. It would be a challenge for the GOP to orchestrate policy at the Provincial and Federal levels;

Ø Education sector allocations had been increased recently. However, tensions on Pakistan’s borders had increased Pakistan’s financing needs also. Although the share of the budget for social sectors would go up but the pie was not big enough to make use of the opportunities available to us and our absorptive capacity; and

Ø There was a need to mainstream education within the Madarssahs.

SESSION IV: HEALTH AND REPRODUCTIVE HEALTH

The leader of the Japanese Delegation chaired the session on health and reproductive health. He outlined the importance of health and reproductive health in helping to develop the human resources of a country. He outlined the Japanese collaboration in the sector and looked forward to his government’s continued involvement in this sector. He also outlined some of the critical challenges in this area facing Pakistan and then invited the different speakers to make their presentations.

Health Sector Policy by Dr. Abdul Malik Kasi, Minister for Health, Government of Pakistan

Main Focus of Presentation:

The Federal Minister of Health ackn owledged the Chairperson of the session on Health and Reproductive Health, and indicated his appreciation for the support of the Government of Japan to the health sector in Pakistan. He explained that Pakistan had inherited a weak health care delivery system at the time of independence in 1947. There was only one doctor in Balochistan and only one medical college in the entire country. Although a reasonable network of health care delivery had been established, the current system had not been able to respond to the needs of the country. Health Care in Pakistan was a mix of government and private sector facilities and services. The private sector was largely unregulated. There were many challenges that confronted Pakistan like the high infant mortality rate, high maternal mortality rates and low birth weight. Pakistan’s health indicators were related to the issue of poverty. Malaria and TB posed a serious threat to national health. Malnutrition and micro-nutrient deficiency disorders were still widespread.

The National Health Policy identified ten key areas for government intervention. These include: reducing widespread prevalence of communicable diseases, addressing inadequacies in primary and secondary health care services, removing professional/managerial deficiencies in the District Health System, promoting greater gender equity, bridging basic nutrition gaps in the health sector, correcting urban bias, introducing required regulation in private medical sector, creating greater mass awareness on public health matters, effecting improvements in the drug sector, and capacity building for health policy monitoring.

The Provincial Governments were in the process of implementing the recommendations of the National Health Policy. The institutions of Local Government were being strengthened at the district level. The number of village health workers was being increased to one Lady Health Worker in each village. About 50,000 LHWs would be given TBA training and instructions about micro- nutrients.

The Challenges in the Health Sector had increased as a result of the Afghan refugee factor. The GOP continued its National Immunizations Days despite problems at its borders. However, the provincial health infrastructure, especially at the District and Tehsil Headquarters, was under great pressure. Sustained and long-term 36 assistance was required for strengthening the provincial health infrastructure, TB, Malaria, HIV/AIDS, etc.

Health Sector Reforms by Mr. Ejaz Rahim, Secretary, Ministry of Health

Main Focus of Presentation:

The Secretary of Health stated that Health was a provincial subject but a national priority and, within the new institutional framework, the challenge was that it had to be shared with the new district governments. The Secretary explained that there was an awareness at policy level of ten critical limitations. These included: the fertility approach, the departmental approach, the sectoral approach, the urban tertiary orientation, gender-biased approach, public sector approach, centra lised mode of governance, neglect of quality and equity dimensions, the lack of institutional capacity and insufficient resource allocation.

The Secretary outlined the background for health sector policy interventions. Pakistan was in an early stage of epidemiological transition, relatively recent and comparatively weak demographic transition, and the population structure was such that there was a high proportion of vulnerable population. In Pakistan, one child died every minute mainly from EPI diseases, diarrhoea and ARI, 400,000 infants die in the first year, and 30,000 women die annually from pregnancy related causes. Traditionally, there was low government spending on health. The public and private sectors were both urban-biased. There was limited coverage and capacity of the NGOs. The health linkages with the different sectors were weak.

The way forward for improved outcomes was to focus on the poverty reduction strategy for ensuring quality access and gender equity. To achieve these, enhanced health sector allocations, and a series of programmatic and institutional reforms were planned. It was hoped that these interventions would help to reduce Infant Mortality Rate from 90 to 65 per 1,000 live births, improve immunisation coverage to 80 per cent, eradicate polio, reduce prevalence of malnutrition in children from 39 per cent to 35 per cent, reduce the percentage of low birth weight babies from 25 per cent to 20 per cent, increase CPR from 28 per cent to 39 per cent, reduce maternal mortality rate from 400 per 100,000 live births, improve DOTs coverage from 25 to 50, and increase LHW coverage from 45 per cent to 100 per cent. These targets had been set for 2004 and represented a major challenge for the GOP.

The institutional reform that the MOH was considering included strengthening the District Health System, inter-sectoral collaboration and co-ordination, public-private partnership, monitoring and evaluation, and regulatory framework in key areas. The long-term vision was that the districts should manage all and related health services. However, during the transitional phase, the principle challenge was to manage the change in a smooth manner while transferring power to the districts. The EDO was also incharge of the population programme. This was a major change and the challenge was to ensure that FP services were delivered through all health outlets. The establishment of district governments and their oversight functions would play an important role. There was need of assistance for strengthening the District Health System. In 20 districts, guidelines for the District Health Management teams had 37 been establish with the help of MSU. There were plans for involving NGOs and the private sector. For this, there was a need to establish guidelines and systems that could be replicated. Frameworks had been developed in Sindh and NWFP. As these reforms were taken forward and revolutionary euphoria had to be mixed with evolutionary pragmatism.

Alternative Approaches to the Delivery of Health and Reproductive Health Services by Dr. Haneef Ismail, Aga Khan Health Services, Karachi.

Main Focus of Presentation:

Dr. Ismail gave a briefing of the Aga Khan Health Services experience in Pakistan. AKHS had been working in this sector since a very long time. Currently, the number of operational units was 252 and these were serving 600,000 people. Approximately, 75 per cent of the operational units were in remote and rural areas. The AKHS was a vertically integrated system which started with VO and WOs at the village level. AKHS dealt with primary and secondary health care and provided an integrated programme of community health services. Dr. Ismail showed some pictures illustrating the accessibility of AKHS’s area of operation. He explained that the type of work that was being done by AKHS could only be undertaken with the collaboration and support of the GOP. AKHSP and the GOP had successfully collaborated on several programmes including EPI and TB Control. AKHS had also a good record of collaboration with NGOs like FPAP, Pavna and Hands. He offered his appreciation to the donors who had supported them with several projects. KFW had provided assistance with Northern Areas, DFID in Chitral, USAID with reproductive health strategies, the World Bank had endorsed the Northern Health Project and EU had supported the Chitral programme. This collaboration and partnership had helped AKHS achieve its objectives. The moral of the story that AKHS tried to present was partnership.

Dr. Ismail presented a model of the interaction between poverty, illness and illiteracy. Population stabilisation was critical in this model. In order to deal with these issues, the AKDN had tried to implement a holistic approach. The result was the fruit on the tree of the model which in this case were the impact indicators. He demonstrated how AKHSP had had an impact through partnership. He also illustrated the difference that would accrue as a result of population stabilisation. The greatest challenge was how we could square the circle that had been presented. In order to illustrate his points, Dr. Ismail pointed out that during his speech there had been 80 births and 20 deaths in the country.

Low Cost Primary Health Care Delivery: Case Study of Appna Sehat by Dr. Nasim Ashraf

Main Focus of Presentation:

Dr. Nasim Ashraf presented the case study of Appna Sehat which was an NGO sponsored by the Association of Pakistan Physicians of North America. The NGO was running a low cost community based primary health care programme premised 38 on providers having a curative orientation. He explained that the model that they were using was very cost-effective. The NGO had a clientele of 160,000 people served by 180 staff members. Of these, 160 were women and only 4 were doctors. Appna Sehat did not have an office. He informed the Forum that the mal-nutrition rate had been reduced in project area through health education and growth without additional food.

The basis for action was the community and the establishment of a Health Committee was a pre -requisite for implementation. One unit of the NGO consisted of 500 households. Each unit had one unpaid facilitator, two dais of the village, two female health assistants, and one male assistant. The vaccines were provided by the MOH. Appna Sehat represented a partnership at the grass roots level. The NGO had a clear exit strategy.

Dr. Ashraf indicated that the NGO had conducted a household survey using ten-year longitudinal survey over 150,000 cohorts. The results of the survey, which measured outcomes, were very encouraging. Without a single paracetamol or anti-biotic, Maternal Mortality Rate had been brought to under 100. This may not be scientifically validated but this was the remarkable improvement in the villages in which the NGO had been operating. In addition, the CPR had gone up and crude birth rate had fallen.

The system was also extremely cost-effective. The cost per person per year for 160,000 people was Rs. 65, including the cost of a secretary in the US. This was about US$ 1.10 per person per year. The NGO’s experience showed that health education, community organisation, hiring of local staff especially women, focus on preventive health care, and public-private partnership at the grass roots were the key to establishing an effective model of health service provision. This was essential in order to achieve the primary health care targets.

Population Stabilisation in Pakistan: An Overview by Mr. Tariq Janjua, Secretary, Ministry of Population Welfare, Government of Pakistan.

Main Focus of Presentation:

Secretary of the Ministry of Population Welfare gave a background about the Population Welfare Programme in Pakistan which started in 1950s with the FPAP. Civil society had come forward in a big way and the GOP supported this programme in the 1960s. Private and public sector had worked together hand in hand and played an active role. Although essentially service delivery related, this was made a concurrent subject in the constitution on both the federal and provincial Lists. He outlined the current status of Pakistan’s population which had grown more than four times and 3 million were added every year. Pakistan’s population doubling time was 33 years. Total Fertility Rate was 4.5, CPR was 28 per cent, and IMR was 85 per thousand live births. One of the principal problems regarding population planning was the low status of women in society which exacerbated the vicious circle of illiteracy, high fertility, and poverty. The rapid population growth added an enormous burden on the social sectors. Pakistan had one of the fastest growing populations when compared with other South Asian countries. The doubling time was the 39 shortest. However, this should not belittle the achievements. There had been serious impediments to family planning including the feudal and tribal structure of society, the social class system, religious opinion leaders in rural areas, etc. Some barriers had been eroded and in the last two decades growth rate had improved and come down to 2.1 per cent.

A Review Assessment Committee, in coordination with MOH and MOPW, had been established and is reflective of the serious commitment on this issue. In one year, the Committee had reviewed the spectrum of the program and consulted all the stakeholders in a process of transparent consultation, and recommendations have been finalised. The recommendations form part of the policies of the GOP. There was need to have a focused programme with ownership at the district level where it would be devolved for service delivery. The programme focus was on population stabilisation, advocacy, male involvement, and public -private partnership with a role for SMCs, NGOs and HRD. The objectives of the programme were to reduce TFR. The Secretary outlined how population stabilisation could contribute to prosperity.

Core elements of the population programme were to establish Family Welfare Centres and establish a mobile service unit. For areas with low population density, mobile service units were being established. These units had not performed well in the past and were being reorganised to ensure their efficacy through better communication, advance information and better co-ordination between councillors and reproductive health service centres. This represented a multi-sectoral approach involving the Ministry of Population Welfare and the Departments acting as co- ordinating departments. NATPOW had been strengthened and was in a position to help NGOs build their capacity and pass on funds to NGOs with viable projects. As part of the bigger effort to involve men, several large institutions had been targeted such as the Karachi Port Trust, Karachi Steel, and the employees of the textile, sugar and cement industries.

Procurement of contraceptives was being organised at the national level. Contraceptives were procured through the donors and provided at subsidised rates. The contraceptive requirements were close to US$ 75 million spread over the next three years. If all the elements of the programme were put in place, Pakistan could look forward to achieving its goal of 1.9 in the next two yeas. In order to meet the challenge, US$ 1 billion was required over the next 10 years. The fertility transition had set in and critical investment was required to ensure that stagnation was avoided. He was sure that Pakistan could meet the challenges given the supportive resources.

Social Marketing of Contraceptives in Pakistan: Reaching the Market Place by Dr. Rehana Ahmed, Social Marketing Pakistan Ltd, Karachi.

Main Focus of Presentation:

Dr. Ahmed outlined the social marketing concept and its contribution and future in Pakistan. She wanted to take the Forum participants back to Cairo in 1994. It had been made clear than that family planning allowed choices. In Pakistan, we would have to keep our focus on family planning rather than reproductive health. Social 40 marketing entailed adapting commercial marketing techniques for achieving social goals, affordability, and motivating users. The Social Marketing process begins with market and consumer research. Branding was another component of Social Marketing and it imparted personality to the product and encouraged consumers to identify with the product and continue using it. To strengthen demand, there was need for increased promotion to show that contraceptives were effective and helped people identify their family planning needs. This would eventually increase consumers and the CPR.

There were differing social marketing approaches in practise. One approach emphasized using marketing tools and subsidised the product for reaching the poor and the other did not underwrite the product cost but only for promotion. Both approaches were being offered in Pakistan. SMP in Pakistan had introduced a range of products such as multi-load IUD, hormonal prescriptions, etc. Branded advertising helped to reduce the information barriers, facilitate purchase and de- stigmatise use. Demand creation could be undertaken through the use of the mass media. On TV in Pakistan, SMP was not allowed to say condom or Sathi. Detailed information on contraceptive methods comes through inter-personal communication and neighbourhood meetings conducted by trained workers.

One socially marketed CYP cost under US$ 6 in Pakistan. This was among the lowest cost in the world and was a sound investment. SMP estimated that US$ 40 million had the potential to cover almost 40 percent of Pakistan’s demand by 2004.

MAIN AREAS OF DISCUSSIONS ON HEALTH AND REPRODUCTIVE HEALTH

Statement of Support from JICA: The representative from JICA pointed to the need for a health care system that met the needs of the Pakistani population as a priority area. JICA was considering ways to disseminate support to local level health personnel using PIMS which had been supported by the Japanese Government for two decades. Areas of particular interest were nursing care, safe motherhood, control of infectious diseases, TB control, EPI, Polio eradication, etc. The JICA representative indicated that as the main donor to Pakistan’s health sector, they were interested in promoting co-ordination with other donors to avoid conflict of interest and duplication. He indicated that he was pleased to see the collaboration between the Ministry of Health and Populatio n Welfare. The representative of the Government of Japan explained that a Japanese Mission had recently visited Pakistan to identify the needs in the health sector with particular reference to determine what could be done for Afghan refugees. It was evident that the weak health infrastructure had been over-burdened. The findings of the Mission had been discussed and would be implemented with a mid -term to long-term perspective. The representative pointed to his experience of working with NGOS and CBOs in Pakistan through the grant programme. About 140 grass roots organisations had been provided grants from this programme. At least 47 of the NGOs and CBOs who had been provided the grants were dealing with health and reproductive health components. The Government of Japan was committed for the long-term to the health sector in Pakistan.

Statement of Support from WHO: The representative of WHO congratulated the Federal Minister and the Secretary of Health for a need and equity based health policy. After acknowledging the GOP’s efforts, he felt that it was important not to pass this opportunity to safeguard the health of the people. The measures taken by the GOP regarding primary health care expansion, disease control mechanisms, controlling HIV/AIDS, polio eradication, establishing reproductive health services and the recruitment of Lady Health Workers inspired confidence. The remaining challenges were the high rate of mal-nutrition, maternal and infant mortality, inequality in the health status, distric t devolution of the planning and management functions of the health system, capacity building, establishing decentralisation culture, and mobilising public, private and civil society efforts which permit the implementation of community and consumer driven models. There was need to have a holistic vision of health and for this it was important to identify the major determinants of ill health. Poverty reduction was an important focus but it was important to remember that it was not only absolute poverty that resulted in ill-health. The WHO representative indicated his full commitment to provide support to improve the national capacity in planning and implementation for the sector.

Statement of Support by the Government of Norway: The representative from Norway expressed his view that the health sector had been burdened by the lack of good governance and solutions for this had to be found within the reform process. The representative of Norway indicated that their support was limited to HIV/AIDs. Although current prevalence rates were low, there were high risks and the number of people infected was increasing in Pakistan. It was important to recognise that HIV/AIDS was not an isolated health issue and preventive action could be taken. He indicated that the Norway delegation was pleased that the curtain had been lifted by this Forum as an important first step. Norway was prepared to increase the possibility of support in this important area.

Statement of Support from the United Kingdom: The representative of the United Kingdom indicated that the Forum presented an honest and comprehensive picture of health sector needs for both the public and private sectors. The IPRSP set out a solid foundation and provided an impetus to national programmes. The Government of UK acknowledged the commitment and effort that had been put into these measures. In view of these efforts, DFID had already announced its support to the health programme and in particular to the LHW programme. DFID had committed recently UK £ 7 million to the Ministry of Health. The representative indicated that he was pleased to see that the EPI and LHW allocations initially set at low levels had increased to appropriate levels. The main challenge for the Ministry of Health was to ensure that these funds would be used effectively for sustained allocations in future. From the DFID perspective, he indicated a commitment to provide whatever support needed. A principle challenge was implementation and a major area of concern for DFID was the lack of understanding of what was going on at the provincial and district tiers. DFID did not have the modalities to work at those levels. It was important to recognise that there were a series of opportunities that were available and if these were missed they would not come back. The next round of budget preparation had to be undertaken carefully. DFID recognised that the current phase was a transitional phase. However, as district governments took shape and the political map evolved, a new phase would begin. He stressed that it was important to ensure that the opportunities would be capitalised upon. 42

Statement of Support from the ADB: The representative of ADB thanked all the presenters for their excellent presentations. ADB was highly supportive of the GOP approach which was creating a conducive environment for change and innovation. ADB appreciated the merger of LHW and the village-based Family Planning workers, but would like to see a more explicit approach for safe motherhood and the supply of contraceptives to health facilities. ADB reiterated its commitment to support women’s and reproductive health in Pakistan.

Statement of Support from USA: The representative of USAID stated that this was a real time of transformation and cross-roads, and it was exciting to come here when so much was happening. There was great reason for optimism. He appreciated as to what had been laid out with reference to social marketing, reproductive health and the role of NGOs. He would keenly await the results of the integration of the health sector at the local level to ensure that the role of NGOs was not de-emphasised. Enhancing women’s choices regarding reproductive health was very important and there was no trade-off here. The representative of USAID informed the Forum that USAID would be opening a USAID office at the Embassy. They would be working in the areas of education and health. The mission would begin small. He was here to listen to ideas and advice on the challenges and opportunities, though the size of the U.S. assistance was yet to be determined. He was impressed with the progress that had been made and was impressed with the policy work. However, in his experience, there were three things which would make it work: implementation, implementation and im plementation.

Integration, Streamlining and Effective Implementation: The representative of UNFPA shared his concern about the urgency in the population area. He appreciated the coordination that is evident between the Ministries of Health and Population Welfare and the integration between the Village Based Family Planning Workers and the LHWs. However, integration also meant streamlining and it was important to streamline for a better definition of roles and responsibilities of each of the ministries. While contraceptive procurement would be the responsibility of the Ministry of Population Welfare, it would be important to see a smooth and effective flow of supplies from the central warehouse to the LHW and other outlets. Proper streamlining also led to effective implementation and it was important not to be shy if implementation remained a problem. The representative of UNFPA enquired how the GOP intended to address streamlining issues on a daily basis. The Secretary Health replied that the integration of the two cadres had been undertaken after tremendous discussion and the leadership came from the Population Welfare Minister. A proper syllabus for training and deployment had been prepared and the transfer was undertaken in an amicable manner.

Ownership of Programmes at the District Level: The Nazim from Khairpur pointed out that she was the lone voice of the districts represented at the Forum. She explained that the districts were the implementers. Although this Forum had been considering design issues, it should have addressed implementation issues. There were 97 new District Governments in place and these were mentioned in a very abstract and faceless manner. The emerging problems that are likely to arise at the district level need to be addressed and there should have been space for this at the Forum. A key question which remained unanswered was whether the districts 43 would own the programmes that were being discussed here and designed externally. In the last two days, there had been simultaneous presentations of policies, programmes and projects. In contraceptive jargon, this represented a cafeteria approach to development and would crowd out district governments. One of the basic problems at the district level was lack of good and qualified people. A lot of these programmes would be unnecessary if there were capable people at the district level. The focus of this Forum, therefore, should have been on new district governments and implementation. The Finance Minister felt that it was important to create ownership at the level of districts and pertaining to implementation. He stated that the District Nazim of Khairpur had rightly pointed to this aspect. The NGOs would also have to co-ordinate with District Governments.

Human Development Requirements: A representative from MSU informed the Forum that MSU had undertaken an analysis of the human development needs of the health sector. This analysis indicated that a stronger effort was required in human development and unless the human resource were available, it could become a major limiting factor. The Secretary Health explained that there were opportunities for the LHW to utilise partnerships with the community. Once capacity was developed and there was an assured level of resources, the next step was linking up with the communities, NGOs, CCBs and Women’s Voluntary Groups. The TB programme had been expanded to 11 districts alongwith the participation of the private sector. Even the Homeopath had been involved. The Secretary Health further explained that polio, routine EPI, and other communicable disease programmes all had a clear mandate of training for service delivery.

Public-Private Partnership with a Separate Focus: A representative of the private sector informed the Forum that he was a party to this partnership. In his estimation, 65 per cent of the health care was covered by the private sector. Both the public and private sectors focused on urban areas and provided mostly curative services. He enquired if it was possible to use the GOP funds for preventive care in rural areas and the private sector funds for curative care in urban areas.

How Lessons from Innovative Experiences Would be Incorporated: The representative of the World Bank commended the combination of strategies and case studies that had been used to make presentation at the Forum. He enquired how the innovations in service delivery and public-private partnership be implemented? Similarly, how would lessons learnt from the experience of LHWs be incorporated? The Secretary Health, in answering the issues raised by the World Bank representative, said that despite the investments in infrastructure, the results had not been forthcoming. Health was a provincial subject, and unless the local government took ownership of trying innovative approaches, results would not be forthcoming. However, some innovative ways of managing BHUs and RHCs had been implemented. A group of doctors had taken over the management of a BHU together with its budget in what was being described as the Dassu model. The Dassu model was also being tried in which the BHU budget was not used but only the physical infrastructure of the health facility was used. The Secretary explained that the Trust Fund idea was to support community groups that could come up with innovative models. The health sector interventions were of a nature that needed to utilise the nexus between the private and public sectors.

Effective Use of Funds: The representative of the World Bank noted that there were many ways to spend money and these had been outlined at the Forum. However, in evaluating these programmes did the GOP assess that the techniques were adequate and that the money would follow the patient and the student more directly instead of just following inputs? He enquired if the objective of targeting the poorest was being achieved. More importantly, was the GOP satisfied that the reforms were proceeding in a manner in which outputs were being focused rather than inputs? The Minister of Finance elaborated that a clear strategy had been reflected in the IPRSP document. The effective role of any Ministry was not just to get more money and spend it. The outcomes would be carefully monitored and the type of partnerships established would be reviewed. The para digm shift was that the GOP would be monitoring outcomes instead of measuring expenditure. The GOP felt that its primary job would be to undertake monitoring and the donors would also be welcome to conduct their own assessments. Once ownership of the programmes had been established at the district level, it was hoped that participatory monitoring mechanism would also be established.

Support for the Private Sector: The representative of UNFPA recognised that the GOP was experimenting with different arrangements for public -private partnership which would lead to different results. He enquired how the GOP would provide support to the private sector, the non-profit sector, etc. The Greenstar project was facing problems in calling a condom a condom. Some s upport from the public sector could help overcome this problem. He enquired when the National Committee would be established. The representative was informed that the National Committee proposal was underway to give political clout to family planning and to ensure that it should happen and not be forgotten.

Incorporation of SAP Lessons: A representative from MSU felt that nothing had been discussed regarding SAP. He emphasized that had this been done, important lessons could have been used for future projects.

Reliance on Donor Assistance: A representative from the MSU indicated that a comparison of the education and health programmes indicated that the health programme appears to rely more on donor assistance. The Secretary Health explained that while the GOP was proud of the donor inputs because of its belief that health was a global matter, there were some programmes that had been instituted with GOP funds. The MOH had undertaken an analysis of donor funding and this made it clear that donor support had actually been diminishing. He stated that for a quantum jump, immediate donor support was necessary.

Verticality of the Health Sector Programme: A representative of the MSU assessed that one of the central limitations of the programme was verticality and a sense that one got from the health package was that it was geared to the programme approach. In this context, the pertinent issue is where did the programme meet the district level. The Secretary of Health responded that it was important to identify priority areas and give necessary inputs where required. In this sense, verticality was avoided and the problem was addressed. District Health System had come into operation with capacity for monitoring.

Challenges for the Future: The Minister of Population Welfare and Women’s Development emphasized that whatever may be the cause, it would be a lost cause without population stabilisation. The PRSP document had clearly illustrated that the parameters around which it revolved was poverty, illiteracy and ill health. There was a proposal to have a Population and Family Planning Commission, but due to the GOP’s other preoccupation, this could not be pursued. The population programme was not just moving out of the federal level, but it was being devolved to the districts. From April 1, a change management plan for district government was planned. In case this plan did not work at the district level, it would not work at all. The lack of participation by men in the programme was a major problem area. The Minister said that in this Forum, she had brought up the issue of fundamentalism and obscurantism. All these ideas existed in the male mind. The Minister pointed out that they had demonstrated that ministries could work together and there were no turf battles being fought within this government. This Government realized that if it could do the impossible with Health, it could do the same with Education. Within a few years, CYP had been increased from 32 per cent to 40 per cent. The Ministry was brin ging together the for-profit commercial sectors, and NATPOW had also been strengthened for collaboration with NGOs. The Minister indicated that three key areas in which she felt that emphasis needed to be placed for the future were: Islam and family planning, adolescence education and family life education with a sexual health component. The Ministry would welcome the collaboration of its partners in addressing these and other challenges before it.

DAY THREE: JANUARY 26, 2002

SESSION V: MAINSTREAMING GENDER

The leader of the European Union Delegation chaired the session and outlined the importance of gender mainstreaming without which there would be limited scope for growth and human development in Pakistan. The Chairperson expressed his confidence that the presentations would explore the full range of challenges confronting Pakistan. He then invited the speakers to make their presentations.

Mainstreaming Gender: An Overview by Dr. Attiya Inayatullah, Minister for Population Welfare and Women Development, Government of Pakistan

Main Focus of Presentation:

The PRSP poverty profile revealed that 71 per cent of Pakistan’s poor were women. This vulnerability had been created as a result of discrimination, marginalisation and low status. The gender gap had become a pervasive flaw in Pakistan’s development. This was illustrated by the fact that although the GDI rating put Pakistan at 138 out of 174, the GEM put Pakistan second last on its list of the same countries. These gender differentials were found in literacy and school enrolment, nutrition and family planning and in social, economic and political life. This gender disparity could not be justified and its manifestation was human deprivation. Pakistan without women was Pakistan without hope.

The GOP’s response to this situation had been to provide choice, opportunities and actualisation of human potential. Under the Education for All in the ESR and the ten- year perspective plan, there were plans to increase women’s literacy rate from 38 per cent to 65 per cent by 2010. The net female participation rate would be increased from 53 per cent to 87 per cent. Under the ESR, special schools would be selected in each district for the introduction of technical and vocational streams. At the secondary level, the focus would be on female education. Special efforts were being planned for increasing adult literacy and women’s skills. Women’s study centres were established in five universities in the current year.

In the Health Sector, skills of 70,000 women employed at various levels were being upgraded. It was planned to increase the EPI coverage to 85 per cent of children under one year by 2005 and TT to 75 per cent for pregnant mothers. The Women’s Health Project had been introduced in 20 distric ts and a girl’s nutrition project had been introduced for one million girls in primary schools. There were plans for piloting of 1688 state of the art Family Centres for introduction of life span family health. There were plans to introduce trained community mid-wives in 5000 union councils by 2004.

For enhancing women’s political participation, an independent permanent National Commission on the Status of Women had been established. There was an allocation of 33 per cent of seats for women at local government levels. Women’s seats in the provincial assemblies, national assemblies and the senate had been restored and increased. There was a directive that at least 33 per cent of members of the Local 47

Zakat Committees should be women. There was a programme for mentoring of women in politics.

For enhancing women’s economic empowerment, the GOP had ratified the ILO conventions on equal remuneration of women and child labour. There would a special effort launched to increase women’s skill training and provision of credit to them through the First Women’s Bank, Khushali Bank and the Pakistan Poverty Alleviation Fund. In addition, a host of projects had been launched for poverty alleviation. Better gender disaggregated data was being generated for giving statistical visibility to women in national accounts. Inheritance laws were being strengthened for enforcement of property rights of women.

In terms of improving the legislative and social justice status of women, a number of important steps had been undertaken. A national policy on women had been prepared, the additional protocols of CRC had been ratified and the GOP had undertaken the implementation of the Beijing Action Plan and CEDAW through the National Policy and the National Action Plan for women. A special Family Protection Project had been launched to protect women from violence, increase awareness of these issues, and improve the institutional infrastructure for the protection and safety of women at the district level. Special measures had been undertaken to improve the condition of women in jails. Special measures were also being undertaken to sensitise police regarding gender issues. Women were being appointed in the judiciary and for police training. The Family Laws were being strengthened by a joint task force of the MOWD, NCSW and PLC. The Hudood Ordinance was being reviewed and domestic violence was being declared a crime.

The Minister for Population Welfare and Women’s Development felt that lack of choice or voice was the poverty of women. She looked forward to continued partnership in these endeavours.

Case Study of Community Schools and Girls Participation in Balochistan by Mrs. Roshan Bharucha, Minister for Social Welfare, Government of Balochistan

Main Focus of Presentation:

The Minister from Balochistan gave an overview of the Balochistan Province which had been badly affected by drought and the influx of Afghan refugees. She provided an overview of girl’s education in Balochistan. The current situation (2001) was compared with the situation in 1992. A decade ago, there was lack of parent’s willingness to send girls to schools and teacher’s unwillingness to go to far-flung areas. However, many changes had taken place in this period and literacy had gone up from 1.5 per cent to 8.9 per cent. This significant change had occurred as a result of the Community School Programme through which the process of community support had been recognised and accepted as an effective approach for enhancing female literacy.

She outlined that significant bottlenecks still remained, and Balochistan still had villages where no schools existed. Many of the schools were overcrowded in terms of space and student teacher ratio. She stressed that it was important to focus on girl’s education. When one educates a boy, one educates an individual; but if one 48 educates a girl, then one educates a nation. Balochistan wanted to go forward and the people of Balochistan were thankful to the donors and looked forward to their support.

Provincial Perspectives: Mainstreaming Gender by Ms. Shaheen Ateeq-ur- Rehman, Minister for Social Welfare, Government of the Punjab

Main Focus of Presentation:

The Provincial Minister from Punjab gave an overview of Punjab and said that an impression was often created that poverty did not exist in Punjab. She informed the Forum that of the 34 districts in Punjab, 18 districts were very poor. However, this situation was often overlooked by most donors. In terms of the gender situation, she highlighted that women as mothers got the respect that they deserved; but there it ended. Women do not get recognition in their own individual capacities. The Minister highlighted the achievements in Punjab. A fact-finding had been completed on the poor and a profile had been compiled on the state of children of Punjab. The Government had started a directory of women which was being put on the web. A task force for women had been established to build the second line of leadership. The Government of Punjab had undertaken many awareness -raising workshops. The Minister appreciated the contribution of UNICEF and UNESCO for facilitation in establishing non-formal centres. She also lauded the efforts of UNDP. She also noted her gratitude to the two Federal Ministers of Education and Women’s Development who had helped in making the policy makers accept that adult literacy mattered. She appreciated the efforts of the Federal Minister Dr. Attiya for having women’s political representation. In this connection, she also mentioned that the present government had 7 women Ministers.

There were more than 75 million people in Punjab of which about 35 million were women. The strategy in Punjab was to concentrate on the 15 to 19 age or the pre- productive age which was the most vulnerable. There were about 800,000 women in this age group in Punjab. Every minute 8 children were born and every 20 minutes a woman was lost in child birth. In the area of education, there was low enrolment and high drop-out among girls. Less than 3 to 4 per cent reach th e secondary school level. The Punjab Government had several studies available on violence against women. There were a large number of women who were disabled in Punjab alone. Drug addiction had affected 1.9 million people out of which only 3 per cent were women. However, families were very badly affected by drug addiction.

In order to deal with these problems, Punjab had established provincial core groups and a provincial task force. There was an attempt to create a bigger network and involve more people. There was a special focus on agriculture and industry. The CCB that were being established at the grass roots level would be used to implement government plans and strengthen the network for women. District Core Group for women had been established. These groups included women’s groups, activists and lawyers. The DCG met once a month in Sanathzars. This was the first time that Punjab had a focal point for women at the district level. Women were being given skill training, and a crash course on adult literacy had been launched with the name of Ujala at a cost of less than US$ 10 per woman. Learning kitchen gardening 49 and food preservation had been started. District Co-ordination Councils had been established to watch over the 4,500 NGOs in Punjab.

Violence against women was a serious problem. It was estimated that 80 per cent of the women got beaten. As a result, there were plans to establish women shelters, burn centres, police stations for women, and a radio programme to raise awareness about the issue of violence against women. A question and answer session had been started to help answer questions and concerned raised regarding the issue of violence. There were special programmes for recruitment of women police officers and sensitising the police regarding the violence issue. A special programme of training women councillors had been initiated. The Minister reiterated that the Government of Punjab was determined to make a difference.

Family Protection Programme by Dr. Farzana Bari, Quaid-e-Azam University, Islamabad

Main Focus of Presentation:

Dr. Bari explained that as a women’s right activist, it was gratifying to note that for the first time the GOP had recognised violence as a major problem. Violence was a form of control. This control also impacted women’s mobility and determined their access to health and education services. Violence was a global phenomenon. There was insufficient data to gauge the extent of the problem of women’s abuse in Pakistan. However, micro-data suggested that every second woman was a victim. There was a strong link between abuse of women and child malnourishment, depression and pregnancy outcomes. Dr. Bari emphasised that a life free of violence was the right of each member of the family. The national strategic framework of family protection aimed at: providing a multi-pronged approach through a balance between protection and prevention, reducing the tolerance for abuse and providing the appropriate policy framework, breaking the silence, access to information and access to services. She outlined the main features of the Family Protection Project in Pakistan.

In this effort, several donors were supporting the strategic entry points to begin the implementation framework. A budget of US$ 70 million had been identified for protective services. However, despite these measures, the response was inadequate and ineffective. There were high social and economic costs to ignoring the problem of abuse. Violence had been recognised world wide as a priority area of action. Dr. Bari emphasised that in order to solve the problem for the long-term, there was a need for restructuring the patriarchal mindset of the people, and she hoped the donors would support Pakistan in this effort.

MAIN AREAS OF DISCUSSION FOR MAINSTREAMING GENDER:

A Gender Approach vs. a Woman Oriented Approach: The representative from the EU chairing the session highlighted that gender was larger than just focusing on women’s issues. He felt strongly that every project should have a gender dimension, and it was critical to be sensitive to this issue. He elaborated that from the 50 perspective of the EU, there was a commitment to undertake a gender assessment in every appraisal in order to identify and study the gender dimensions and assess gender impact. The Federal Minister of Population Welfare and Women’s Development appreciated the fact that the EU appraised projects on the basis of gender mainstreaming.

Special Approach to Addressing Gender Concerns: The representative of UNFPA recognized the difficulty of empowering women and addressing gender issues in a traditional and feudal society like Pakistan. However, there was lack of male involvement that made the task much more difficult. Pakistan had made amazing progress in the last one year. The Ministers from Balochistan and Punjab illustrated the types of changes that were taking place in the field. However, there was need for a special effort for male involvement. Although women’s representation had been increased to 33 per cent, it was equally was important to focus on the 67 per cent of the men who were sitting in the assemblies, and make them more gender sensitive. The UNFPA representative emphasized that these were issues that also existed in most other countries. There was a need to start as early as possible for fostering attitudes and changing the nature of integration between men and women at all levels. It was important to focus at the school level and in this connection the representative of UNFPA observed that enhanced co- ordination was taking place between the MOE and UNESCO. The representative of Norway emphasised that gender was not a sector but a concern that had to be incorporated broadly. It was important to see that progress had been made in the political arena in Pakistan with local women councillors in place. The representative of UNESCO commended the GOP on the policy on women’s empowerment and offered her support in enhancing women’s profile in political decision-making. However, she wanted to suggest a different approach to dealing with violence and felt that it might be more appropriate to look at the root causes of violence. There was a need to look into male roles and examine what it meant to be a good man and a good father in Pakistan. There was a need to promote non-violent conflict resolution. She offered UNESCO’s co-operation in dealing with these issues. A participant from the floor emphasised that it was important to transfer the concept of gender to the grass roots and examine the type of assistance that would be required at this level. It was important to remember that we were trying to change attitudes and behaviour, and this required long term commitment. The Punjab Minister for Social Welfare explained that one approach they had adopted was to work with the principals of girl’s colleges and use them as catalysts for widespread change.

CEDAW and a Supporting Legislative Framework: The representative of UNFPA indicated that the GOP had expressed some reservations regarding the ratification of CEDAW. He enquired about the type of assistance that the GOP may require at various levels in order to develop its capacity to implement the Convention. The representative felt that Pakistan’s legislation was old fashioned with respect to gender and this also had to be reviewed. The representative of Norway enquired about the progress regarding the review of the Hudood Ordinance by the NCSW and the extent to which domestic violence had been made a crime. The representative of the World Bank said that the formation of the NCSW was a commendable step and the legal status of women was probably the most amenable to early public action. He enquired about the status regarding the leadership of the Commission. A representative from an NGO said that there were many laws that were retrogressive 51 and there was a need to understand what the GOP intended to do about them. The Federal Minister explained that the Hudood Ordinance was under examination. Regarding criminalization of domestic violence, a high powered and distinguished group of jurists were reviewing action in this regard. The Federal Minister shared with the Forum, in confidence, the situation regarding the leadership of the Commission.

Integration of Gender in the IPRSP: The representative of Canada felt that the voice of women in the IPRSP process was not evident and needed to be elaborated. The representative of UNFPA voiced his concern that gender was not flagged in the current budgeting process. He enquired about the level at which donors should invest their funds and asked whether this should be at the federal, provincial, district or community level, or whether it should be a mix of these. He enquired about the views of the participants regarding the mechanisms for disbursement at various le vels. The representative of the United Kingdom enquired if the IPRSP was gender sensitive and whether it could be more gender mainstreamed. The Federal Minister for Population Welfare and Women’s Development explained that a consultative process had been used to identify the language that needed to be inserted in the IPRSP for gender mainstreaming. In addition to the other gender dis-aggregated data in the IPRSP, the Ministry had suggested the inclusion of age at marriage of girls as an important indicator for measuring the change in the status of women over time.

Engendering Economic Development: The representative from the Human Development Centre reminded the Forum of Dr Mahbub ul Haq’s contention that economic development would be endangered if it was not engendered. She emphasised that if women were not economically empowered, than their status would not improve in any other arena. The representative from the International Labour Organisation commended the Federal Minister in ratifying two international conventions. The first was the convention on child labour and the second was the convention on equal remuneration for women. The representative of ILO indicated that he would be working with the GOP to ensure compliance. Referring to the Ten- Year Perspective Plan, the representative of ILO hoped that this would be in favour of women’s economic empowerment and looked forward to following the progress. The Federal Minister emphasised that poverty had a female face because women’s contribution had not been recognised. She emphasised that women suffered the most due to poverty. Employment was central to Pakistan’s poverty reduction strategy and it was to be noted that the GOP was attempting to empower women economically rather than trying to eliminate the symptoms of poverty.

Continued Support for Women’s Participation in the Political Process: A representative of an NGO appreciated the fact that the Government had brought women’s issues to the central level. At the local political level, this was the first major opportunity for women to become part of the decision-making process. It was important to ensure that women were properly supported and did not feel discouraged. It was important to understand how the GOP and donors would support women. This was especially important for women from remote and isolated areas who had come forward. The Federal Minister explained that arrangements were being made for mentoring of women councillors and for women members in the provincial and federal areas. There was a need to strengthen democracy through 52 this caucus of women. There were also plans to reach out to the male Nazims. UNDP had extended seed money for these activities and further support would be appreciated.

Strengthening Women’s Management Capacity: The representative of Norway emphasised that in order to have service delivery focused on women, there was a need for more women in management positions. He felt that in order to combat the violence against women, it was important to have women in the police system. The GOP had already shown its strong commitment to this by recruiting women police officers. The representative of Norway also commended the documentation prepared by the Punjab Minister. The representative from the United Kingdom felt that there may be need for more women to be involved in the delivery of education and health services for women. He hoped that the Government culture would be reformed in ways that made it less biased, and enquired as to how the provincial governments would encourage women to join the public service. The Punjab Minister for Social Welfare explained that the Punjab Government had improved the women recruitment from two to five per cent. In addition, computer education had been introduced to allow them to come into the mainstream. Regarding women’s employment in the public sector, the Federal Minister informed the Forum that women constituted 5 per cent of the work force in the public sector. The division of work was very uneven and while service delivery was undertaken mostly by women, decision-making was undertaken by men. The Minister acknowledged the need to get more women in management. In this context, they were keenly awaiting the ADB report. In order to encourage female employment, the GOP was akingt a serious look at sexual harassment at the workplace. A code of ethics was being developed for the work place. In the event of sexual harassment, the action that was being contemplated was to remove the offender from employment.

Implementation of Recommendations: The representative of Canada commended the GOP for pushing ahead on various fronts and recognised the establishment of the National Commission on the Status of Women. However, he was interested in learning how the recommendations would be implemented at lower levels. He felt that women’s participation in the political process was important for empowering women and ensuring poverty alleviation. The representative of EU endorsed the concern of the Canadian representative with implementation. The representative of the EU emphasised the importance of moving from policy to implementation, and action and the need to move from pilot to full-fledged projects.

Violence against Women: The representative of the United Kingdom appreciated the GOP commitments regarding gender issues. This was the first time that the GOP had clearly addressed the issue of violence against women publicly. He hoped that resources would be allocated accordingly and that practical measures would be undertaken such as sensitising the police and the health workers in picking up signs of violence and dealing with it appropriately. The Minister for Social Welfare, Punjab clarified that violence against women was not confined only to Pakistan but was a global issue. It was an issue of the traditional bully and the bullied. There was a need to change attitudes and in particular focus on the mother-in-law who was simply circulating the treatment that had been meted out to her. The Punjab Minister felt that the mass media could be used effectively in raising awareness. The Punjab Government had motivated the police and sensitised them to the need for more 53 humane treatment. The Punjab Government was working closely with the local Bar Association to support women’s issues and see how the support of the large number of women lawyers and jurists could be galvanised to help other women. The Punjab Minister for Social Welfare clarified that the police had been sensitised to the issue of domestic violence and were specifically nstructedi to identify the tell tale signs of domestic violence and take appropriate action in this regard. The Federal Minister for Women’s development pointed to the need for shelters for women in distress. Such centres had been established in a few districts; however there was a need for such centres in every district.

The Price of Gender-Inequities: The representative of the World Bank indicated that there was plenty of evidence from the World Bank that countries which suffered from gender inequality paid a price in terms of poverty and ill health. As such, the emphasis given to this topic and the concrete steps that were taken were appreciated.

Identify Causes for Poor Social Sector Service Delivery to Women: The representative from the United Kingdom enquired the reasons why many women and vulnerable groups did not have access to social sector services. There was a need to look at in-service delivery and for GOP to examine why the services were not getting to the poor and vulnerable groups. DFID had sponsored participatory poverty assessments and these would help in understanding some of the issues.

Need for Gender Desegregated Data: The representative from the EU appreciated the comprehensive policy of the GOP but highlighted the need to improve understanding further on gender, and outlined the need for gender-desegregated statistics. The Federal Minister explained that UNDP and UNFPA were assisting the Ministry in establishing a gender-desegregated MIS. This system was expected to be ready in about a year and would provide data on who was doing what.

Policy regarding Separate Girl’s School or Co-educational Schools: The representative of the EU had some specific question regarding both education and health services. He enquired whether the GOP would continue to support separate girls schools or whether it would support co-educational schools. The Federal Minister for Population Welfare and Women’s Development clarified that the formal school system was co-education upto the primary level. In hiring primary teachers, priority would be given to female teachers.

Best Method to Reduce Maternal Mortality Rates: The representative of the EU enquired about the best way to reduce maternal mortality. The Federal Minister replied that the best manner in which Maternal Mortality Rate could be reduced was the widespread coverage of TT. She acknowledged the efforts of the Japanese Government in this regard. There was also an attempt to move away from the TBA and get trained mid-wife support. In th is context, it would be desirable to see the expansion of the Women’s Health Project to other districts as it had the important component of emergency obstetric care. There was also a need to expand the Family Protection Project. A representative from the floor enquired about the Family Protection Project and enquired how the GOP would integrate it into its plans and how it would be carried forward. With reference to the Family Protection project, it was clarified that the project was likely to be continued beyond its current project life. 54

The Role of the Media: The Chairperson of the session enquired about the role of the media in informing and changing behaviour and the role of men. The Punjab Minister explained that workshops had been conducted with the media and they were made aware of the difference between dealing with women’s issues in a sensitive manner and sensationalising of incidents. The Federal Minister for Population Planning and Women’s Development informed the Forum that a policy had been submitted to the Cabinet. It was the first time that a policy on development and empowerment of women had been prepared and submitted to the Cabinet. Once this policy was approved, it would play an important role in moving forward with collaboration with the media. A Media Network and a Media Advisory Committee had been established for greater collaboration. In addition, there were a large number of women journalist who had excelled in this field on their own. There was a need to bring the men on board and encourage them to undertake investigative journalism for women rather than sensationalising news regarding women.

SESSION VI: FINANCING SOCIAL SECTORS

The representative of the Asian Development Bank chaired the session on financing the social sectors. The Chairperson underlined the key issue of financing and the major challenges that lay before Pakistan in this regard. He felt that Pakistan had made some important progress and invited the participants to share their financing strategies and reform plans for financing the social sectors.

Financing for Social Sectors & Poverty Programmes by Mr. Mueen Afzal, Secretary General Finance, Government of Pakistan

Main Focus of Presentation:

The Secretary General of Finance outlined the five areas that he wanted to discuss. These included the adequacy of finances, sources of financing, government plans, contribution of donors, and ensuring ownership at the district level. The Secretary General shared the public expenditure figures on health and education in the last twenty years. In percentage terms, the expenditure on education and health had remained static with education generally getting less than 2 per cent of GDP and health getting even less than one per cent. He concluded that overall spending was not adequate. The main sources of funds were the GOP, donor funds, private sector expenditures and philanthropic contributions. The Government had been constrained by having to keep within the limits prescribed by debt strategy and fiscal deficit targets in accordance with agreements with IMF.

There were new possibilities for donor assistance. Limited use could be made of external grants within the macroeconomic framework agreed with IMF and the availability of Swap funds within the different frameworks possible for individual or multi-donor assistance. The Swap funds could extend financing for the private sector. There was also a potential for philanthropic fund raising and it was estimated that about 2 per cent of GDP or about Rs. 75 billion annually could be generated through charity from internal and expatriate sources. These would be directed into areas which had been identified as priority areas nationally. The private sector was already making a significant contribution to the education and health sectors, and it was expected that this would grow in the future.

Financing by the Government was constrained because of limited fiscal space and there was need for external grants to be used for key areas in social sector development. The external grants would not add to the debt burden and were preferable instruments of financing, and ought to be utilised to maximise our efforts. A comprehensive poverty reduction strategy had been prepared which was reflected in the IPRSP. This had been prepared in consultation with civil society and donors. It had identified major outcomes, identified financing requirements, and the monitoring arrangements to ensure that outcomes are achieved.

Government financing from its own resources had increased for poverty reduction programmes from Rs. 119.3 billion in 2000-2001 to Rs. 150.4 billion in the current financial year. While the targets in primary health, elementary education and employment generation were fairly ambitious, progress could be accelerated if 56 additional funds were made available. He outlined the measures that provincial governments needed to undertake. However, the provinces were dependent on contributions from the federal government for their annual development plans and faced critical problems if the Federal Government could not release these funds on time. Often the uncertainty about federal finances also led to the Provincial Governments withholding their expenditures until there was little time or no time left for implementation.

Donor assistance needed to be co-ordinated to ensure that the overall framework under the IMF programme was protected, the PRSP targets were adhered to, that donor assistance was used to achieve poverty alleviation targets, and that their input was provided to keep PRSP as a dynamic and evolving strategy. In order to enhance donor co-ordination several forums and meetings were scheduled. These included the Aid to Pakistan Consortium, the Human Development Forum, Provincial Development Forums, Aid Co-ordination Group organised by government for those providing grant and Swap funds, and the finance ministry’s periodic briefings for donor community. Overall co-ordination was the responsibility of the Economic Affairs Division.

The Secretary General emphasised that several steps had been taken to ensure that money flowed through to the district governments. In the education sector, formal agreements had been signed with the provinces. The lessons learnt from SAP would be integrated so that failures were not repeated. There was a strong focus on outcomes and not expenditures. The government would ensure that the increase in allocations for the provinces did not lead to the Provincial Governments curtailing their own allocations and expenditures. The grants to the provinces would be made on certain well-specified basis. A special allocation would be made for distribution to the most needy districts. The Provinces would be required to ensure proper accounting by the districts which would have the autonomy to decide how the funds would be spent within the eligible items. The mechanisms would be constantly improved and evolved for improved spending.

Provincial Perspectives on Social Sector Financing by Mr. Abdul Hafeez Shaikh, Minister for Finance, Government of Sindh

Main Focus of Presentation:

The Provincial Finance Minister of Sindh explained that decade of the 1990s was a lost decade. In particular, it was a decade of disaster for Sindh. There had been an economic slump, fiscal imbalance, provincial budgetary constraints, decline in development, and worsening of social indicators. In the last few decades, crude death rate had increased, and infant mortality rate had increased while the fertility rate had shown no change. Unemployment increased from 25 per cent to 33 per cent and less than half the population of the province had access to safe drinking water. Although the province was resource rich, 50 per cent of its population was extremely poor. An ADB sponsored study of five districts showed that 82 per cent of the population lived on less than US$ 1 per day. There was disparity in urban and rural areas. Weak governance led to poor mobilisation of revenues and inadequate implementation. The Provincial Government had limited fiscal powers with only 57 residual sources of revenue. He informed the Forum that 80 per cent of provincial revenues were allocated by the Federal government through the National Finance Commission and provincial receipts barely financed debt-servicing liability.

Development Expenditure as a percentage of the provincial budget had come down drastically from 26 per cent in 1991 to 4 per cent in 2001. Provincial government expenditures were skewed in favour of establishment costs. From 1999 to 2002, employment in the Sindh Government had increased from 285,042 to 459,151. Of the total budget of the province, about 40 per cent was allocated for salaries and 16 per cent for debt servicing. Debt servicing had grown by more than 11 per cent from 1993 to 2000. Out of 25 per cent of the provincial budget spent on social sectors, 90 per cent was spent on establishment costs and only 10 per cent on non-salary components.

As a result of social sector reform and financing, there had been some major changes. There had been increased provincial allocations, fiscal restructuring, federal government support, international support, and public-private partnership. The Provincial Government of Sindh had undertaken tax reform. It had increased the tax base and reduced the number of taxes from 23 to 10, and a reduction in stamp duty was approved. Agriculture tax was converted to a combination of land and income based system, the professional tax was being restructured, user charges were being levied for some services, and motor vehicle tax was being converted from a flat per vehicle rate to a levy on fuel.

Expenditure management reform was introduced under which there was a reduction in the number of government departments from 29 to 23 and 12,502 posts were abolished. The Provincial Government had placed strict limits on expenditure through ban on recruitment, limits on utility and petrol consumption, and air- conditioners, medical coverage and furniture. As a result, the debt and deferred liability obligations had been lowered by Rs. 20 billion within two years. Overdraft facilities extended by the State Bank had been decreased from Rs. 10 billion in 1999 to Rs. 1.5 billion in 2002 and were projected to go down to zero by June 2002. The interest liability had come down from Rs. 100 million per month in 1999 to Rs. 15 million per month in 2002. For the first time, the Province of Sindh had become cash surplus. These measures had improved the credibility of the provincial government.

The decline in development expenditure had been reversed and development expenditures had been increased by more than double. The Government of Sindh had assigned a high priority to growth and poverty reduction schemes and aimed to achieve horizontal equity across districts. Priority was assigned to counterpart funding for donor-assisted projects and completion of unfinished schemes. The Provincial Minister felt that donors had, in the past, been shy because of our own neglect and we wanted to prove to be deserving counterparts. The Minister outlined some of the bold measures that were being undertaken in the social sectors. The non-salary budget had been increased in the health and education sectors and there was a focus on the water sector. There were also improvements in gender-balanced assistance to vulnerable groups through free textbook distribution, staff rationalisation, operationalisation of selected closed schools, merit based recruitment of teachers, community participation, and partnership with private sector.

The Sindh Government was working with the World Bank for a fiscal restructuring plan. It was hoped that it would be able to enhance revenue by more than 11 per cent per annum for the next five years through a broad spectrum of measures. As part of its efforts for fiscal decentralisation, District Government budgets were being made and District Governments were being given complete autonomy over utilisation of non-salary recurrent expenditures. A Provincial Finance Commission would develop a revenue sharing formula between Provincial and District Governments.

The Provincial Government had re-established a dialogue with donors for supporting development and reducing poverty. The ADB financed Sindh Rural Development Project was brought back on track. The ADB financed Road Sector programme was launched, the Drought Emergency Recovery Assistance Programme was launched and many other donor assisted projects were revived. However, the Provincial Minister of Finance felt that there was need for increased interface with the international donor community. There was a need to think of new ways to engage donors. The Provincial Forum planned for Karachi needed to be followed up in other provinces. There was need for Multi-Donor Support Units in each province in order to improve co-ordination.

Before he closed, the Finance Minister wanted to bring to the attention of the Forum a tragedy that was unfolding on the coast of Pakistan, somewhat unlamented and unnoticed. The River Indus was not reaching the sea but the sea was coming to the river. It was estimated that a minimum of 10 Million Acre Feet of water per annum had to be discharged to the sea for environmental reasons and to protect the local eco-systems. Last year, less than 1 MAF was discharged into the sea. The land of Sindh was being destroyed causing massive ecological damage. Part of the Taluka had already submerged into the sea at Keti Bander. He wanted to reach out to the Forum and plead with them to do something about this tragedy that was taking place on such a big scale.

Mr. Fareed Rehman, Minister for Finance, Government of NWFP

Main Focus of Presentation:

The Provincial Minister of Finance of NWFP wanted to focus on some key areas which included measuring of human development, investing in human developm ent, issues and challenges, and strategies for financing human development. He mentioned that Human Development Indicators were a recurrent subject of discussion. NWFP suffered from some of the same problems that were highlighted by the other provinces. Traditionally, progress in the social sectors was measured by focusing on physical outputs rather than outcomes such as hospital bed, Basic Health Units, Rural Health Centres, schools, etc. Since the National Household Survey did not capture the particular problems of NWFP, it was, as such, very difficult to determine how to measure human development. Other factors which impeded an accurate situation analysis were social barriers which entailed that many of the problems were never brought out openly. For example, there was a state of denial in Pakistan as far as HIV/AIDS was concerned.

With assistance from UNICEF, NWFP conducted a survey of 13,500 households in which over 40 indicators were used. The result was a Human Development Index for the NWFP. The Minister indicated that he wanted to present the results of this survey at the Forum. A ranking of districts had also been attempted using a composite of six indicators in NWFP. This survey had highlighted some critical issues and identified the wide variation in districts in NWFP in terms of the human development indicators. The under five-mortality rate was equivalent to the poorest of the poor. Mal-nutrition indicated a state of emergency in NWFP. The whole world protested when malnutrition fell below a certain level in Iraq. However, NWFP today is in a worse situation than Iraq. The demographic transition was still to visit NWFP. Chitral ranked very favourably as a result of the work of the Aga Khan Rural Support Programme. The great variance in the districts illustrated that the concept of having national indicators did not appear to be appropriate, as these would not reflect the objective situation on the ground.

An analysis of investment in NWFP showed the declining trend of investment in NWFP. However, social sector investments, as a percentage of annual budget, had remained at around 25 per cent. An analysis of budgetary allocation vs. revenue generation was undertaken for individual departments. This analysis showed that no department of the provincial government was self-financing, not even irrigation. The cost recovery system for services was not properly functioning in NWFP and the government was examining it to understand what measures could be undertaken in this regard. The practical implication of this state of affairs was the lack of fiscal space for social services. From the total budget allocations in NWFP, 27 per cent was being used for debt servicing and only 22 per cent was available for social services.

NWFP’s total debt stood at Rs. 60 billion and annual debt servicing amounted to between Rs. 8 to 10 billion. Average interest on social sector loans equalled 15 per cent to 18 per cent. The Federal Government charged 2 per cent mark-up on loans transferred to the provinces and soft foreign loans for poverty programmes required an exchange risk cover that raised the mark up to about 11 per cent. This entailed that the provincial government was paying a higher interest rate for girl’s education than it would have to pay for financing a Mercedes or a BMW from a bank. An interest rate of 15 to 18 per cent was too high and was constraining social sector investments. To highlight his point, the Provincial Minister for Finance said that a 2 per cent reduction in interest rates would enable him to send 50 thousand more girls to school.

Under the devolution plan, the district would be delegated the responsibility for implementation of social sector development. There were diverse needs of social development and districts had a weak resource base. The Provincial Finance Commission was devising resource allocation formulas. However, while implementation responsibility had been transferred to lower tiers of government, the Federal Government still controlled the budget. There was a need to ensure that social sector funds were available on a timely basis.

The key issues and challenges that confronted NWFP included the following: no fiscal space for future expansion, increasing recurring cost liabilities, heavy burden of debt repayments, lack of adequate returns from social investments, and inadequate 60 implementation capacity of District Governments. There were 10,000 vacancies for teachers but no money to fund them. There were no resources to correct the imbalance between primary and higher levels of education and there was no budget for medicines and supplies.

The Provincial Strategy for financing social development was to formulate a reform agenda, propose new ways for creating fiscal space, and give financial autonomy to tertiary institutions like hospitals and colleges which would have to become self- sufficient while ensuring services to the poor. Resources were being moved to the primary rather than the tertiary service levels. The NWFP Government was encouraging public -priva te partnership, user charges would be levied for essential services, handing over schemes of water supply as far as possible, and a 25 percent increase in irrigation cess every year.

The Provincial Minister for Finance highlighted his proposals for creating fiscal space for social development which included debt forgiveness, abolishment of 2 percent mark-up on loans transferred to the provinces, relief from providing risk cover, conversion of all donor loans into Swaps, and the future financing of essential social programmes on grant basis.

MAIN AREAS OF DISCUSSION ON FINANCING SOCIAL SECTORS

Good Governance and Fiscal Space: The representative form the World Bank quoted the Vice President Ms Meiko and said that it all boiled down to governance. Donor financing in the social sectors had been reduced mainly due to governance problems. It was not possible to educate all the children in Pakistan without a local government. It was not possible to run a delivery system from the provincial capital with weak administration. It was not possible to run a modern government with such low levels of financing for social sector services. Although these truisms did not take us very far, yet some of the core issues of governance were being addressed. There was need to avoid political abuse of power in the appointment and transfer of teachers, health workers and site selection for social sector facilities. The World Bank representative felt the current Government was addressing the problem by shifting their resources to the social sectors dramatically. The direction of change in Pakistan was important and called for and justified the support from donors. The representative of the USA indicated her view that Pakistan had done a remarkable job in demonstrating fiscal discipline. The US Government had great confidence in the GOP plans and had backed that confidence with grant funds. She indicated the US Government’s interest in hearing government plans regarding continued spending in these areas so that a long-term commitment was ensured. The Secretary General of the Ministry of Finance indicated that the GOP was committed to shifting finances to the social sectors on an on-going basis. However, the regional environment was not helping Pakistan and he hoped that the US would offer Pakistan its support at the broader level in this regard.

Existence of Framework for Social Sector Spending: The representative of the Government of Japan outlined his experience that for sustainable implementation capacity, it was important to have the right mix of finances and people. The representative of the Netherlands commended the GOP on its modifications in its 61 socio-economic policy. Long-term commitment had been demonstrated by the strategies and programmes that the GOP had outlined. The GOP had moved from a consultative process to a participatory process in which there was increased participation of women. Furthermore, the President had announced national elections at the end of the current year. He reiterated the Netherlands Government’s intention to support the GOP within the framework of IPRSP when his Government decided to start new activities. He envisioned that the support from the Netherlands was likely to be in the form of debt swaps. The representative of Canada was pleased with the fact that the PRSP would provide the policy framework and that devolution would provide the implementation framework. The representative of Norway felt that it would be very challenging to consider using debt swaps not only from bilateral sources but from multilateral sources as well.

Fiscal Relations Between the Provinces, Districts and Donors: The Chairperson of the session pointed to the fact that the fiscal distance had increased between the Federal Government and the districts that would have the main responsibility for implementation. The representative of the World Bank felt that the process of devolution would assist in getting financing closer to the districts. The representative of EU enquired about the issues of responsibility between the Local Government and Federal Government in terms of determining who would bear the risk of financing. He stated that it was important to clarify at the outset about the risk factor, affix responsibility for it, and use it as a monitoring instrument as well when funds were blended using both grants and loans. The representative of Canada felt that coordination in terms of aid effectiveness was important not only between donors but within line ministries and across departments. He also enquired about the link between accountability and absorptive capacity. The accountability curve was being shifted to the local level. He wanted to hear more about potential bottlenecks regarding fiscal decentralisation and ensuring that funds reached the districts in a timely manner. He expressed a need to hear the district perspective on some of these issues. In replying to these issues, the Secretary General of Finance admitted that co-ordination and accountability had been weak in Pakistan and suffered even more in the 1990s when aid amounts were small. However, these aspects would be strengthened. He informed the participants that in the 1970s each province had the equivalent of an Economic Affairs Division and these would be activated. The Minister of Finance added that it was at the district level where the rubber met the road. As such, it was important to get the districts sensitised. In the past, there had been a tendency in the districts to use the funds as give-aways. A major challenge would be to change the mindset of the elected people and ensure the same rigours of transparency and accountability that are used for others. The Minister for Finance reassured the Forum that there was no complacency on the part of the GOP in this regard.

Resource Allocation and Variation in Districts: The Chairperson of the session was impressed with the Multi-Indicator Survey presentation of NWFP. The survey highlighted the wide variation in socio-economic indicators in the districts and pointed to the need for taking this into account to ensure equity within the province in allocating resources for social sector development. The representative of the United Kingdom enquired about the availability of good district level data and wondered how provincial awards could marry performance and address inequities at the district level. The representative of Norway appreciated the data presented by NWFP which 62 showed district variation and enquired whether there were plans to have similar surveys in other provinces. A representative from the floor congratulated the Minister of NWFP for producing the Multi-Indicator Survey for NWFP in record time and the nerve shattering information it produced indicating the massive investment requirements in human development in NWFP. She enquired how this information would be used and whether this information would be gender-desegregated. She also raised the issues of human development in the Federally Administered Tribal Areas and felt that these should be addressed. The Secreta ry General Finance agreed that these issues were important but suggested that the proper forum to discuss these would be the provincial forums. The Minister of NWFP informed the Forum that FATA was federally administered and that the President of Pakistan had taken some important decisions in this regard recently. Answering the question of how resources would be distributed between the districts, the Minister of Finance from Sindh indicated that there was a Provincial Finance Commission that would consider factors that included aspects like population, backwardness and fiscal contribution from the local level. In affixing a formula for distribution of funds, it was important to ensure that game playing was not unleashed among the districts. The Government of Sindh had also developed a ranking of districts and were in the process of preparing profiles.

Moving from a Project to a Programme Approach to Financing Social Sectors: The representative of the World Bank wondered about the best mechanisms to support the social sectors. Experience showed that the project approach was beset with a wide range of problems like the focus on physical infrastructure, counterpart funding issues, governance issues, procurement and disbursement issues, etc. The SAP approach had been a radical approach but it suffered from implementation problems and had fallen afoul due to deteriorating macro-economic situation, flawed governance, and weak institutions. There were no clear-cut answers in this regard. He suggested that a start be made by funding the federal programme in health policy reform and communicable disease control such as the EPI, Polio eradication and HIV/AIDS. These programmes needed to be appraised. The role of the Provincial Governments had changed and they would now be focusing on developing a regulatory framework, setting standards, and policy-making and monitoring. In undertaking the provincial government’s fiscal reform, the World Bank would seek to assist these governments with their restructuring to free up the fiscal space that was missing. Provincial budgets were burdened with overhead costs, debt servicing, pension payments and little money was left for programme expenditures. There was a need to free up this space for social sector delivery. The Sindh Minister of Finance informed the Forum that his government had prepared a medium term budget framework in order to provide a better sense of the fiscal flows. The Sindh Government had also arranged to meet with the World Bank to consider provincial re form. This was the first time that such an exercise was being attempted at this level directly. Responding to the concern for monitoring a programmatic approach, the Federal Minister of Finance indicated that this would be done by ensuring greater accountability and not through micro-management. Any province or district that would not perform according to expectations was likely to get black listed. The community would also be involved in the monitoring for effective implementation.

Modalities for Using Funding Within IPRSP: The Government of Japan enquired that in case there were health interventions which the Japanese Government wanted to finance than how would the GOP reconcile them within the framework of the IPRSP. The Secretary General Finance replied that such funds would be used to push targets within the IPRRSP to higher level, e.g., the immunisation targets could be increased from 80 percent to 82 percent. The representative from the European Union indicated that the EU had moved from a project mode to a programme mode and he was confident that this would not create complacency. He felt that the question of accountability would be better addressed if appropriate benchmarks had been established for measuring process and outcome indicators. The Secretary General of the Ministry of Finance reassured his EU colleague that benchmarks and monitoring indicators had been developed within the framework of the IPRSP and the GOP had the means for effective monitoring. The Federal Minister of Finance reassured the Forum that the GOP was committed to managing the outcomes and wanted to move away from measuring expenditures.

Need for Co-ordinating Financing at Local Level: The World Bank representative said that he was excited about the local government design that he had heard on the first day and this would be the first real local government in South Asia if it worked. The legitimacy of the Government was well established and he hoped that it would be accountable to the people who had elected it. However, the capacity and resources of the District Governments were very weak and needed strengthening. There were several initiatives for financing implementation and programme support at district level. These initiatives included the drip irrigation scheme proposed by NRB for programme support, and the idea of incubators for capacity building support as proposed by PTFHD. In addition, there were initiatives such as the PPAF, Khushali Bank, the Khushal Pakistan programme, the Rural Support Programmes, th e CIP, etc. There was a need for sorting through these various initiatives. He suggested that the GOP organise a meeting that focused on the financing of capacity building and programme delivery at the local level, and let the knowledgeable people sit around a table and discuss these issues if they wanted to take us into confidence. The representative of Norway felt that coordination should be brought to the provincial level. In this context, he was looking forward to the provincial meeting in Karachi and he hoped that the meeting would provide a district focus. The representative of Canada welcomed the announcement that similar forums would be held at the provincial level including the district governments. The Secretary General reassured his colleagues from Norway and Canada that district participation would be more active at the provincial forum meetings and one special session would be earmarked for this purpose.

Ensuring that Additional Funds Resulted in Additional Expenditures: The representative of the Government of the United Kingdom enquired how could it be demonstrated that additional resources resulted in additional expenditures. He enquired if there would be health related agreements for fund flows on the model of education agreements with District Governments. The representative of the EU felt that in order to ensure that GOP funds were additional to external funding, these would need to be planned properly and closely monitored. He further stated that internal resource mobilisation was an area of concern and needed to be built into the process indicators. Responding to the question from the UK representative, the Secretary General Finance replied that in principle education type agreements could 64 be used for the health sector, but only partially, because the health sector programmes were different in that they were being driven by the Federal Government. However, for health interventions, the Provincial Governments could have agreements with the Ministry of Health. However, these mechanisms needed to be refined further to ensure that the provinces pass on the funds to lower tiers of government. The GOP visualised that the Provincial Governments would sign agreements with Districts Governments. The Secretary General Finance clarified th at if grants and debt swaps were offered, they would be added to the GOP’s existing resources and would be used within the PRSP framework.

Mobilising Internal Revenues: The representative of IMF felt that there was a need for aid to be integrated into the macro -economic framework. Pakistan was faced with an external debt problem. He expressed his concern that if donors came up with innovative schemes like debt swaps and grants, could the implementation capacity actually guarantee that these would be spent additionally. It had been effectively demonstrated by the provinces, how the current interest burden made it difficult to implement worthwhile projects. However, he did not want to solve one problem by creating another one. It was important to examine where the constraints actually lay. The revenue generation was low and it was important to raise the level of revenue. The IMF representative enquired if the GOP had a concrete strategy in terms of lifting the country out of poverty and improving tax compliance in the country. The Federal Minister of Finance agreed with the IMF representative that tax reform was important and acknowledged that the tax to GDP ratio was pathetically low in Pakistan. For the benefit of the Forum, he indicated what the GOP was contemplating in order to improve resource mobilization. There was a need for structural change in the tax machinery, broaden the tax base but lower the number of taxes, and change the culture of the institutions. Pakistan had a long way to go in this regard. Replying to the concerns of the representative of IMF, the NWFP Minister of Finance stated that he was not suggesting transferring the debt burden to the Federal Government but to somehow reduce their own debt burden. There was a high rate of interest on CDLs and his appeal was to bring the interest rate down in order to increase the fiscal space to meet social sector requirements.

Balancing Donor Financing with Breathing Space: A participant from the floor voiced her view that the donors should listen carefully to the GOP. The provinces had also developed a realistic reform agenda and needed to be supported. She emphasised that there were many reasons for mismanagement and political instability in Pakistan. However, there was need for greater coordination and transparency among the donors as well. The donors needed to specify why they were supporting certain issues and they should refrain from micro-management, and give the government some elbow-room. Although donor assistance had reduced steadily, the challenges confronting Pakistan had increased. In this context the donors needed to examine how their resources would increase. There was also a need for reduction in military expenditure to ensure greater expenditure on human development. The Minister of Finance from Sindh requested that while accountability was important, an atmosphere of fear had been created which had paralysed decision-making. He requested the Forum to consider a definition of accountability which would encourage nnovationi and enable the government to meet the challenges that lay ahead. He indicated that what the government was trying to do in the social sectors was worthwhile and urged the donors not to get 65 exasperated but to redouble their efforts of support. The Federal Minister of Finance indicated that he wanted to elaborate on the defence expenditure which some had raised openly and others in guarded terms. He wanted to inform the Forum that the current Government had kept the defence expenditure flat in real terms in one year and flat in nominal terms in the next year. At the policy level, there was agreement to bring down the expenditure in real terms. However, if the defense budget was analyzed, it would be evident that this was largely an employment programme. The level of transparency in the defense budget had gradually increased.

Need for Globalisation of Social Sector Development: The Executive Chairman of the Atlas Group of Companies felt that the process of globalisation in commerce and industry would have to be matched by globalisation of social sector programmes. The economic graph of Pakistan had shown consistent improvements despite changes in the government and the economy had so far been affected negatively only by the Nuclear explosion and the Afghan war. However, the economic graph was likely to fall down unless the chart of health and education improved. A participant from the floor stressed that the human resource development needs should also consider that the reconstruction effort in Afghanistan would be assisted by many people from NWFP and there was a need for investing in local capacity for undertaking this task. There was a need for a long-term commitment to human development and the development of partnerships for undertaking this task.

SESSION VII: CONCLUDING SESSION: DONOR’S VIEWS/STATEMENTS

The concluding session was chaired by the leader of the World Bank delegation. The Chairperson expressed his appreciation for the Forum, the way in which it was conducted and the provision of information in such an encapsulated manner. He stated that he would begin by making comments on behalf of the World Bank and invited the representatives from other delegations to make their comments thereafter.

Statement by the World Bank:

The World Bank representative remarked that it had been impressive to see the ownership for the IPRSP and the commitment to reduce poverty. It was clear that there was a genuine new start on the side of the GOP in developing and enunciation of new strategies. The achievement of the millennium development goals posed a particular challenge for Pakistan as it was behind its neighbours. It would be difficult to achieve these goals by 2015 but there are potential winners to help Pakistan catch up on lost ground. Devolution to the district level was a step in the right direction and the World Bank experience had shown that one could not provide proper service delivery, particularly in the social sectors, without local governance. There was a clear commitment to establishing a partnership with the private sector, NGOs and civil society.

The World Bank supported these efforts and offered to provide assistance in the following manner: adjustment lending for the Federal and Provincial governments to help create fiscal space; review the strategies proposed by the GOP carefully from the standpoint of financing; assist in establishing priorities for implementation; examine the role of the Federal and Provincial Governments and the bottlenecks that might arise and review the monitoring and evaluation components. The World Bank indicated its willingness to provide a formal response to the GOP on how they viewed their role in the next few months.

In view of the business language that had been used by the GOP suc h as strategies, partnerships, business plans, and incubators, the World Bank wondered about the need for quick wins to show the citizens some tangible results. Some possible ideas in this regard could be to show improvements in the coverage of EPI. Although this required money, real focus and people, it would provide a clear win. In the field of education, the timely delivery of books or the provision of discretionary funds to the head mistress could provide quick wins if these could be undertaken within the next school year. The idea of incubators could be tested to show the real difference. The concept could make a difference in supporting and nurturing local level managers.

The World Bank would be happy to be the lender of last resort and wished the GOP success in seeking grant funds. However, the World Bank would be more than willing to help with technical assistance and finances for specific purposes, if required. There was a need for donors to review the programmes even if the GOP was able to obtain grants.

Statement by the Asian Development Bank:

The representative of the Asia Development Bank congratulated the Government for organizing this highly successful Forum on human development. The Forum came at a critical juncture in that investments in human development were essential to promote peace and stability as well as economic growth, and poverty reduction in the region. In this context, ADB welcomed a social sector partnership with Pakistan. The representative outlined that recent international events and the global downturn of the economy had adversely impacted the social sectors in Pakistan. This had increased the challenge before the Government of Pakistan. The Government needed to guarantee a minimum budget floor to the social sectors, promote internal efficiency through rationalizing inputs, lower overheads, promote cost recovery where possible, and encourage social targeting. These approaches would require the use of innovative partnerships and new devolution practices to ensure that investments were need-based and had the desired impact.

In the past, Pakistan had under invested in human development and allocations within the sectors had been unbalanced and budget releases had been delayed. This had resulted in social indicators that were not commensurate with the country’s economic development. However, the Government had undertaken important new measures. The measure to decentralize responsibility to the district level represented an important opportunity and ADB would continue its assistance to the decentralization process.

The ADB representative outlined the cumulative assistance to Pakistan which was US$ 11.5 billion of which US$ 8 billion had been disbursed. In addition, ADB had provided grant technical assistance amounting to US$ 92 million. He outlined the long history of partnership between ADB and GOP. Over the last decade, ADB’s development strategy in Pakistan had shifted away from hard infrastructure to capacity building, institutional strengthening and good governance. ADB’s country development strategy was closely aligned with the strategies emerging from the Forum. The ADB representative outlined the nature of ADB’s interventions in the social sectors and gave details of specific ADB financed projects and programmes.

From its partnership with Pakistan, ADB had learnt that: Pakistan needed to sustain a higher level of investments in the social sectors; governance reforms were essential to promote efficiency in social sector investment; political will and commitment demonstrated during the Forum would be crucial to sustaining higher investments and governance reforms; and social sector investments were best designed and implemented at the local level. As such, the enthusiasm witnessed at this Forum in support of devolution was appreciated by ADB.

While there was donor grant financing available to supplement social sector development, the GOP would need to continuously find ways to fund social programmes as these eventually represent a contract between the government and the people of Pakistan. Furthermore, in the changing world of today, most governments were seeking ways to reduce their direct intervention in many social services. Pakistan would have to conduct its own debate internally to determine the

68 scope and level of intervention by the public sector. The donor countries could only support this dialogue.

ADB saw itself as a close partner in Pakistan’s efforts to promote human development. Over the next two to three years, a significant portion of (20 to 30 percent) ADB’s planned lending of about US$ 1 billion annually would be allocated to the social sectors. ADB’s assistance in the area of macro-economic reform, governance and devolution would also aim at improving the financial sustainability of social sector investments. Developing the social sectors was in the long-term interest for Pakistan to foster economic and social development. Pakistan would have to tailor its approach to its own socio-economic and cultural context. The strategies and reform agenda in the social sectors, presented by the GOP, at the Forum merited donor assistance. ADB stood ready to assist in whatever way it could help Pakistan develop strong and efficient social services that met the needs of its people.

Statement by the Resident Co-ordinator of the United Nations:

The representative of the United Nations commended the Government on the manner in which the Forum had been organized. It was very instructive to learn about the strategies that the GOP had outlined and the manner in which partnerships had been established. The depth of analysis, insights and the readiness to engage in dialogue that was evident in the Forum had been very encouraging for all. The Forum had also proved useful for renewing donor commitments. There was good reason to hope that further progress would be made with strong external support. Mr. Kofi Annan, the Secretary General of the United Nations, had noted the significant convergence between the Millennium Summit targets and IPRSP suc h as reduction in the poverty ratio, ensuring food security, health, literacy, provision of safe drinking water, and elimination of gender disparities.

The representative of the UN outlined that human development was a process of enlarging human choices and strengthening capacities. Human development was central to the broad process of economic, social and political reform. It was important that all segments of the population were included in this development, especially women. As such, the United Nations looked forward to strengthening the gender dimensions of the PRSP, initiation of gender sensitive budgeting, increase in female employment, and implementation of CEDAW. The contribution of the private sector, NGOs and civil society in innovating models of development and service delivery highlighted the need for public-private partnerships in the social sectors.

Although environmental issues had not been highlighted at the Forum, it was important to raise them for sustained development. The dramatic drop in the water table in Balochistan threatened the more vulnerable sections of society and survival was a pre -requisite for human development as was passionately pointed out by a participant at the Forum.

The essential role of the Government was to establish a policy framework and in setting the basic rules. It was important to enable the districts to innovate and fulfill their responsibilities under the devolved system of governance. One of the most 69 pressing issues was implementation. Having recognized that community participation was important, there was a need to ensure that the District Governments had the funds and the mechanisms to undertake their tasks. There would be a need for new mechanisms to translate the principle of devolution into practice. It was important to capitalize on these opportunities urgently as the window of opportunity for poor communities may not stay open for long. In the past, there had been delay, in procurement as a result of lack of procedural clarity. The UN representative suggested three ways to deal with some of these issues:

Ø Establish mechanisms to channel donor funds directly to the district;

Ø Sponsor devolution facilitators to assist the provincial authorities in establishing the new relationships; and

Ø Share the successful innovative pilot experiences and provide flexibility at the local level to form new partnerships for testing and rapid dissemination of these models through appropriate training opportunities and developing methodologies.

The UN representative offered the support of his organization and looked forward to the Provincial Development Forums in the North West Frontier Province and Sindh with participation of District Government representatives. In the end, he expressed his hope that everyone would rise to the challenge that confronted Pakistan.

Statement of the International Monetary Fund:

The representative from the International Monetary Fund stated that he fully shared what his colleagues had said. It was reassuring to note that the IPRSP was a home- grown document backed by the top and that it had been developed in a participatory manner. The larger task was to ensure its distribution and dissemination to the population at large. The IMF representative, while sharing global experiences, emphasized that there would be little progress in poverty alleviation unless and until the economic fundamentals were right. The authorities had made considerable progress including the introduction of transparency in fiscal accounts, fiscal reform and privatization. The fact that the fundamentals were right allowed the dialogue between the GOP and the donors to move to a higher level. The dialogue that we were engaged in currently spoke of issues of governance, poverty reduction, social progress , etc. This dialogue was different from earlier dialogues where discussions focused on whether the rupee should be devalued and the price of petrol increased. He expressed his satisfaction that the GOP and the donors could engage in a much higher quality dialogue. He informed the Forum that the IMF had been involved in a technical and financial programme with the Government and a mission was expected in Pakistan soon. He was hopeful that the first review would be completed successfully.

Statement o f the Government of Italy:

The representative of the Government of Italy said that he had listened very carefully in order to learn more about the developments in Pakistan, its needs and aspirations. The tone of the Forum had been set by President General Pervez Musharraf who had outlined three choices in which the Government could proceed: to improve the existing system; reform it; or restructure it completely. The President was clear that there was a need to restructure the system completely and to work in a new way. This Forum had proved that the GOP was trying to restructure in order to improve the quality of life of its people. The Government of Italy noted with satisfaction that the GOP recognized that it was not acceptable to leave anyone out of the development process and everyone had been taken into account. The process of decentralization would play a fundamental role and the transfer of power to the districts would allow civil society to be more active. There was a need to try all the innova tive ideas that had been outlined to involve the people whether it was through the CCBs or NGOs or the Incubators. This was important because there was need to uplift the attitude of the people who had previously waited for help to come in a passive manner. It was important for people to recognize that their destiny lay in their own hands. It was important to help people to start some enterprise, provide education, health services and improve reproductive health, improve the gender balance, and provide employment generation. Without education, no one could play a meaningful role or participate fully in economic and social development. Poverty was not just an economic phenomenon but a state of deprivation. The Government of Italy supported the PRSP whole-heartedly and was confident that a more democratic society would emerge. He stated that his government had recently decided to cancel Pakistan’s debt worth 85 million. The modality of how this would be undertaken would be worked out. He promised that more help would be forthcoming but this would be in proportion to the requirements of transparency and efficient utilization of funds.

Statement by the Government of Saudi Arabia:

The representative from Saudi Arabia stated that the Forum provided an opportunity to discuss key issues in the PRSP. The Kingdom of Saudi Arabia had provided grants, commodity assistance and concessional loans worth US$ 65 million. He reiterated the willingness of the Saudi Fund for Development to fund the social sectors, particularly education.

Statement by the Government of Japan:

The representative of the Government of Japan wanted to place the support and commitment from his Government within a broader context. The President of Pakistan had expressed his concern regarding terrorism, violence and fundamentalism, and referenced to his desire to make Pakistan a moderate Islamic State. The representative stated that although he was not in favour of Jihad generally, but Jihad against poverty famine, and illiteracy was a shared objective. The Government of Japan was committed to the GOP’s endeavour for human development and reiterated his Government’s intention to contribute US$ 300 million 71 as grant aid. He expressed his feeling that he thought all the donors were working for the same set of goals. However, there were several types of assistance that the donors could provide. He hoped that in approaching the same set of goals, there was some flexibility and coordination among donors. He felt that the Forum had been inundated by acronyms in the past two days and this was not only awe- inspiring but illustrative for the need for greater donor co-ordination. He wanted to reiterate that although human development was very important, it was equally important to focus on econom ic revitalization and engendered economic development. There was a continuing need to help Pakistan with such pro-growth areas such as agriculture, industry and to have a balance between the social sectors and other sectors of the economy. He hoped that he would have the opportunity of being further enlightened by the GOP regarding its plans for these sectors.

Statement by the European Commission:

The representative from the European Commission said that although the right vocabulary had been spoken at the Forum, what had impressed him the most was the vision, the commitment and the willingness to undertake concrete action at all levels. He felt that some people had been very outspoken at the Forum and this had made it a worthwhile experience for him. He wanted to outline the follow -up on the part of the EU to the Forum. There were a number of instruments that were available to the EU and he wanted to use all these instruments to strengthen the partnership with Pakistan. There was a need for the GOP to ensure that the benefits that would accrue from the measures taken, including those from trade and commerce would be widely shared and improved living standards for all segments of the population. There was need for internal follow-up by the GOP to ensure the broad distribution of benefits. Good governance measures would help to ensure this happens. The frustrations outlined by Ms Short in this regard should be kept in mind. The EU had allocated EURO 30 million additional funds to the budget and was finalizing a package of EURO 50 million for use in the current financial year. This quick infusion of funds was to ensure immediate impact. The EU had realized that its delivery system had been very insufficient in the past and that aid should be delivered in a less cumbersome manner. He indicated that there were plans to strengthen the level of dialogue in Islamabad. In order to achieve this, the EU would transfer the responsibility for financial and contract management to its Delegation in Islamabad. He hoped that this would stimulate the discussions, help the dialogue and allow the GOP to follow up on its aspirations.

Statement by the Representative of USA:

The representative of the USA thanked the GOP for the opportunity to participate. She was pleased with the focus on improving fiscal management. The US had provided US$ 600 million for the social sectors. This was pledged, signed and released in October 2002 within a record time frame of only two months. However, grants could only contribute in a limited manner and it was important to improve revenue collection. The Forum had been a benchmark event and a rallying point. The GOP had shared its plans which appeared to have the right thrusts. The IPRSP was an excellent framework and the manner in which it had been developed showed true leadership and the collaboration of many players. This needed to be followed by 72 the devolution of funding to the districts and to ensure proper implementation. She wanted to reiterate that USAID was back and that she was very pleased to join the development community in Pakistan. However, the nature and the type of programmes USAID would undertake was under consideration, but the emphasis would be on gender, human development and economic development.

Statement by the Representative of the Islamic Development Bank:

The representative of the Islamic Development Bank indicated that in his view the Forum had been highly successful. He reiterated the commitment of the IDB to support the initiative of the GOP. He wanted to state that coming with a background of project implementation, he was very interested in seeing how the various partners collaborated and coordinated for successful project implementation.

Statement by the Representative from the United Kingdom:

The representative from the United Kingdom congratulated the GOP on a successful Forum. There was now a need for communicating to the public and signaling to them that the Government would strive to improve their well being through the social sectors. The United Kingdom had developed a new approach to working with Pakistan. This approach focused on two main objectives in order to reduce poverty: improvement in economic conditions, and improving education and health outcomes. Additional funds had been approved for Pakistan and total DFID funds for the next year would be UK£ 60 million. The UK Government was committed to working with the GOP for the long haul as it understood that the effective use of funds depended on lasting commitment and a productive partnership with donors and all tiers of government.

He appreciated the honest analysis that had been undertaken and the frankness of people who had participated in the Forum. DFID was behind the principle of public- private partnerships and the principle to harness all resource for the common effort. However, he wanted to signal a warning that the GOP should be careful not to set up parallel systems. The GOP should work with what they had got. The GOP needed to take ownership of the entire package that was delivered. It should provide an enabling environment in the field of education and provide the framework within which both public and private schools deliver education to all Pakistani children.

He endorsed the view that implementation provided the real challenge. The IPRSP and good sectoral plans provided the basis around which everyone could work together. The development of coherent and well publicized plans would ensure that plans were achieved and would allow donors to set up common mechanisms for working together effectively. He reiterated the need for committed and trained staff for effective implementation at all levels. There was need for capacity building and improved systems of management, and DFID stood ready to assist in meeting these capacity building needs.

Statement by the Government of Canada:

The representative from Canada extended his gratitude to the GOP for hosting the Forum and welcomed the focus on human development. He felt that both the government and the people of Pakistan had engaged in this debate. He recognized that resources were insufficient and there was limited scope for tax reform. There was thus the need to use scare resources for human development. However, for good financial management, it was necessary to reform the processes as well as actual spending. There was need to have representative and accountable government at all levels to increase investor confidence. He outlined that gender equality was a particular area of concern and he expressed his satisfaction that a session on mainstreaming gender formed part of the Forum. He emphasized women’s empowerment, support for devolution and citizen’s participation. He welcomed the provincial government’s comments and looked forward to participating in the provincial forums. There was need for coordination among the larger circle of stakeholders for clarity of roles and responsibilities. He reiterated the Government of Canada’s plans to contribute Canadian $ 447 million outstanding loans into the social sectors through debt swap. He welcomed the GOP’s consideration of the role of the private sector, NGOs and for mobilizing private sector resources towards this goal. He thanked the Government of Pakistan and looked forward to the donor meeting in Paris.

Statements by NGO representatives and Concerned Citizens:

Mr. Shoaib Sultan Khan highlighted the importance of harnessing the potential of the people. He emphasized that the main reason for the favourable position of Chitral in the district ranking of NWFP was because there was a framework of village level institutions. Although AKHS and AKES had been operating in Chitral for decades, it was only when people got organized that they were able to make a difference. Mr. Khan had visited more than 5000 comminutes and had seen thousands of households coming out of poverty. He emphasized that the Social Action Programme had never been given a chance and it was never fully implemented. SAP was supposed to be people centred but the people were nowhere. The key to successful implementation of social and economic sectors was organized communities regardless of the name you chose to give them. It did not matter if you called them CCBs or Incubators or Village Organizations or Women’s organizations. For successful implementation, it was important to have a country wide framework for grass-roots institutions.

Dr Salma Maqbool, representing an NGO dealing with disabilities, emphasized the need to set aside specific funds to cater to the needs for the disabled and the most disadvantaged and the poorest sections of society.

Dr Farzana Bari recommended that while the concept of gender mainstreaming had been adopted, there was a need to conduct gender auditing of the budget. The women of Pakistan were concerned that they should not receive crumbs anymore. The current government had been one of the most friendly governments towards women’s issues, and the donors needed to help them to achieve gender mainstreaming objectives in an integral manner. 74

The representative of the Academy for Educational Development stated that the discussions had been encouraging for a service organization which had worked with the GOP and NGOs previously in Pakistan. It was important to remember that the level of the dialogue that was taking place today was the result of earlier investments. There had been a steady progress in building the leadership within the NGOs, civil society and among women. This was a long-term process. However, it was heartening to see the produc ts of earlier investments of an organization like AED, which had also invested in this process, are now forthcoming.

Mr. Ali Shaikh from Lead Pakistan emphasized the need to build on the nexus between poverty and the environment.

Representative of Congressman Owens regretted that he could not join the Forum due to his other commitments. The Congressman had always been a voice of support for Pakistan. She assured the Forum that she would be taking back the material distributed at the Forum for him. She reiterated his voice of support in the Congress for Pakistan and its economic development and social goals.

Closing Statement by Mr. Shaukat Aziz, Minister for Finance, Government of Pakistan:

The Minister thanked the participants for being present at the Forum and assured the gathering that their participation was a source of strength for Pakistan. There was broad acceptance of the IPRSP as the framework for the overall human development effort in Pakistan. However, the PRSP was an evolving document. He assured the donors that whatever type of assistance that was forthcoming would be used within the framework of the IPRSP which was a comprehensive document. He wanted to place some takeaways on the table which indicated the direction in which the GOP was moving. These included the following:

Ø From expense management to outcome based development: This placed tremendous responsibility in terms of data requirements and in particular to collection of data on outcome indicators. The FBS and the Planning Commission had been charged with this task and would ensure that appropriate data would be collected and disseminated in a transparent, authentic and timely manner. This shift in emphasis entailed a bigger challenge and GOP was up to the challenge.

Ø There was a large array of stakeholders that had to be involved such as NGOS, voluntary organizations, civil society and private sector. Thus Public- Private Partnership would have to be the manner in which to proceed.

Ø The allocation for social sector expenditures would be raised through greater efforts on raising revenues. In the last two years, there had been a 13 per cent growth in revenues. It was critical to restructure the Central Board of Revenue. The GOP was improving tax collection with the assistance from the World Bank and IMF. However, the GOP recognized that we need to do more in this regard.

Ø Without basic macro-economic stability and sound economic policy, all our plans would be academic. These issues were not focused in this Forum but we hold the views that economic development is critical to lay the foundation for human development.

Ø The GOP was aware of the issues of SAP. Both donors and GOP recognize that they would undertake SAP differently if they had another chance. SAP was micro-managed and over-managed, and there was little ownership of it at the provincial level. He emphasized that the lessons from SAP had been learnt.

Ø Capacity Building was an important aspect for effective implementation both within the GOP and of the other major stakeholders without which the desired impact would not be obtained. Having recognized this need, capacity building units would be created to train people.

Ø The process of devolution had created a major sea change in Pakistan and had created opportunities and greater challenges. Districts would be the focal point of many activities and the Federal and Provincial Governments would have to change the manner in which they did things and make appropriate adjustments.

Ø There was need for coordination betw een the donors. The EAD provided the one window for donor co-ordination at the federal level. There was a need to develop mechanism for donor co-ordination at the provincial and district levels.

Ø Implementation would be the critical success factor in GOP’s human development programme. GOP is conscious of the need to pursue capacity building and would appreciate assistance in this regard. Ownership and validation of ownership of the strategies and programmes should be key in the donor and GOP appraisal of implementation on the ground.

Addressing himself to the question of resource gaps, the Minister indicated that this year’s gap was filled. However, financial gaps were projected for the years ahead and he hoped that with donors help, these would be filled. He indicated that once funds were received it would be ensured that these were transferred quickly and spent effectively. In terms of the type of assistance that the GOP would prefer, it was grants, followed by debt swaps, and then concessional loans. Pakistan was very seriously carrying out an upgradation of its human development capacity. What had been done recently surpassed what had been done by all previous governments. Pakistan also had the advantages of having some Centres of Excellences like the Edhi Foundation, NRSP, AKRSP, the Human Development Centre, OPP, etc. A lot of the cerebral work had been done by these centers, and their work needed to be built upon. The GOP understood that the path to achieving ambitious outcomes was not easy and it would involve partnerships between the various tiers of government, public-private partnerships and with donors to achieve a better quality of life for the average citizen of Pakistan. The views expressed by the President of Pakistan at the Inaugural session of the Forum came from his heart. It was a demonstration of complete ownership at the highest level. The enthusiasm of 76 the President augured well for all our efforts. Furthermore, excellent inputs had been provided by Ms. Short and the President of the Islamic Development Bank and the Secretary General of the UN. The support that the donor community had extended was heartening and would not make us complacent. The GOP realized that it had a major challenge before it and undertook this challenge with a greater sense of commitment and realism. The GOP had an opportunity to improve the life and lot of its people. The Minister stated that the Government wanted to build a moderate, vibrant and modern Pakistan and he thanked the participants for their support in this effort.

Closing Statement by Ms. Zobaida Jalal, Minister for Education, Government of Pakistan:

The Minister began by saying that this was the beginning of a new dawn for Pakistan. The President had set the tone for the Forum by stating that human development was the anchor of his economic development policy. He had indicated very clearly that the change that he was seeking was restructuring as the old structures were not working. The Minister indicated that she recognized that effective implementation was critical. The districts would be the focus of implementation. At the district level, implementation was expected to be easier as it would be led by the Nazims. It was also important to build an intelligent relationship between the social sectors and the Ministry of Finance for the creation of fiscal space for effective implementation. There was need for a change of culture and availability of information freely in the public domain. The media would be given a central role and a communication strategy would be developed. Many innovative models for delivery of social sector services had been developed. The time span between innovations and their replication had decreased and there was need to build capacity at the district leve l for the implementation of innovative models. The Federal and Provincial Governments would need to adjust to the district as the focus of implementation and the Federal Government would have to shed many layers. There was a need to facilitate public-private partnerships and establish a regulatory framework to make the GOP an effective enabler. There was agreement to focus on outcomes and performance, and gender would need to be mainstreamed to ensure that human development was not endangered. The National Commission on the Status of Women would oversee this process as a watchdog and an advocacy partner, and ensure that the public sector remained women friendly. Mr. Kofi Annan had raised the issues about the environment challenge in the Inaugural session. In addition, there was the question of the Information Technology challenge. However, the GOP recognized that reform must take place at the level of the school and the BHU. This Forum must be viewed not as an event but an honest effort at introspection. The basis of a rich dialogue had been laid and it was important to continue this dialogue. In the end, the Minister of Education thanked the Minister of Finance for his support and all the other participants for their presence, participation, and commitment.

Closing Statement by the Chairperson:

The Chairperson of the session congratulated the GOP on its comprehensive human development programme. The high level of attention to Pakistan’s human 77 development future was very encouraging. The session on gender mainstreaming had reinforced GOP’s commitment to reducing the gender gaps. The session on financing raised critical financing issues. He summarized some of the takeaways presented by the Minister of Finance. The Chairperson noted with interes t the plans to convene the provincial forums in which implementation and financing issues would be discussed further from the perspective of the provincial and district governments. He thanked the organizers of the Forum for the excellent arrangements and all the distinguished delegates for their participation.

ANNEXURES

ANNEX I: AGENDA AND PROGRAMME ANNEX II: STATEMENT BY THE MINISTER FOR FINANCE ANNEX III: STATEMENT BY THE MINISTER FOR EDUCATION ANNEX IV: STATEMENT BY MS. CLARE SHORT, SECRETARY OF STATE FOR INTERNATIONAL DEVELOPMENT, UK ANNEX V: STATEMENT BY DR. AHMAD MOHAMED ALI, PRESIDENT, ISLAMIC DEVELOPMENT BANK ANNEX VI: LIST OF PARTICIPANTS

ANNEXURE I

1. AGENDA AND PROGRAMME

DAY ONE: JANUARY 24, 2002 (THURSDAY)

Session I INAUGURAL SESSION

1000 Registration at the Islamabad Convention Centre

1100 Guests to be seated at the Chief Executive Secretariat-II

1130-1135 Recitation from the Holy Quran

1135-1145 Address by: Mr. Shaukat Aziz Minister for Finance Government of Pakistan Co-Chairperson, PHDF

1145-1155 Address by: Ms. Zobaida Jalal Minister for Education Government of Pakistan Co-Chairperson, PHDF

1155-1205 Address by: Mr. Kofi Annan Secretary General United Nations

1205-1220 Address by: Dr. Ahmad Mohamed Ali President Islamic Development Bank Jeddah

1220-1240 Keynote Address by: Ms. Clare Short Secretary of State for the Department for International Development Government of the United Kingdom and Northern Ireland

1240-1300 Inaugural Address by: General Pervez Musharraf President of Pakistan

Session II PAKISTAN POVERTY REDUCTION AND HUMAN (1400-1720) DEVELOPMENT STRATEGIES

Session Chair: Islamic Development Bank

1400-1430 Devolution and Shift in Government Lt. Gen. (Retd.) S. Tanwir H. Naqvi Strategy for Social Service Delivery: Chairman National Reconstruction for Sustainable National Reconstruction Bureau Democracy and Durable Good Governance 80

1430-1500 Pakistan Poverty Reduction Strategy Dr. Shahid Amjad Chaudhry Deputy Chairman Planning Commission

1500-1515 Poverty Reduction and the Role of Zakat Mr. Ma hmood Ahmad Ghazi Minister for Religious Affairs, Zakat and Ushr Government of Pakistan

1515-1535 Tea and Coffee Break

1535-1550 Preliminary Report of the Dr. Nasim Ashraf Human Development Task Force Team Leader, HD Task Force

1550-1720 Discussion and Q&A

DAY TWO: JANUARY 25, 2002 (FRIDAY)

Session III EDUCATION (0900-1300)

Session Chair: Leader of the USA Delegation

Presentations: 0900-0930 Education Sector Strategy Ms. Zobaida Jalal Minister for Education Government of Pakistan

Provincial Perspective: 0930-1000 Vision for Delivery of Improved Mr. Imtiaz Gillani Education Services Minister for Education Government of NWFP

Alternative Approaches to Delivery of Education Services

1000-1015 Experiences of NGO and Foundation Schools Sindh Educational Foundation Prof. Anita Ghulam Ali

1015-1030 Tea and Coffee Break

1030-1045 Experiences of Private Education – Dr. Shahid Hafiz Kardar low cost service

1045-1100 Education Development Through Lt. Gen. (Retd.) Voluntary Services Sabeeh Qamar-uz-Zaman, Director, Citizens’ Foundation, Karachi.

1100-1130 Discussion and Q&A

1300-1400 Lunch break

Session IV HEALTH AND REPRODUCTIVE HEALTH (1400-1745)

Session Chair: Leader of the Japanese Delegation

1400-1415 Health Sector Policy Dr. Abdul Maalik Kasi Minister for Health Government of Pakistan

1415-1445 Health Sector Reforms Mr. Ejaz Rahim Secretary Ministry of Health Government of Pakistan

1445-1500 Alternative Approaches to Delivery of Dr. Haneef Ismail Health and Reproductive Health Services Aga Khan Health Services Karachi

1500-1510 Low Cost Primary Health Care Delivery: Dr. Nasim Ashraf, Team Leader Case Study of “Appna Sehat” Human Development Task Force

1510-1530 Discussion and Q&A

1530-1600 Population Stabilisation in Pakistan: Mr. Tariq Janjua An Overview Secretary Ministry of Population Welfare Government of Pakistan

1600-1615 Social Marketing of Contraceptives Dr. Rehana Ahmed in Pakistan: Reaching the Market Place Social Marketing Pakistan Ltd. Karachi.

1615-1745 Discussion and Q&A

DAY THREE: JANUARY 26, 2002 (SATURDAY)

Session V MAINSTREAMING GENDER (0830-1000) Session Chair: Leader of the European Union Delegation

0830-0845 Mainstreaming Gender: Dr. Attiya Inayatullah An Overview Minister for Population Welfare and Women Development Government of Pakistan

0845-0855 Case Study of Community Schools & Mrs. Roshan Bharucha Girls Participation in Balochistan Minister for Social Welfare Government of Balochistan

0855-0910 Provincial Perspective: Ms. Shaheen Ateeq-ur-Rehman Minister for Social Welfare Government of the Punjab

0910-0920 Family Protection Programme Dr. Farzana Bari Quaid-e-Azam University Islamabad

0920-1020 Discussion and Q&A

1020-1030 Tea and Coffee Break

Session VI FINANCING SOCIAL SECTORS (1030-1300)

Session Chair: Asian Development Bank

1030-1050 Financing for Social Sectors Mr. Mueen Afzal & Poverty Programmes Secretary General Finance Government of Pakistan

Provincial Perspectives on Social Sector Financing 1050-1110 Sindh: Mr. Abdul Hafeez Shaikh Minister for Finance Government of Sindh

1110-1130 NWFP: Mr. Farid Rahman Minister for Finance Government of NWFP 1130-1300 Discussion and Q&A

1300-1400 Lunch Break

Session VII CONCLUDING SESSION (1400-1700)

Session Chair: World Bank

1400-1630 Donor’s Views/Statements

Statement by: World Bank Statement by: Asian Development Bank Statement by: Islamic Development Bank Views and Statements: Other Donors

1630-1650 Closing Statement by: Mr. Shaukat Aziz Minister for Finance Government of Pakistan

1650-1700 Closing Statement by: Ms. Zobaida Jalal Minister for Education Government of Pakistan

ANNEXURE II

Address by Mr. Shaukat Aziz, Minister for Finance Pakistan Human Development Forum January 24-26, 2002

· General Pervez Musharraf, President, Islamic Republic of Pakistan · Mr. Kofi Annan, Secretary General, UNO · Ms. Clare Short, Secretary of State, Department for International Development, Government of United Kingdom · Dr. Ahmed Muhammad Ali, President, Islamic Development Bank · Ms. Zubaida Jalal, Minister for Education · Cabinet Colleagues · Members of Delegations · Excellencies, and · Ladies and Gentlemen

It is a matter of great honor for me to welcome you all to Pakistan Human Development Forum. It was in the month of March 2001 that we had gathered in Islamabad for a special sess ion of Pakistan Development Forum. The Forum, which was established as a substitute of the erstwhile Aid to Pakistan Consortium, was then meeting after a long break of 3 years. It was an exercise in confidence building. We had aimed to restore the confidence of donors in the seriousness of Pakistan’s reform effort and our unqualified determination to forge ahead with its implementation. The response of the forum was overwhelmingly positive, not only in appreciation of reforms but also in extending support for its successful implementation.

It was the success of the PDF 2001 that prompted us to organize a special forum on human development. The centrality of human development in our reforms effort should not be surprising and neither the interest of the donors in this subject. It is here, more than anywhere else that we need to make significant progress and where donors need to markedly increase their level of support. I am happy to report that the idea was enthusiastically supported by the entire donor community, and what we see today is the culmination of our efforts in the form of largely attended forum where some 400 delegates from 22 countries and 18 multilateral agencies are present.

Mr. President,

The journey that the country started under your leadership 2 years ago is steadily moving mile by mile toward its desired destination. In the 7 Points program that you had given to the nation, you had accorded high priority to the objective of economic revival. A grass roots program of reforms and reconstruction was launched for this purpose in December 1999. The program, for the first time in our history, had adopted an integrated approach combining economy, social development and governance. Such an approach was imperative: it was not merely our economy that faced serious challenges, the state of poverty was alarming and institutions of state charged with the delivery of social services and ensuring people’s participation in the governance of their affairs, were in crisis. Hence, a focus on 86 growth alone would not have addressed the deeper malaise that afflicted our economy and society.

Through a diligent implementation effort, notable successes have been achieved in almost all the goals of the program. Some of the most notable achievements are:

· The macro-framework of the economy has been stabilized. There has been a steady increase in GDP-though it is slower than what we would like to see, inflation is historically on a low level, deficit in balance of payments is all time low, fiscal defic it has been significantly brought down and money growth is steady;

· Our exports have increased and except for petroleum products, our imports have remained contained, and consequently balance of trade has improved considerably.

· Our foreign exchange res erves position is extremely comfortable as our reserves are standing at an all time high of nearly $5 billion;

· We have launched a broad-based reform effort that encompasses all the key sectors of the economy-expenditure control, tax policy, trade and tariffs, oil & gas sector, banking and finance, privatization, capital markets, insurance, water and power, small and medium industry, information technology and agriculture. In each of these areas meaningful and path breaking reforms were undertaken to achieve any of the following objectives: (a) expand the space for private sector, (b) reduce the role of the government, (c) improve the pricing policy, (d) deregulate the regulatory regime or (e) to improve the functioning of the market;

· It was the strength of our program that won us the support of the multilateral agencies. We successfully completed the Stand-by program of IMF and fulfilled all our obligations to secure significant assistance from World Bank and Asian Development Bank.

· Yet again, it was our performance under SBA that qualified us to secure a three-year medium term program from IMF and unprecedented rescheduling of our entire stock of bilateral debt from the Paris Club. The commensurate support from both the World Bank, Asian Development Bank and Islamic Development Bank is also forthcoming.

We are conscious, however, that we still need to go a long and the challenges we are facing are far from over. As such there is no complacency in our efforts, which remain engaged and focused on the program.

Ladies and Gentlemen,

Human development lies at the core of our reform efforts. We believe that the ultimate measure of sustainability of the development effort is its impact on human welfare. In fact, in a country where the potential of human resources is not fully developed, primarily for lack of adequate facilities of education and health, the growth potential of its economy remains limited and constrained. Focusing on human development, accordingly, means radically expanding the growth potential of the economy and as such the expenditures on social sectors needs to be viewed as capital investment and not mere consumption.

The poor state of human development does not merely entail a constrained growth environment. It casts a specter of poverty binding the poor in a vicious cycle of deprivation that runs through many generations. Poverty is not merely a state of low income. Rather, it is a multidimensional concept encompassing economic, political and social needs that are sine qua non for a meaningful existence. The poor in Pakistan are not merely deprived of financial resources but they also lack access to basic human needs such as education, health, clean drinking water and proper sanitation. Limited access to such human needs limits their ability to secure gainful employment, and results in income poverty and social exclusion; while also making them vulnerable to exogenous shocks. This cycle is further exacerbated when institutions of governance tend to exclude the most vulnerable from the decision- making process and thus feeds into poverty and human deprivation. It is indeed such conditions that give rise to desperation and extremist behavior, and fall prey to the forces opposed to social order and discipline. In fact, the less the stake the poor have in the organized society the more vulnerable they are to be exploited by forces undermining the peace of civil societies.

Viewed in this perspective, the more formidable challenge for the government is that of poverty reduction, in the all encompassing and holistic sense I have elaborated the concept. This has been our focus in the formulation of Pakistan Poverty Reduction Strategy Paper (PRSP), whose interim version was finalized last November. This is a wholesome account of government’s efforts to bring about reforms in economy, social sectors and institutions of governance, all with the overriding objective or reducing poverty. The strategy has three planks, namely to:

(a) unleash export-oriented private-sector-led growth by giving lead to sectors with high employment potential;

(b) significantly improve the current level of social indicators by increasing social spending and raising the level of access to basic human needs and

(c) meaningfully devolve the power to lower tiers of government thereby giving the poor a voice and stake in governance and improving the efficiency of public services delivery system.

The PRSP framework has allowed us to pin-down the desired level of performance in each of the areas, particularly those related to social sectors. A selected number of indicators in each sector have been agreed upon with the line department as representing the most important measure of their performance. A set of outlays has been allocated that is considered essential for achieving the desired performance. With a few to facilitating quick assessment of performance, intermediate outcomes have also been identified, whose progress can be measured at shorter intervals. In education, for instance, the primary enrollment has been targeted to increase from 89% to 100% over a three-year period. As a major input to achieving this outcome, during the same period, the expenditure on education is planned to increase from 1.6% of GDP (Rs.56 billion) to nearly 2% of GDP (Rs.92 billion). Here the intermediate outcomes are reduction in non-functional schools, increase in the ratio of trained teachers and decline in the level of absenteeism.

The monitoring framework developed under the PRSP will be closely tracking not only expenditure but also the progress of intermediate and final outcomes. This is a major undertaking where a variety of capacity building needs will also have to be addressed. We are committed to meet the challenge of evolving a credible framework and already we have successfully instituted a system of quarterly tracking of poverty related expenditures. The report in this regard is now available on Ministry of Finance’s web site.

I would like to single out two critical factors that would determine the success of the PRSP. First, the availability of resources and their increasing diversion toward poverty related expenditures. Second, on the quality of PRSP system of monitoring, evaluation and feedback.

As for resources, the basic philosophy behind the adoption of PRSP approach by multilateral institutions was to ensure that the resources made available from debt relief were directed toward poverty reducing expenditures. The debt relief alone, however, will not suffice, particularly for countries that are faced with huge domestic debt burdens, while at the same time striving to maintain fiscal discipline along side poverty reduction efforts. Thus the flow of quick disbursing concessional financing is essential to support the PRSP. It is imperative that the donors’ as sistance is directed to achieving the objectives and programs of the PRSP. For this purpose, the most convenient mode of funding would be the straight budgetary support, which would enable the government to ensure that the planned expenditures in poverty related areas are actually incurred. On our part, we have already made significant allocations to poverty reducing sectors, where expenditures will rise from Rs.119 billion (or 3.4% of GDP) in 2000-02 to Rs. 230 billion (or 5% of GDP) in the year 2003-04. A significant additionality to this effort comes from Zakat, private charities and philanthropy in general.

As for the monitoring framework, we face a number of capacity constraints that would require technical assistance as well as innovative arrangements to achieve the required credibility. Here again the support from donors is critical as in its absence the existing budgetary constraints would not permit establishment of the system with desired characteristics. However, what is clearly evident from the past practices of this government, we believe in total transparency and disclosure of public information. Here alone our efforts have placed us in a totally different class 89 compared to previous governments. Accordingly, we are ready to take all measures that would enable the donors to place the right amount of trust and confidence in the monitoring framework.

In the next three days, Mr. President, this Forum will have an opportunity to closely examine the strategies of the government that we have developed in health, education and gender. We will also brief them about the financing needs to implement these strategies. A special focus of our deliberation will be the effective use of debt swaps for increased social spending, as this is a new source of funding made available by recent initiatives of some of the donors. We hope to improve human development strategies in the light of feedback that we receive in this forum. Our aim is to forge a strong development partnership with donor countries. They are important stakeholders in the development process of this country, while at the same time enriching our understanding about best international practices in the area of human development.

Ladies and Gentlemen:

Pakistan’s plans for human development are constrained by the availability of resources. The work that needs to be done in this field, particularly to fight and check the menace of extremism, is enormous. Through this forum we are making an even stronger case for renewed and expanded involvement of donors in the poverty reduction efforts of the government. The PRSP is not cast in stone neither is it a static document. Apart from annual revisions that would be necessitated by the system of monitoring and feedback, we are ready to expand the scope of almost all the major programs in health and education in case greater amount of resources is made available. In fact, most of these programs are scalable, such as immunization, where higher targets can be set if additional resources are provided.

Mr. President,

Let me put on record the unflinching support and untiring guidance that you have personally provided to process of strategy formulation in the field of human development. It is also you personal interest that has motivated a group of highly accomplished expatriate Pakistanis to voluntary work for human development.

We all understand that your commitment to human development flows from your deeply held belief that social justice lies at the core of civil order and human progress. This is a cherished value of our Islamic heritage, and it was for this reason that on numerous occasions Quaid -e-Azam Muhammad Ali Jinnah had exhorted the nation that it must create conditions of social justice in the society for its stability and progress.

While underscoring the significance and centrality of State in achieving social ideals, on the occasion of opening the Chittagong Port, the Quaid had said:

“Only through our State] would it be possible for us to realize the great ideals of human progress of s ocial justice, equality and fraternity, which on the one hand constitute the basic causes of the birth of Pakistan and also the limitless possibilities of evolving an ideal social structure in Pakistan.” 90

Our state is now fully matured. However, the ideals that the Quaid had set for us remain to be achieved. I earnestly hope that Human Development Forum would be a watershed in establishing a strong partnership between Pakistan and its development partners that would allow us to make a major leap forward in improving the overall state of social indicators.

Thank you.

ANNEXURE III

Inaugural Speech by the Chairperson of the Social Sector Co-ordination Committee of the Cabinet and Co-chair of the Pakistan Human Development Forum (PHDF) January 24, 2002

1. Today we meet for sharing experiences and strategies confirming yet again OUR convergence in conceptualization of human development. I believe that strong societies lead to strong states and not vice versa. There has been a presence of two simultaneous trends pertinent to our deliberation: 1) The focus on economic development in Pakistan has been driven by an excessive reliance on economic growth without adequate attention to the condition of human resources; as a matter of fact economic growth is a means and not an end; and 2) The unparalleled rise of the citizen sector confirmed by its robust examples of good practice in social sectors and substantive philanthropy equivalent to Rs. 70 billion or 2.2 per cent of GNP1 (AKF 2000). This gives us hope and a basis for alternative thinking. The logic of citizens first, has been by passed in favour of the Prince and the Merchant. The flawed logic minus the citizen has disabled both the Prince or the State, as well as the Merchant or the market. The challenge for this forum is to revisit facts and figures cast in people-centered perspectives, as a non-negotiable moral minimum.

2. From the Pakistan Development Forum in 2001 to the Pakistan Human development Forum 2002, we have undergone extra-ordinary transitions. We have crossed over from SAP to post SAP period; from pre-devolution to post devolution; from pre-September 11, 2001 to post September 11; from fundamentalist to a humanist progressive Islam; and from a prolonged Afghan crises to social and economic reconstruction of Afghanistan, in which Pakistan continues to be a frontline state. These transitions need to be underscored. To the Human Development Forum we will be presenting fundamental propositions for the uplift of the social structure. As we embark on a new social contract, work undertaken during the last two years has to be factored as a period of intense consultations, honest assessments of baselines, rethinking systems and redesigning governance, policies and plans. Some hard facts need to be confronted.

3. Ladies and Gentlemen the Pakistan Human Development Forum is placed within the framework of poverty alleviation and the Interim-Poverty Reduction Strategy Paper (I-PRSP). Conservatively speaking, 32 percent of our population lives below the poverty line. The figure rises up to 48 percent if we factor in the multi-dimensional definition of poverty leading to deprivation and social exclusion. As basic entitlements are withheld from citizens, their support to the state and society becomes fragile. Poverty has an absolute core and anywhere in the world poverty breeds extremism, carrying high social and economic costs. As the chairperson of the Social Sector Co-ordination Committee of the Cabinet, I want to share with you profiles of the social sectors.

1 Pakistan Human Development Forum : Inaugural Session January 24, 2002 92

4. On the population front, the good news is that there is a demographic transition with fertility rates falling. The population growth rate has fallen from 3.1% to 2.1%, and the Total Fertility Rate (TFR) from 5.6 births in 1994/5 to 4.8 births in 2001, (NIPS 2001). This is greater than the decline experienced in the previous two decades. We must have done something right, but now we can do better than this. The awareness and demand for contraceptives is increasing, requiring better outreach to bridge the practice gap through improved supply and efficient methods of distribution. The hard fact remains that in the next 33 years, our population will double from 142 million to 284 million! There has been a shift in our vision from family planning to reproductive health, reduction in fertility and improvement in the health of mothers through reduction of Maternal Mortality Rate (MMR).

5. Our current challenge is management of a large population between the ages of 5-19 years estimated at 39 percent, and a growing older population. The government has to plan for a co-coordinated policy to ensure that these bulges do not become a source of burden on a tight resource base but can lead to prosperity, through effective programs. We believe, human resource could be turned into economic and social assets. A major cause for high population growth rate is due to low female education. Rising female literacy, leads to delay in marriage, smaller family size and women’s economic productivity.

6. Health, water supply and sanitation are interconnected. Over 80 percent of communicable diseases are water borne and linked to sanitation and water supply issues. In Pakistan the burden of disease attributable to communicable diseases is 38 percent. Fifty percent population has no toilet facility at the household level and one third do not have any sanitation disposal system. Almost 63 percent of households do not have the facility of garbage collection. Five percent have access to municipal services. Almost 47 percent urban, and 26 percent rural households rely on a private garbage collection service.

7. The cost of burden of disease on households has risen from Rs.1770 per annum in 1996/97 to Rs.3,540 in 1998/9. Poverty and disease are spiraling. People are using private sector facilities in greater numbers, from 65% in 1996/97 to 78% in 1998/99. Yes Infant Mortality Rate has been reduced from 100 to 89 per thousand in the past decade and maternal mortality rate (MMR) is 400 per 100,000. But this is insufficient keeping in mind high costs of disease for the poor. Service delivery problems remain pervasive with insufficient and mismatched human and physical resources at the primary, secondary and tertiary levels. There are only 0.3 dentists, 0.6 LHVs, 2.1 nurses and 6.7 doctors for every 10,000 households. A new vision, sensible strategies and improved targets have been factored in the health sector reforms, focusing on primary health care as the major challenge.

8. Whilst private sector and NGOs are making up for the supply gap, there is evidence of uneven quality of supply, which requires regulation for assured service to the public. Capacity and knowledge gaps plague both public and private sectors, to which citizens become hostage in their fight for survival.

9. The combined public sector spending on health, population and water supply and sanitation is 1 percent of GDP, which is clearly sub-optimal. Bottlenecks in improved health, include poverty and low education especially of women, poor sanitation and high levels of environmental pollution.

10. The common factor in population, health, sanitation and poverty is that of illiteracy, particularly of girls and women. This fact point towards the unequivocal multi-sectoral significance of the education sector. Almost 34 percent of the age group 5-9 is out of school, and this figure rises to 57 percent, depending if we are using EMIS or PIHS data sources. Reliable data is critical to social sector planning. The lack of credible data remains an unresolved area which must be focused as a starting point, with improved co-ordination between PIHS, NEMIS at the federal or EMIS at the provincial levels.

11. Our literacy level is 49 percent, with vast variation in women’s literacy, from 1.7% in rural Balochistan to 56.7% in urban Sindh. The impact of low literacy rates of women has been highlighted in the analyses of all social sectors.

12. We have worked exclusively in public sector, without giving attention to municipal facilities, non-elite education options, and the madrassahs. Ladies and Gentlemen, we have not only confronted the exclusion but also taken bold steps to correct the anomaly. A focus on primary education at the expense of all other sectors made us prisoners of imagined high rates of returns. This needs correction, especially with a larger young population demanding transition from primary to secondary levels. The premise of rates of returns needs to be supplemented by a more holistic approach which integrates economic and non-economic human values. Curriculum relevance, competencies and reliable assessment systems have become the achillies heal for quality. None of these can be addressed without function budgets and efficient financing mechanisms. Allocations reveal a downward trend, which have been rec orded to be as low as 2.06 percent, with expenditure levels even lower.

13. The Ministries of Finance and Planning have mobilized additional funds in the Public Sector Development Programme (PSDP) 2001-2002 for Education Reform Action Plan (ESR) 2001-2004. The ESR has evolved through consensus to counter skewed attention only towards primary and elementary education. A consideration of all sub-sectors and partners supplementing government efforts was long over due. The Government of Pakistan has adopted a sector wide approach set within the macro framework including secondary, technical, higher and madrassah education.

14. Public private partnership is both a thrust area and an anchor strategy of the ESR. It is built upon the conservative estimate of 25 percent provision of education by the private and NGO sectors. A rationalization is needed of who can do what at different levels of the education spectrum as a multi-sectoral pre-requisite. Resource base can be widened with an inclusive approach between sectors and with partners. Estimation of the financing gap and its mobilization is being undertaken vigorously. This includes, national efforts as well as a strategic presence at international forums. The Ministry of Education has been active in participating at the High Level Group Meeting on Education For All (EFA) in Paris last October, 2001, Beijing in August 2001, and at the upcoming ECOSOC meetings on Education and Development in 94

February 2002, where only five ministers have been invited from all over the world. Resources for EFA have been promised by the G-8 countries. Work is in progress by the recently constituted G-8 Taskforce on EFA. Debt swaps and debt relief for social sectors have moved from promise to reality.

15. The facts and figures across social sectors provide us with the raw data of inequity and inefficiency. The challenge for Pakistan has been to build a case for equity, entitlements and social inclusion, on the basis of these hard facts. The Interim – Poverty Reduction Strategy (I-PRSP) is a nationally owned strategy, influenced by inputs of all social sectors. It is an outcome of analyses, questions and challenges, seeking alliances for remedies within government and civil society.

16. District based planning is the emergent framework for all programmes and budgeting for social sector as envisaged in the Local Government Plan. This framework must be factored in our deliberations. The Ministry of Education has initiated a series of dialogues with district teams comprising Nazims, DCOs, EDOs and CSOs as lead partners in development. Pertinent issues on capacity, match between responsibility and authority, mechanisms for civil society participation have been raised in the dialogues, which need attention. 100 per cent ESR funds have been transferred through the provinces to the district governments for addressing the implementation gap. The breakthrough in women’s participation in politics and presence in local government with 33 percent seats is another milestone in mobilization for gender and development. Electoral reforms are evolving on the principle of inclusion.

17. Accountability, transparency and people-centered planning are the pillars of the devolution process. The accountability machinery has been in place to identify misuse of auth ority and resources, where there have been no exemptions for senior or junior officers, and even politicians.

18. Ladies and Gentlemen, it is important to remind ourselves of our collective institutional memory regarding formulation of past development paradigms and our development errors. We have been partners for a long time and have shared many large scale projects. We have moved from project modernity and functional inequality in the 60s, to project nationalization and Islamization in the 70s and 80s, and finally Social Action Program project I & II in the 90s. Whilst the first hypothesized pre -requisites for take off and sustained economic growth, which would lead to trickle down to people in which the fittest could survive, the second had assumed characteristics of a supra -state which could empower people through ideological prisms. The first two represent a world which was operating under the cold was syndrome. The third mega project, concurrent with globalization, was SAP I & II. It was designed to correct development deficits of the past through a design which was supposedly fool proof against human flaws and indigenous variations. The design logic was convincingly undertaken by government and donors, but in its implementation, access was virtually blocked through a cumbersome maize of procedures and monitoring regimes. Whilst evaluation reports and AG objections piled high, ownership and implementation lagged. Governance became intractable, simple logic and local flexibility fell prey to the altars of precise standardized guidelines, but minus the human element.

19. Its most graphic illustrations were the setting up of the School Management Committees to undertake repairs and maintenance as surrogates for local governance and the Participatory Development Program (PDP) I & II to mobilize civil society for improved service delivery. PDP over-estimated capacity of Civil Society Organization (CSOs) and relied on non-participatory screening mechanism, whilst PDP II went overboard in designing mechanisms to disburse US$45 million. Tools were designed, beautiful formats developed, people trained, workshops held, proposals invited, vetting committees formed, but not a single penny could be disbursed. PDP II was abandoned and eventually SAP II had to meet the same fate reporting slides in social sector rather than expected strides. We are not here to critique SAP alone, but to move forward on the basis of lessons learnt and recent home grown design for social sector development. As social sector targets bec ame elusive, the governance challenge widened for the present government. Staff absenteeism in all social sectors increased.

20. September 11 and its after math has become a painful leveler for humanity. Reactions to the tragedy for humanity were both expected, and most unexpected. Inspite of stipulated institutional benchmarks for multi-culturalism in the first world, rhetoric gave way to spontaneous reactions of people, which were divisive, seeking divides across religion and region. A schizonphrenic response was seen against terror. Bombs and bread were dropped simultaneously on Afghanistan. The US ambassador to Pakistan could not help but take the costs of each daisy cutter and cluster bomb, which could have educated thousands of children, women and men, but the cause demanded otherwise. It is ironical that at the dawn of a new millennium, it took a war to remind us that social sector development was needed in Pakistan. However, the global divide between haves and have-nots continues unabated; 20 percent people have access to 80 percent resources.

21. The exercise of the coming three days will be a rich one of reflection and action, building on concrete and holistic approaches to address social exclusion. We the Government of Pakistan and its partners want to share initiatives undertaken thus far with increasing coherence, commitment and an unprecedented political will, which should form a firm basis for our commitment towards social sector development. The state must become effective and is redefining its elf in light of emerging social and human realities. Its role, is sometimes of a development broker and facilitator, sometimes an arranger and at times a provider. Each segment of the three days will illustrate how the delivery gap is being addressed, and what are the issues which need to be highlighted during this mutual consultation.

22. For Pakistan, the focus is a specific one. We have been dealing with social sectors through multiple approaches, viz. poverty reduction, economic and social sector reforms, devolution and the accountability processes. Our markers for future work comprise an intelligent interface with the following:

· The malaise of centralization is being corrected through devolution at the district level. However, it must be matched by decentralization at the provincial and federal levels, so that the objectives of subsidiarity may be achieved. Equity is critical and requires an intelligent focus on governance where decentralization is a means, and not an end. In some districts there

may be a need to pool in provincial and federal resources to ensure that rights are being addressed competently without any implementation gaps. · Personnel recruitment and performance policies need to be reviewed for practical reforms which can be institutionalized at local levels, with adequate incentives and accountability measures. · Co-ordination between and within departments has become critical. Inter- sectoral linkages between population, health, drinking water, sanitation, environment and education has bec ome indispensable. · Financing must be aligned to the policy shifts as must the new financing methods and tools so that fiscal space is created through devolved mechanisms for resource transfers which are outcome based. (Some of these initiatives will be shared). · Capacity building needs must be addressed creatively and effectively through public and private partners adopting a mix of decentralized and centralized approaches; building on materials available and good practice, through a systematic approach. · Flexibility is required, especially for systems in transition at the political, social and economic levels. · Mobilization of partners through suitable operational mechanisms is critical as government cannot achieve the targets alone. This is sharing and not abdication of the state’s responsibility for social sectors. The President’s Task Force on Human Development comprising of expatriate Pakistanis has been mobilized for this purpose in integrated human development. · Quality to support service delivery remains the central challenge for which adequate monitoring and information-based planning need to be in place, without delay. · Mainstreaming the Madrassahs, not just for education but also for health, nutrition and gender issues.

23. Let us deliberate collectively on the design and implementation strategies. Let us pool our knowledge systems and emergent technologies to improve on what we have; change what has not worked; and implement through a participatory manner to achieve targets which make practical and measurable difference to the lives of people. Texts and words have lost credibility among people. Let us act NOW, and act together as partners for global peace and development. Let us embrace the company of doers and achievers, who want to walk the talk.

Human development is the anchor of my economic revival policy which will focus on education, health and poverty alleviation.

President of Pakistan, January 19, 2002

ANNEXURE IV

Speech by the RT Hon Clare Short MP Pakistan Human Development Forum January 24, 2002

A Better Future for Pakistan: Poverty Reduction and Human Development

It is a great pleasure for me to be back in Pakistan and I am very honoured that you have asked me to contribute alongside such distinguished speakers.

I have a longstanding interest in Pakistan. Many families in my parliamentary constituency are originally from here and continue to maintain their links with family and friends. They often express their concerns about poverty and corruption back home. I have also seen their hopes and subsequent disappointment with the recent series of governments.

Following the coup in October 1999, the UK Government decided that we should put our development work on hold and observe closely what kind of regime had taken over. I was very conscious that since Independence, the people of Pakistan had been seriously let down by bad governance, poor economic management and corruption – and that this in turn had let Pakistan to make limited progress in the reduction of poverty. But early on, there were clear signs that your Government was committed to a crackdown on corruption, responsible economic management, pro- poor policy and a transition to genuine democracy; and there has been good progress since. But we all know that the transition to effective democracy and sustainable development in Pakistan is an enormous challenge, and that there will be many tough choices and obstacles along the away. But we know, too, that Pakistan may not get a better chance. Now is the moment, to break with the failed policies of the past, to build a new inclusive democracy, and to drive through a far- reaching reform agenda to reduce poverty. This is not just an agenda for economic reform; political and social reform are equally vital. Giving the poor a more effective political voice and investing in human development will drive sustained economic growth and development. This is a truly historic opportunity for Pakistan; all who care for its people and their future should work hard to ensure that this trans ition is successful. With the right policies and support from international community I believe that Pakistan can make this transition and offer a better future to its people.

But success this time means learning from the mistakes and missed opportunities of the past. There were similar hopes for a new era at the beginning of the 1990s. Aspirations for the future of the country internally and externally were huge. Commitments were made to reform public services, to reach out to the poor, generate livelihoods, respect human rights and attract inward investment and economic growth. Morale was high and success seemed to be on the horizon. But these hopes and promises were dashed. As you know, from 1988 to 2000 four successive governments failed in their democratic responsibilities.

The price of this failure has been high. A decade of political instability in turn generated economic instability. As a result, annual GDP growth in the 1990s averaged 4% compared to 6.2% in the 1980s, and poverty increased to the extent that almost a third of Pakistanis today live on less than $1 a day.

Between 1997 and 2000, per capita expenditures on health and education under the Social Action Programme declined by more than 10%. Inevitably public services declined. Poor people suffered the most. Elementary School enrollment rates have largely stagnated. Health has fared slightly better, but infant mortality is declining only slowly and maternal mortality hardly at all. People in poor rural areas and poor urban neighbourhoods have been largely failed by both the public and the private sectors.

For Pakistan, in terms of human development and poverty reduction, the 1990s were a lost decade. This is the sorry legacy with which your Government is grappling. But we know that real progress is possible.

Your Government has set out an ambitious reform agenda and the UK Government and other members of the international community are committed to supporting this process of reform.

We know that for poverty to be reduced, there has to be faster and more inclusive economic growth. The reforms that have been introduced to encourage increased investment – both domestic and foreign – must be carried forward. That includes tougher action on corruption.

However, faster growth alone will not reduce poverty. Pakistan will also need to invest more in education and healthcare. In our globalising world, where information technology is driving change and development, investment in human capital delivers high returns. In the field of education, the evidence is clear that investment in universal primary education, with a special effort to include girls, is the single most important investment in development that any country can make. Girls that have been to school transform their country as they grow up. They tend to marry later and have fewer children who are more likely to live. They help increase household income and in turn they insist on access to education and healthcare for their own children.

Similarly with healthcare, it used to be assumed that better healthcare was highly desirable but that the first priority was economic growth in order to pay for it. This is wrong. The poor are not a static group of people. They work enormously hard and often manage to lift themselves out of poverty but ill health constantly throws them back. Frequently the breadwinner becomes sick and therefore cannot work, or a child is sick and families sell what they have and borrow what they cannot afford to obtain medical care, throwing themselves into deeper poverty.

The report of the Commission on Macroeconomics and Health commissioned by the World Health Organization and led by Jeffrey Sachs of Harvard has demonstrated 99 that investing relatively small amounts - $30 per head – to put in pla ce basic healthcare systems not only saves lives but also produces enormous economic gains.

This is not just academic theory; we know it works in practice. Take the experience of the East Asian economies. These countries achieved a faster reduction in poverty for a larger number of people than has ever previously been achieved in history. The reform that delivered this was both economic and social. Economic policies to attract inward investment, but also investment in health and education – the nation’s human capital – to increase productivity and growth.

By investing in its human capital, Pakistan too can make major progress in poverty reduction and development. And by creating hope for ordinary people, this will also support the Government’s objectives of building a more tolerant, open and democratic society.

Achieving progress in human development requires political will and commitment at every level of government. In many respects, this has been the biggest failing in Pakistan over recent decades. Without such a commitment, the pledges set out in the Poverty Reduction Strategy Paper will not be delivered. At the Pakistan Development Forum last March, Government and donors focused on the need to move beyond policy to implementation. I am greatly encouraged by the progress that you have made since then despite difficulties created by the drought and more recently the war in Afghanistan. Pakistan’s first ever completion of an agreement with the IMF is a very significant milestone and a symbol of the seriousness of your commitment to the reform process.

But enormous challenges lie ahead particularly in the social sectors. Strong and committed government action is required to respond to the needs of ordinary people for education, life skills, health, water, sanitation, livelihoods, security, and rights.

At the national level, the Government has already charted a timetable for political reform. Local elections have taken place – with one third of the seats reserved for women. This is also an important achievement and you are heading towards parliamentary elections in October 2002. You have set out an agenda to reform political parties, strengthen elected assemblies and the Senate, and provide greater freedom of information. This will help to improve the accountability of the political system and to give poor people a more effective voice to safe guard their interests. This is essential if Pakistan is to sustain the economic and social reforms necessary for growth and poverty reduction.

At the local level, devolution offers a unique opportunity – perhaps a once in a generation opportunity – to build a relationship of trust between government and citizen that has been so lacking in Pakistan. For the first time in many years, people will be able to hold government directly accountable for the services they receive, through the mechanisms created by devolution and ultimately through the sanction of the ballot box. Government – whether at district, provincial or federal level – must value and nurture this accountability.

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People should know in clear terms the minimum standards they can expect from their schools, from their health providers and from their water and sanitation authorities. They should be informed about the money that has been provided and the way it is being spent. They should be empowered to demand their rights. Above all, the voices of the poor need to be heard.

It is important that the expectations created by devolution are not disappointed. Government needs to strengthen its capacity to deliver services. Fulfilling the objectives of the Poverty Reduction Strategy will require a campaign of action that gives provinces and districts both adequate resources and the capacity and authority to implement agreed policy.

The interim PRSP and the recently agreed programme with the IMF map a provisional path for poverty reduction, and spending to support social services. I understand that further work is underway to refine the analysis underpinning the PRSP; but our preliminary work indic ates that the current spending projections are unlikely to be sufficient to achieve social sector targets. I welcome the higher poverty related expenditure in recent budgets, but greater fiscal resources are likely to be required. The Government and donors need to work together to agree how to increase resources to support social spending. On the Government side, this may include increasing tax revenue, and the reallocation of resources by reducing the debt burden and cutting expenditure on non-priority areas.

And resources that are allocated must be spent. Between 1997 and 2000, only 72% of what was budgeted for basic education was actually spent. Looking within the education budget, non-salary components fared even worse. There is a similar picture for health. We should not delude ourselves over the impact of cutting expenditure in this way. This has major adverse impact on the lives of the poor.

But, as you know, the public sector reform agenda is not just about resources. There is also an urgent need for institutional reform. Transforming the bureaucracy into a true “public service”, oriented towards serving the citizens of Pakistan, is a fundamental challenge.

Obviously the unresolved conflict over Kashmir could endanger progress. We must all work for a peaceful resolution of the dispute that improves the life of all the people of Kashmir and reduces defense spending in both countries so that greater progress can be made in reducing poverty.

Addressing these issues may be difficult, but the potential dividends are obviously enormous. More teachers in school, better motivated, trained and equipped to do their job; effective water and sanitation systems; and health staff committed to their work in decent buildings with essential drugs and other equipment.

In Pakistan, the private sector has come to play an important part in education and health. This does not mean that the public sector can withdraw and leave education and health to the private sector; but rather that there is a strong basis for partnership between the public and private sector to help the Government meet its responsibility for delivering basic services. I know that such models are being developed in education, for example in allowing NGOs and communities to use government 101 primary schools to provide middle and secondary education; and in health, for example under the national TB control programme. Such examples should be encouraged and nurtured. However, for partnership to work, there needs to be a clear understanding of what the respective roles and capacities are, with regulation where appropriate to ensure quality of service. We should regard the private sector as partners and innovators.

Finally, I want to turn to the role of donors, including the UK, in supporting your reform agenda. The decade of the 90s that began with such promise also began with a campaign to revive the social sectors – the Social Action Programme. This campaign had noble objectives; to increase access to education, health and rural water and sanitation, particularly for the poor. But in a decade of interrupted political processes, failing governments and economic decline it is hardly surprising that the campaign had limited impact. Government became disheartened. And donors became frustrated. And too many people are still waiting and wanting for basic services.

Today, donors as well as government need to learn the lessons. New targets for the social services have now been set in the interim PRSP. These sector objectives and plans are being refined further and need to be costed realistically. Donors and Government need to find new mechanisms and instruments to support different tiers and functions of government to reach these targets.

Pakistan needs a set of donors who work well together. We should stand ready to rally around a single plan, to offer our commitment for the long-term, to build up the capacity of Pakistan’s own institutions and to work together more collaboratively than in the past. This means sharing information, trusting each other’s work, pooling funds, and working with common procedures. The UK Government is committed to such collaboration and is keen to work with others who share these aims.

I have spoken today in candid terms. As a friend of Pakistan – a friend that is committed to work with you to reduce poverty and give the people the chance of a better future. You and I both know that this is a long-term agenda. Entrenching a genuine democracy, growing the economy, rooting out corruption and expanding and improving education, healthcare, water and sanitation will not be achieved overnight. But it can be done if there is political will. It is imperative for the future of Pakistan that this time we succeed.

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ANNEXURE-V

Statement by Dr. Ahmad Mohamed Ali President Islamic Development Bank (IDB)

Hohorable President of the Islamic Republic of Pakistan, H.E. Mr. Shaukat Aziz, the Minister for Finance, H.E. Ms. Zobaida Jalal, the Minister of Education, Honorable Mr. Abdul Sattar Edhi, H.E. Ms. Clare Short, Secretary of State for the Department for International Development of the United Kingdom, Excellencies the Ministers, distinguished brothers and sisters.

Assalamu’alaikum wa rahmatullah wa barakatuh.

The Islamic Development Bank warmly welcomes the opportunity to participate in the meeting of the Pakistan Human Development Forum and looks forward to interact closely with the members of the civil society in Pakistan, the Government, and other international partners in the development of Pakistan.

This Forum, as we all know, is a major milestone on the road to developing a consensus on the ways and means to address the daunting challenges of developing a pro-poor economic policy framework ultimately leading to appreciable and sustainable reduction of poverty in Pakistan.

Today, in this august gathering, we are participating in the process of developing a consensus on the setting of social and economic priorities for the people of Pakistan over the medium term. The Islamic Development Bank commends the Government of Pakistan for taking this initiative of consultation with the members of civil society, district and provincial governments, and the international development community.

Human development as a universally recognized development objective is the core of Islamic teachings. The teachings of Holy Quran and the Sunnah of our Prophet (SAW) aim at developing all aspects of human life with a view to create harmonious and equitable social environment. Towards these ends, Prophet Mohammad (SAW) taught us not only in saying but also in deed the recognition of education as means for attaining human development. The Prophet (SAW) emphasis placed on education is best exemplified by the policy adopted to deal with prisoners of war of Badr. The Prophet (SAW), despite the dire need of the State at that time for cash, offered to free any one of the prisoners of war who could teach ten children of Madinah to read and write in lieu of paying financial redemption. This was an unprecedented example to emphasize the role of education in human development. Similarly, an obligatory system of Zakat collection and distribution has been instituted for the poor and the needy with a view to ensuring that basic human needs are satisfied leading to significant contribution to human development.

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The implementation of Islamic system of social justice in the modern state requires the setting of a number of institutions, both public and NGOs, that are inclusive and lead to a broad-based consensus on the setting of social and developmental priorities. In an Islamic society, the most basic requirement for delivering social justice to people is to at least remove the causes of extreme forms of poverty. This requires developing strategies for resource allocations in key social sectors, such as education, health as well as organizing a Zakat collection and distribution system to assist the most vulnerable and the needy segments of the society.

Human Development is the foundation for political progress and economic advancement. It is also the most effective way for narrowing the gap between the haves and have-not at the national level but also at the international level. Progress in human development is essential to face the challenges facing Pakistan at the regional and global levels. Pakistan is an important and leading member of the Organization of Islamic Conference and as such it has great responsibility towards the Ummah. In this context, the Pakistan Poverty Reduction Strategy is essential to fulfill this responsibility and obligation.

The Pakistan’s Poverty Reduction Strategy will play a pivotal role in galvanizing the different structures of the Pakistani state – the Federal government, provincial and district governments, and further down – to implement a viable human development program. The Poverty Reduction Strategy rightly stresses four major thrust areas (i), Good governance through devolution of power plan to induce greater citizen participation, (ii). Creating income generating opportunities through asset creation in the form of housing for the poor, land for landless farmers, improving access to micro credit, etc. (iii). Improving human development indicators in the areas of education, health , water supply and sanitation, and (iv). Reducing the vulnerability of the poor to shocks through better targeted Zakah distribution system, food support program, and various social interventions aimed at generating economic activity through public works program. In this context, it is the duty of all stakeholders in the economic development of Pakistan to demonstrate their commitment by actively participating in the design and implementation of a viable and all encompassing poverty reduction program.

Honorable President of the Islamic Republic of Pakistan, Excellencies the Ministers, distinguished ladies and gentlemen.

In the past, Pakistan demonstrated the capacity and determination to address challenges at both the regional and global levels. Pakistan stood firm beside the people of Afghanistan when the communist forces invaded Afghanistan. The Pakistan people gave full support to their Afghan brethren in that struggle. The victory against the communist was not only victory for Afghanistan and Pakistan but it was a victory for all freedom-loving people all over the world.

During the last twenty-two years Pakistan followed the true tradition of the “Ansars” of Madinah by hosting over 3 million Afghan refugees. Despite the present economic difficulties, Pakistan announced in the true Islamic brotherhood spirit a contribution of $100 million during the Tokyo Conference convened this week to discuss the reconstruction of Afghanistan. 104

Honorable President of the Islamic Republic of Pakistan, Excellencies the Ministers, distinguished brothers and sisters

The Islamic Development Bank has worked closely with the people of Pakistan in supporting their various social uplift initiatives and economic endeavors. IDB also encourages promotion of trade between Pakistan and other member countries of IDB. Since the first project was approved for Pakistan in 1977, the total IDB financing amounted to about US$3 billion through various modes of financing to finance 37 development projects, eight special assistance operations, and 154 trade operations.

Some examples of IDB’s participation in the area of human development in Pakistan are National University of Science and Technology, Hub Dam Water Supply, Rawal Pindi Medical College, Greater Hyderabad Sewerage, GIK Institute of Engineering and Technology, Mansehrah Village and Bhawalpur rural development projects, and a number of operations in the Afghan refugee camps in Pakistan.

Today in this august gathering, the Islamic Development Bank pledges its full support to the goals and objectives of Pakistan’s poverty reduction and human development program. In this regard, the IDB would like to actively participate in the financing of various projects and in strengthening of existing institutions and developing new institutions.

In conclusion, the IBD lauds the effort of the Government of Pakistan to organize the meeting of this Forum and we pray to Allah SWT that the outcome of our deliberations provide us with a clear and better understanding of the challenges and opportunities faced by our brothers and sisters in Pakistan. I hope that all the participants and stakeholders will be able to distill the role each of us can best play in the development of the people of Pakistan.

Thank you.

Assalamu’alaikum wa rahmatullah wa barakatuk.

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ANNEXURE-VI

List of Participants Pakistan Human Development Forum, Islamabad January 24-26, 2002

Federal Cabinet Minister 1. Mr.Shaukat Aziz, Minister for Finance & Economic Affairs 2. Ms. Zobaida Jalal, Minister for Education 3. Dr. Abdul Malik Kasi, Minister for Health 4. Dr. Attiya Inayatullah, Minister for Population Welfare & Women Development 5. Mr. Mahmood Ahmad Ghazi, Minister for Religious Affairs, Zakat & Ushr

Dignitaries with the status of Minister/Minister of State 6. Lt.Gen. (Retd.) S. Tanwir H. Naqvi, Chairman, National Reconstruction Bureau 7. Dr. Shahid Amjad Chaudhry, Deputy Chairman, Planning Commission 8. Mr. Mueen Afzal, Secretary General, Finance & Economic Affairs 9. Dr. Ishrat Hussain, Governor, State Bank of Pakistan 10. Dr. Nasim Ashraf, Team Leader, President Task Force on Human Development

Federal Secretaries 11. Mr. Javed Masud, Cabinet Division 12. Mr. Tariq Aziz, Chief Executive Secretariat 13. Mr. Nawid Ahsan, Economic Affairs Division 14. Mr. Tariq Farook, Ministry of Education 15. Mr. Javed Zafar, Ministry of Environment, Local Govt. & Rural Development 16. Mr. Younis Khan, Ministry of Finance 17. Mr. Inam-ul Haq, Secretary, Ministry of Foreign Affairs 18. Mr. Ejaz Rahim, Ministry of Health 19. Mr. S.Anwar Mahmood, Ministry of Information 20. Dr. Mutawakkil Kazi, Secretary, Planning & Development Division 21. Mr. Tariq Janjua, Population Welfare Division 22. Mr. Jamil Ahmad Bhutto, Ministry of Religious Affairs, Zakat & Ushr 23. Dr. Perveen Qadir Agha, Women Development & Special Education

Government Officials 24. Mr. Nusratullah Khan, Senior Joint Secretary, Religious Affairs 25. Maj. Gen. ® Mohammad Aslam, Director General, Ministry of Health 26. Prof. M. Hayat Zafar. President, Pakistan Medical & Dental Council, Ministry of Health 27. Dr. Sultan Farooqui, President, College of Physician & Surgeon of Pakistan, Ministry of Health 28. Mr. Matiullah Khan, Sr. Joint Secretary, Ministry of Health, Islamabad. 29. Dr. Athar Saeed Dil, Executive Director, NIH, Islamabad 30. Dr Fazal Hakim Mian, Ministry of Health 106

31. Ms. Tasleem Akhtar, Chairperson, Pakistan Medical Research Council, Islamabad. 32. Ms. Shaheen Masood, Project Director, Women Health Project, Ministry of Health 33. Mr. Azhar Saeed Malik, Deputy Project Director, Ministry of Health 34. Mr. Maqbool Ahmad Khakwani, Joint Education Advisor, Ministry of Education 35. Ms. Baela Raza Jamil, Technical Advisor, Ministry of Education 36. Dr Khalid Hassan Bokhari, Consultant ESR, Ministry of Education 37. Col. Anwar Adil, Staff Officer to Minister, Ministry of Education 38. Mr. M. Ibrahim Khan, Joint Education Advisor, Ministry Education 39. Dr. S. Irshad Hussain Tirmazi, Joint Education Advisor, Ministry of Education 40. Mr. Najmuddin Mangrio, Joint Education Advisor, Ministry of Education 41. Dr. Haroona Jatoi, Joint Education Advisor, Ministry of Education 42. Mr. Said Ghulam, ESR, Ministry of Education 43. Dr. Saleem, EFA Wing, Ministry of Education 44. Mr. Shahab Khawaja, A.S., Ministry of Population Welfare 45. Dr Waqar Masood, Ministry of Finance 46. Mr.Javed Sadiq Malik, Additional Secretary (EF), Ministry of Finance 47. Dr. Ashfaq Hasan Khan, Economic Adviser, Ministry of Finance 48. Mr. Mushtaq Malik, Joint Secretary (EF), Ministry of Finance 49. Mr. Ansar Hussain Shamsi, AS, Ministry of Finance 50. Raja Raza Arshad, Deputy Director General (Coordination), Ministry of Finance 51. Mr. I. N. Abbasi, Director General (Publicity), Ministry of Finance 52. Mr. Muhammad Hasan, Protocol Officer, Ministry of Finance 53. Mr. Nayyar Agha, A.S., Economic Affairs Division 54. Mr. Arif Azim, Joint Secretary, Economic Affairs Division 55. Mr. Ahmad Jawad, Joint Secretary, Economic Affairs Division 56. Dr. Parvez Tahir, Chief Economist, Planning & Development Division 57. Dr. M. Aslam Khan, Chief, Poverty Alleviation, Planning & Development Division 58. Dr. Mushtaq A. Khan, Member, Planning & Development Division 59. Sheikh Murtaza Ahmed, Special Assistant to Deputy Chairman, Planning Commission 60. Dr. A.R. Kemal, Pakistan Institute of Development Economics 61. Brig. (Retd) Muhammad Sarfaraz, Managing Director, Baitul Mal 62. Mr. M. Younas Khan, Chairman, National Council of Social Welfare 63. Mrs. Sadia Mohsin, Member, Special Edu. Action Committee, Women Dev. & Social Welfare 64. Mr. Majid Mufti, Chairman, National Senior Citizen’s Task Force 65. Mr. Tariq Mustafa, Chairperson, Special Education Action Committee 66. Mr. Shaukat N. Tahir, Ministry of Women Development, Social Welfare & Special Education 67. Dr. Nuzhat, Karachi University, AERC

Members, Task Force on Higher Education 68. Syed Babar Ali, Pro Chancellor, Lahore University of Management Sciences 69. Capt. U.A.G. Isani, Vice Chancellor, Quaid-i-Azam University 70. Dr. Najma Najam, Vice Chancellor, Fatima Jinnah Women University 107

71. Dr. Zulfiqar H. Gillani, Vice Chancellor, University of Peshawar 72. Justice (Retd) M.A. Rasheed, Vice Chancellor, University of Balochistan 73. Dr. Zafar Saied Saifee, Vice Chancellor, University of Karachi 74. Dr. Qasim Mehdi, Director General 75. Mr. Mazhar-ul-Haq Siddiqui, Vice Chancellor, University of Sindh, Jamshoro 76. Dr. Qamar Valani, Rector, Agha Khan University, Karachi 77. Mr. Hunaid Lakhani, Chancellor, Iqra University, Karachi 78. Dr. Arif Ali Zaidi, Associate Dean, Agha Khan University, Karachi

Members of Education Advisory Board 79. Mr. Lobo, Bishop, Rawalpindi 80. Mrs. Nazneen Najeeb, Principal, Headstart School, Islamabad 81. Prof. Dr. Meera Philbaus, Kinnaird College, Lahore 82. Mr. Zafar Alam 83. Mrs. Sultana Baloch, Director, Provincial Institute for Teachers Education, Quetta 84. Ms. Robina Khilji, Associate Professor of English, Jinnah College, Peshawar

Members, Task Force on Human Development 85. Dr. Musadik M. Malik 86. Dr. Moazam Khalil 87. Dr. Naeem uddin Mian 88. Mr. Fazal Hussain 89. Dr. Naheed Qayuyum 90. Dr. Omar Atiq 91. Dr. Attiya Khan 92. Mr. Saqib Khan 93. Mr. Ghani Khan Marwat 94. Dr. Khail Riaz 95. Mr. Shahid Yousaf 96. Dr. Frederick Shaw 97. Ms. Surriya Jabeen 98. Mr. Muhammad Jahanzeb Khan 99. Mr. Shabir Hussain 100. Ms. Aliya Rashid 101. Dr. Salman Syed Naqvi 102. Ms. Rawia Ashraf 103. Mr. Faisal Hamdard 104. Mr. Shuja U. Keen 105. Mr. Shehriar Ashraf 106. Ms. Nadia Khan 107. Ms. Shan Kandawala 108. Ms. Mehr Qayyum 109. Mr. Moeen Raza 110. Dr. Zeenat Anwar 111. Ms. Asila Ashraf 112. Mr. Tariq Maah 113. Mr. Ibrar Syed 114. Mr. Shabir Safdar 115. Mr. Ehsan Mani 108

Provincial Governments

Government of Punjab 116. Mr. Tariq Hamid, Minister for Finance 117. Ms. Shaheen Atiqur Rehman, Minister for Social Welfare 118. Prof (R) Mahmood Ahmad, Minister for Health 119. Mr. Amer Mahmood, District Nazim, Lahore 120. M. Akram Malik , Chairman, Planning & Development Board 121. Mr. Salman Siddiq, Secretary, Department of Finance 122. Mr. Sibtain Fazal Halim, Secretary, Department of Education 123. Mr. Wasim Afzal, Secretary, Department of Health 124. Mr. Tauqir Ahmad, Secretary, Population Welfare Department 125. Mr. Taimur Azmat Osman, Secretary, Department of Social Welfare

Government of NWFP 126. Mr. Farid Rahman, Minister for Finance 127. Mr. Imtiaz Gillani, Minister for Education 128. Mr. Qari Roohullah, Minister for Social Welfare 129. Mr. Humayun Saifullah Khan, District Nazim, Lakki 130. Mr. Abdul Wajid Rana, Additional Chief Secretary, Planning & Development 131. Mr. Arbab M. Shahzad, Secretary, Department of Education 132. Mrs. Rashida Malik, Secretary, Department of Education 133. Mr. Salim Khan, Secretary, Department of Health 134. Mr. Jamil Amjad, Secretary, Social Welfare Department

Government of Sindh 135. Dr. Abdul Hafeez Shaikh, Minister for Finance 136. Prof. Anita Ghulam Ali, Minister for Education 137. Maj Gen (R) Ehsan Ahmed, Minister for Health 138. Justice (R) Abdul Rahman, Minister for Social Welfare 139. Ms. Nafisa Shah, District Nazim, Khairpur 140. Mr. Shahzado Shaikh, Additional Chief Secretary, P&D Department 141. Mr. Fazal ur Rehman, Secretary, Department of Finance 142. Mr. Nazar Hussain Mehar, Secretary, Department of Education 143. Maj. (R) Khalid Latif, Secretary, Department of Health 144. Mr. Ashfaq Hussain Memon, Secretary for Social Welfare

Government of Balochistan 145. Mr. Jalil Khan Dotani, Minister for Finance 146. Mr. Agha Abdul Za hir, Minister for Health 147. Ms. Roshan Bharucha, Minister for Social Welfare 148. Mr. Abdul Rahim Kakar, District Nazim, Quetta 149. Mr. Ahmed Buksh Lehri, Additional Chief Secretary (Dev), P&D Department 150. Mr. Saleem Sethi, Additional Secretary Incharge, Department of Finance 151. Mr. Arshad Bhatti, Secretary, Department of Health 152. Mr. Azmat Hanif Orakzai, Secretary, Social Welfare Department

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Government of AJK 153. Sardar Abdul Rashid, Additional Chief Secretary, Planning & Development Department 154. Secretary, Department of Education 155. Secretary, Department of Finance

Multi-Donor Support Unit 156. Mr. Jahed-ur-Rahman, Chief 157. Mr. Abid A. Mallick, Sr. Program Coordinator 158. Dr. Sameen Siddiqi, Sr. Health Specialist 159. Dr. Tauseef Ahmed, Population & Reproductive Health Advisor 160. Ms. Nargis Sultana, Technical Specialist, Education

Non-Government Sector (Pakistan) 161. Dr. Fauzia Saeed, Action Aid (Pakistan) 162. Mr. Munir Marali, Chief Executive Officer, Agha Khan Development Network 163. Dr. Haneef Ismail, Agha Khan Health Services 164. Mr. Stephen F. Rasmussen, Agha Khan Rural Support Programme 165. Mr. Shamsh Kassim Lakha, President, Agha Khan University & Medical College 166. Dr. Moazzam Khalil, Apna Sehat 167. Mr. Julio Andrews, Country Representative, Asia Foundation 168. Ms. Mehnaz Akbar, Asia Foundation 169. Nigar Ahmad, Aurat Foundation 170. Mrs. Shahida Jaffery Jamali, Balochistan Rural Support Programme 171. Mrs. Nasreen Kasuri, Beacon House School System 172. Begum Akhtar Riazuddin, Behbud Association 173. Chief Executive, Bunyad 174. Mr. S. A. Abidi, Managing Director, Falcon Education 175. Mr. Sohail Ahmad, Chief Executive Officer, Family Planning Association of Pakistan 176. Ms. Khadija Haq, Human Development Center 177. Dr. Sarfaraz Qureshi, Human Development Center 178. Mrs. Bushra Gohar, Human Resource Management & Development 179. Dr. Qurat ul Ain Bakhtheari, Institute for Development Studies & Practice 180. Institute for Education Development 181. Dr. Iffat Farah, Director Policy Studies, Institute for Education Dev., Agha Khan University 182. Dr. Roshaneh Zafar, Kashaf Foundation 183. Mr. Ghalib Nishtar, President, Khushali Bank 184. Director, Khwendo Kor 185. Mr. Kevin Kingfield, KSM 186. Mr. Saifullah Khan, KSM 187. Dr. Mohsina Bilgarami, Marie Stopes Society 188. Dr. Ashfaq Ahmed Khan, Executive Director 189. Mary Adelaid, Leprosy Control 190. Mr. Shoaib Sultan Khan, Chairman, National Rural Support Programme 191. Mr. Qadir Baig, Programme Manager, NGO Resource Center 192. Dr. Rashid Bajwa, General Manager, National Rural Support Programme 193. Ms. Parveen Rahman, Orangi Pilot Program 110

194. Ms. Shahnaz Wazir Ali, Chief Executive, Pakistan Centre of Philonthropy 195. Dr. Salma Maqbool, Chairperson, Pakistan Foundation for Fighting Blindness 196. Mr. Martin Rimmer, Pakistan Participatory Poverty Assessment 197. Mr. Kamal Hayat, Chief Executive, Pakistan Poverty Alleviation Fund 198. Syed Shahid Ali, Chairman, Pakistan Red Crescent Society, Islamabad 199. Dr. Yasmeen Sabeeh, PAVHNA 200. Dr. Yasmeen Rashid, President, PM Association, Lahore 201. Dr Zeba Sattar, Population Council 202. Ms. Shehnaz Bokhari, Progressive Women Association 203. Dr. Amjad Saqib, Punjab Rural Support Programme 204. Dr. Farzana Bari, Quaid-I-Azam University 205. Mr. Masood ul Mulk, Sarhad Rural Support Programme 206. Mr. Steve Ashby, Programme Director, Save the Children (UK) 207. Mr. Bruce Rasmussen, Save the Children (US) 208. Dr. Nabila Ali, Save the Children (US) 209. Khawar Mumtaz, Shirkat Gah 210. Mr. Kaiser Naseem, Managing Director, Small Medium Enterprise Bank 211. Mr. Zafar Iqbal, Social Marketing Pakistan 212. Dr Rehana Ahmed, Social Marketing Pakistan 213. Nicole Charman, Social Marketing Pakistan 214. Mr. Kaiser Bengali, Social Policy & Development Center 215. Aisha Ghaus, Social Policy & Development Center 216. Dr. Fareeha Zafar, Society for Advancement of Education 217. Mr. Ali Akbar, Chief Executive, Strengthening Participatory Organization 218. Dr. Shahrukh Rafi Khan, Sustainable Development Policy Institute 219. Mr. Shahid H. Kardar, System Ltd 220. Mr. Amjad Rashid, Taraqi Trust 221. General Sabih , The Citizen’s Foundation, 222. Mr. Iqbal Jafer, Chief Executive, Trust for Voluntary Organizations

Non-Government Sector (International) 223. Mr. Steve Moseley, Academy for Educational Development 224. Mr. Steve Ashby, Academy for Educational Development 225. Mr. William G. Darnell, Academy for Educational Development 226. Mr. Donald Cohen, Plan International 227. Ms. Rushna Ravji, Plan International 228. Mr. Haider Yaqub, Plan International 229. Mr. Richard Brown, Winrock International 230. Mr. Farrukh Captain, Chairman, LRBT 231. Dr. Anwar Aqil. Cath olic Relief Services 232. Mr. Luc Picard, Catholic Relief Services 233. Ms. Anne-Zeindl-Cronin, World Population Foundation

Foreign Missions/Agencies

Australia 234. H.E. Mr. Howard Brown, High Commissioner 235. Mr. George Beardsley, Deputy High Commissioner 236. Mr. Shoaib Tayyab, Senior Programme Officer 111

Austria 237. H.E. Mr. Walter Howadt, Ambassador 238. Dr. Guenther Gallowitssch, Head of the Asia Pacific Department

Belgium 239. Mr. Anthony Bousmar, Charge d Affaires

Canada 240. Mr. Hau Sing Tse, Vice President, CIDA (Asia) 241. Ms. Pauline Kehoe, Director (Pakistan), CIDA 242. Mr. Evan Due, Economic Counsellor 243. Mr. Victor Carvell, Senior Policy Analyst, CIDA 244. Ms. Anne Woodbridge, First Secretary Development, Canadian High Commission 245. Ms. Isabelle Hentic, First Secretary 246. Ms. Solveig Schuster, First Secretary 247. Ms Sadia Ahmad, Development Section 248. Ms. Rukhsana Rasheed, Manager Gender & Development Program 249. Ms. Attiya Hidayat

Denmark 250. Mr. Sven B. Bjerregaard, Charge d Affaires

Finland 251. Mrs. Kaija Ilander, Charge d’Affaires 252. Ms. Tanja Viikki

France 253. Mr. Yannick Gerard, Ambassador 254. Mr. Eric Berti, First Counsellor 255. Mr. Hubert Colaris, Economic Counsellor

Germany 256. H.E. Dr. Christoph Brummer, Ambassador 257. Mr. Gunter Overfeld, Deputy Head of Mission 258. Dr. Ernst W. Boernsen, Ministry of Economic Cooperation 259. Mr. Ralf-Matthias Mo hs, Ministry of Economic Cooperation 260. Mr. Achim Fabig, Ministry of Foreign Affairs 261. Mr. Elmar Eich Head, Commercial & Economic Section 262. Dr. Gabriele Boaringer, GTZ 263. Dr. Sauer, GTZ

Italy 264. Mr. Angelo Gabriele de Ceglie, Ambassador 265. Mrs. Enrica Lomazzi, Ministry of Foreign Affairs 266. Mr. Giampaolo Cutillo

Japan 267. Mr. Sadaaki Numata, Ambassador 112

268. Ms. Asako Okai, Embassy of Japan 269. Mr. Toshiyuki Hashimoto, Embassy of Japan 270. Mr. Hideo Murata, Embassy of Japan 271. Mr. Hiromichi Kitada, Embassy of Japan 272. Ms. Chiyo Hazama, Embassy of Japan

Republic of Korea 273. Mr. Do Young-Suck, Economic Cousellor

Kuwait 274. Mr. Mansoor Abdullah Ali Al-Awadhi, Ambassador 275. Madam Inam Mutawa, Director, Human Resources, Ministry of Planning 276. Mr. Nassar Abdul Rahman, First Secretary

Netherlands 277. Mr. Jaap A. Walkate, Ambassador 278. Mr. M.W. van der Gaag Counselor/Charge d’Affaires 279. Mr. H.J. Putker, First Secretary

Norway 280. Mr. Tore Torang, Ambassador 281. Mr. Morten Svelle, Director NORAD 282. Mr. Alf Arne Ramslien, Counsellor 283. Ms.Benna Nilson, NORAD 284. Mrs. Sidsel Bleken, First Secretary 285. Mr. Bob Smith, NORAD

Oman 286. Mr. Salim Mohammad Salim Al-Wahaibi, Ambassador 287. Mr. Abdulmalik Al-Hinai, Under Secretary for Economic Affairs, Ministry of National Economy

Saudi Arabia 288. Mr. Ali Saeed Auuadh Afferi, Ambassador 289. Mr. Ali Saeed Auuadh Afferi, Ambassador 290. Mr. Abdulaziz Al-Bassam, Saudi Fund for Development 291. Mr. Mohammad Al-Arifi 292. Mr. Abdulah Al-Shoaibi

Spain 293. Mr. Francisco Javier Jimenez, Sub Director General Cooperation AECI, Ministry of Foreign Affairs 294. Mr. Alberto Moyano Bonel, Deputy Head of Mission

Sweden 295. Mr. Peter Tejler, A Mr. Dag Juhlin-Dannfelt, Cousellor 296. Mr. Stefan Dahlgren, Counsellor

Switzerland 297. Mr. Christian Dunant, Ambassador 113

298. Mr. Reudi Hager, Resident Rep, Swiss Development Coordination 299. Mr. Martin Sommer, Senior Programme Officer 300. Mr. Reto Wieser, SDC Berne 301. Mr. Jean Marc Clavel, Deputy Resident Representative 302. Ms. Kaneez Fatima Kassim, National Programme Officer 303. Ms. Faiza Effendi, National Programme Officer

UAE 304. Ms. Faiza Effendi, National Programme Officer

U.K. 305. Mr. Hilary Synott, High Commissioner 306. Mr. Gareth Aicken, DFID Islamabad 307. Ms. Faiza Effendi, National Programme Officer 308. Mr. Moazzam Malik, DFID, London 309. Ms. Juliet Seibold, DFID Islamabad 310. Ms. Miranda Munro, DFID, London 311. Ms. Bronte Flecker, Asst Private Secretary 312. Ms. Beverly Warmington, Press Officer 313. Ms. Laura Conrad, Press Officer 314. Dt. Sgt. Clive Gardner 315. Dt. Const. Richard Cunningham 316. Dt. Const. John Hughes 317. Kirsty Mason, Social Development Advisor 318. Hazel Bines, Education Advisor 319. Stuart Tibbs, Economic Adviser 320. Chris Allison, Health & Population Adviser

U.S.A. 321. Ms. Wendy Chamberlain, Ambassador 322. Mr. Andrew Natsios, Administrator USAID 323. Ms. Lori A. Forman, Assistant Administrator 324. Ms. Joanne Giordano, Deputy Assistant Administrator for Legislative & Public Affairs 325. Ms. Kate Almquist, Personal Assistant 326. Mr. Del McCluskey, Chief Programme Management Division 327. John Swallow, Education Expert 328. Mr. Gary Cook, Helath Expert 329. Mr. Thomas Moorhead, Deputy Under Secretary, Dept. of Labor 330. Ms. Ami Thakkar, International Relations Officer Ms. Elizabeth Howard 331. Ms. Elizabeth Howard 332. Ms. Michele Sison, Deputy Head of Mission 333. Ms. Patricia Haslach, Economic Counselor Mr. Andrew Haviland, Deputy Economic Counselor 334. Ms. Elaine Sarao, Congressional fellow for Foreign Affairs 335. Mr. Robert Sanders, Economic Officer

Asian Development Bank 336. Mr. Y. Iwasaki, Director General, SARD 337. Mr. Edward Haugh Jr. Director South Asia for Social Sector 114

338. Mr. Marshuk Ali Shah, Country Director 339. Mr. Robert Sanders, Economic Officer 340. Mr. William Loxley, Senior Education Specialist 341. Mr. Vincent de wit Senior Health Specialist 342. Mr. Nurul Huda, Project Implementation Officer 343. Ms. Barbara Lochmann

FAO 344. Mr. Adel M. Aboull Naga, Resident Representative

European Commission 345. Mr. Kurt Juul, Ambassador 346. Mr. Erich Muller, European Aid Office, Brussels 347. Mr. Anthony Kirk 348. Mr. Pedro Martinez-Vargas, Counselor 349. Mr. Sergio Piazzardi, Ist Secretary Development 350. Mr. Peter Portier, Program Coordinator 351. Mrs Shahina Waheed 352. Ms. Madeline Wright, Project Coordinator 353. Ms. Brigid Mary Smith, EC Education Expert

Islamic Development Bank 354. Dr. Ahmad Mohammad Ali, President IDB 355. Mr. Khaled Nazer 356. Dr Ahmed Zubair 357. Mr. Kunrat Wirasubrata, IDB Jeddah

International Finance Corp. 358. Mr. Fareed Dossani 359. Ms. Faiza Baata

International Labor Organization 360. Mr. Johannes Lokollo, Director ILO, Islamabad

IMF 361. Mr. Henri Ghesquiere, Res. Rep

Japan Bank for International Cooperation (JBIC) 362. Mr. Toru Arai, Chief Representative, JBIC Pakistan 363. Mr. Tomohide Ichiguchi, Representative, JBIC Mr. Kenji Ishizuka, Country Officer, JBIC, Tokyo

Japan International Cooperation Agency 364. Mr. Kenjiro Izumi, Vice President South Asia Region, JICA 365. Mr. Masataka Nakahara, Resident Representative 366. Mr. Yojiro Ishi, Deputy Res. Rep 367. Mr. Mahmood Jilani, Deputy Res Rep 368. Dr. Ghulam Mustafa Awan, Special Advisor

UNAIDS 115

369. Mr. Abdi Atiq, National Programme Advisor 370. Dr. Farrukh Mahmood Ansari, Senior Programme Officer

U.N.D.P 371. Mr. Onder Yucer, Resident Representative 372. Ms. Lena Lindberg 373. Mr. David Whaley 374. Dr. Soccoro L. Reyes

UNESCO 375. Ms. Ingrid Breynes, UNESCO, Islamabad 376. Mrs. Anjum Riaz ul Haq

UNFPA 377. Dr. Olivier Brasseur, Resident Representative 378. Mr. M. Nizamuddin, Director APD 379. Mr. Karl Kulessa, Deputy Representative 380. Ms. Tahira Abdullah, Assistant Representative

U.N.H.C.R. 381. Ms. Montserrat Feixas Vihe UNHCR Islamabad

UNICEF 382. Ms. Caroll Long, Resident Representative 383. Ms. Serap Maktav, Project Officer 384. Mr. Maurice Robson, Senior Project Officer, Education 385. Dr. Thana-Oke Kyaw -Myint, Senior Project Officer, Health & Nutrition

World Bank 386. Mr. John W. Wall, Country Director 387. Mr. Charles Griffin, Sector Director (SASHD) 388. Mr. Richard Ackerman, Sector Director (SASES) 389. Mr. Abid Hasan, Operations Advisor 390. Mr. John Panzer, Lead Economist 391. Mr. Hugo Diaz, Lead Operations Officer 392. Ms. Tahseen Sayed, Sr. Social Sector Advisor 393. Ms. Christine Allison, Lead Human Development 394. Dr. Inaam ul Haq, Sr. Reproductive Health Specialist 395. Mr. Benjamin Loevinsohn, Senior Public Health Specialist 396. Mr. Gary L. Theisen, Senior Education Specialist 397. Mr. S. Ameer Naqvi, Sr. Education Sector Specialist 398. Mr. Sakwa Bunyasi, Sr. Agric. Economist 399. Mr. Hanid Mukhtar, Sr. Economist 400. Ms. Zareen Naqvi, Sr. Economist 401. Mr. Raja Rehan Arshad, Country Team Leader, Water and Sanitation Group 402. Ms. Zia al Jalaly, Social Development Specialist 403. Ms. Shahnaz Arshad, Sr. Urban Specialist 404. Ms. Shabana Khawar 405. Dr. Bashirul Haq, Consultant 406. Ms. Emma Hooper, Consultant 116

World Food Program 407. Mr. Dely Belgasmi, Country Director

World Health Organization 408. Mr. Khalif Bile Mohammad, Country Representative

117