YEAR BOOK 2018-2019 GOVERNMENT OF PAKISTAN MINISTRY OF NATIONAL HEALTH SERVICES, REGULATIONS & COORDINATION ISLAMABAD i YEAR BOOK 2018-2019 GOVERNMENT OF PAKISTAN MINISTRY OF NATIONAL HEALTH SERVICES, REGULATIONS & COORDINATION ISLAMABAD ii IN THE NAME OF ALLAH THE MOST GRACIOUS, THE MOST MERCIFUL iii @ March 2020 Year Book 2018-19 Ministry of National Health Services, Regulations &Coordination Prepared by: NHIRC, M/o NHSR&C, Islamabad For more information, please visit Web: http://www.nhsrc.gov.pk/ Printed by: Printing Cooperation of Pakistan Press, Islamabad iv MESSAGE From the Federal Minister for National Health Services, Regulations & Coordination Division The year 2018-19 was meaningful for Ministry of National Health Services, Regulations & Coordination, as together with the provincial / area departments of health & population welfare, the ministry was able to start implementing joint strategic actions, which were unified and harmonized with provincial & federal efforts for improved health & population outcomes. On the programmatic front, the starting up of Prime Minister’s Sehat Sahulat Programme was a major achievement, which will ensure access and provision of quality health care services to the poorest families in the country against various diseases, having catastrophic implications. These reforms are critical to protect people from the vicious circle of poverty. It is expected that once fully scaled up in all districts, the positive impact of this programme will be beyond the health sector. The numbers of Polio cases have been brought down considerably in year 2018-19 from more than 300 cases in 2013-14. Pakistan is very close to the interruption of polio virus transmission but more concentrated efforts would be required. Interruption of polio virus is also linked with the performance of routine immunization programme. Although there is significant improvement in the immunization coverage but we have to achieve the milestone of 90 per cent. Through the Ministry, funding support is being channeled to the provinces for the Lady Health Workers’ Programme, the Maternal, New-born and Child Health Programme and the Population Welfare Programme, there is however, a need for a renewed deliberation on how to make these programmes more effective at provincial level. An alarming situation in Tuberculosis and Nutrition highlights these two critical areas where concentrated efforts with enhancement of local financing are now required, in order to achieve sustainable development targets. Drugs Regulatory Authority of Pakistan (DRAP) has been revamped with fresh technical recruitments, clearing the backlog of licensing and registration applications, regulatory reforms, v approval of Pharmacovigilance Regulation 2017, and advancement of Quality level III as per WHO pre-qualification criteria and exports of medicine reached a record volume in 2018. The Ministry took the initiative to ensure improvements in core capacities for the implementation of Global Health Security Agenda (GHSA)/ International Health Regulations (IHR). Based on Joint External Evaluation (JEE) completed in 2016, the process for the development of National Action Plan for Health Security has now completed in consultation with provincial governments. Development of disease surveillance and response mechanism would be a priority considering high risk of life and economic loss. Development of Pakistan Human Resources for Health Vision 2018-30 was a major success story in 2018-19. The reform process also continued in Medical & Dental, Pharmacy, Nursing, Tibb and Homeopathy councils, i.e. conflict of interest being addressed for the first time among members, online registration for nurses, post graduate education in pharmacy brought under the regulatory ambit. In summary, we have attempted to set the strategic direction and create an enabling environment for the health and population sector in the country. However, continued efforts and momentum will be required in the coming years to reshape the future of the sector in Pakistan and to achieve desired results. The year 2018-1ther with the provincial/ area departments of health & population welfare, the ministry was able to start imp FEDERAL MINISTER National Health Services, Regulation & Coordination vi FOREWORD From the Secretary for National Health Services, Regulations & Coordination Division This Year Book has been prepared in pursuance of Rule 25 of the Rules of Business, 1973, relating to the Ministry of National Health Services, Regulations & Coordination activities and achievements during the year. The Year Book is prepared for information of the Cabinet, Government functionaries, researchers as well as the general public. Over the year, extraordinary progress was made in transforming the Ministry and positioning it not only as the national health ministry, but as forward-looking and fit-for-purpose. By developing leadership, managerial structures and systems, the changes that the ministry has undergone is leading to increased effectiveness, efficiency, responsiveness, transparency and accountability. The need for a change had long been a priority since the 2011 devolution, which resulted in fragmentation not only of the health functions at the federal level, but also created a vacuum in the national level leadership and responsibilities. Recreation of Ministry of NHSR&C in 2013 was the first step to address the challenge, while in the year 2018-19, the implementation of eight strategic pillars and expression of commitment continued to make progress on achieving universal health coverage and health related sustainable development goals. In this drive, the federal ministry recognized and made explicit willingness to take on the challenges of modernizing and streamlining the ministry and starting with a clear roadmap/ vision for the health sector. Both within the M/o NHSR&C and among provincial / area departments of health, much further collaboration and coordination is required – particularly to show how all levels of the public health sector contribute to the achievement of corporate objectives in partnership with the private sector and other stakeholders. Setting the tone for the coming years, I welcome the opportunity to work with provincial / area departments of health, other ministries, private sector, stakeholders and partners of making vii ministry perform more efficiently and effectively, getting all levels of public health sector to work more cohesively. I believe that the ministry will truly lead the health sector of Pakistan in terms of results-based management, but there is still some way to go to improve accountability and transparency. Three fundamental challenges as the drivers of change for the ministry are: First, the ministry need selective and strategically focused priorities that would best reflect the ministry’s comparative advantage in the changing health landscape not only at national but also at the international level and lay the foundation for leadership in the coming decades. Second, ministry’s role in the health governance and relation to other stakeholders and partners require more clarity. Third, when faced with new challenges, the ministry need to develop the capacity and culture to be able to respond with sufficient speed and agility. Ultimately, optimizing ministry’s governance, management and programmatic focus would enable the health sector to more effectively fulfil its constitutional mandate as the “regulator and coordinating authority” and, most importantly, better serve departments of health and communities in improving health. I am deeply moved by the hard work and passion of staff of my ministry and expect a new desire to lead the health sector in Pakistan to ensure continuity in the momentum towards progress and to maximize efficiency.This Year Book has been prepared in pursuaforewordnce of Rule 25 of the Rules of 973, relate to the Ministry of Natil Health fServices, Regulations & Coordination activities and achievements during the year. The Year Book is prepared for information of ernment functionaries, researchers as well asgeneral public. SECRETARY National Health Services, Regulations & Coordination viii Contents MESSAGE .......................................................................................................................................... v FOREWORD .................................................................................................................................... vii Acronyms .......................................................................................................................................... 1 An Overview ..................................................................................................................................... 3 Sanctioned Positions in the Division (2018-19) ................................................................................ 9 Budget Estimates 2018-19 ............................................................................................................. 11 Chapter 1: National Institute of Health .......................................................................................... 15 Chapter 2: Drugs Regulatory Authority of Pakistan ....................................................................... 59 Chapter 3: Health Services Academy (HSA) ................................................................................... 89 Chapter 4: Pakistan Health & Research Council (PHRC) ...............................................................