Medical education and research in Pakistan

2234 www.thelancet.com Vol 381 June 29, 2013 The construction of health facilities, establishment of medical schools, and recruitment of health workers in the public sector have been important aspects of a popular political agenda in Pakistan, especially for elected governments. According to offi cial reports, the number of medical graduates has increased from 500 in 1947 to 171 450 in 2012 and the number of medical colleges has increased from two to 88, respectively. The total budget of the Pakistan Medical Research Council (PMRC) has increased 2·5 times between the fi scal years 2007–08 and 2011–12; and the number of health research publications has increased 7·5 times between 2001 and 2011 (fi gure). These increases give the illusion that the number of doctors in Pakistan who are capable and competent of providing needed clinical services to the population is adequate; that there is an increase in the number of research publications about health issues suggesting that we have skilled researchers; and that funding for health research by the government has gone up over the years. The truth is not so auspicious. Over recent years the real increase in the number of medical graduates Medical education and research in Pakistan health system and improving health outcomes for the country’s most vulnerable citizens. The Lancet Pakistan Series further shows the knowledge and public health capability in Pakistan, and clearly points the way to health reform, particularly in the postdevolution scenario. But tough questions remain. Will the commitment and generosity of communities throughout Pakistan be mobilised to address the most devastating day-to-day public health disaster the country faces? Will policy makers use experience of disasters to expand health-care services in diffi cult-toreach areas? Will political resolve be galvanised, reforms implemented, and resources made available? Pakistan has shown some public health success in response to natural disasters and humanitarian emergencies. The lessons and opportunities must be applied to the health system to prevent the continued death of more than 400 000 children and 12 000 women each year.