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Pakistan has likely avoided the brute force of COVID-19 as is currently being experienced by several countries such as India, Brazil, United States and Iran. Even though, Pakistan shares a border with India and Iran, the impact of COVID-19 in Pakistan has been vehemently different than in its neighbors. According to the data provided by Worldometer, Pakistan ranked 54 in terms of new cases and 43 in terms of new deaths globally by October 7. The positivity rate on that date was hovering around 2% while the overall positivity rate since the first case was reported has fallen below 10%. This suggests that Pakistan has successfully curtailed the spread of the virus during its first wave.

Although, there are several factors that could have played a role in Pakistan, the jury is still out on the true causes of low infection rates in Pakistan. However, with hospitalization rates due to COVID-19 at a minimal, it is imperative that the increasing focus on the quality of health infrastructure emphasized upon during the peak of the pandemic must not falter.

The life expectancy is defined as the “number of years a newborn infant would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout its life” by the World Bank. Gains in life expectancy can be used as a viable indicator for the improvement in the quality of lives as well as quality of health services within a country, particularly for developing countries characterized by poor healthcare. It is expected that a country providing better healthcare service delivery to its citizens is likely to report higher average life expectancy.

The improvement in life expectancy is likely to be reflected by the improvement in the quality of health services. The results for the percentage change between 1960 and 2018 as well as the absolute numbers reported in 2018, determined with the data extracted from World Development Indicators, is presented for South Asian countries in Figure 1. Comparing the numbers for South Asian countries between 1960 and 2018, Pakistan fared one of the poorest in the region in terms of the percentage change in life expectancy as well as the absolute value of life expectancy in 2018. Pakistan reported an increase of 48% and a life expectancy level of 67 years in 2018.

*Figure 1: Measuring Life Expectancy in South Asia*

Comparatively, the percentage change in life expectancy is the lowest for Sri Lanka, the average life expectancy in Sri Lanka in 2018 was 76 years. The life expectancy in Sri Lanka was already touching 60 years in 1960, thus the change was much more gradual as it had a more developed healthcare sector relative to other countries in the region. It is important to note that Pakistan reported a life expectancy of 45 years in 1960, the second highest level of life expectancy in the region. It lagged behind with time. Bhutan and Maldives were able to more than double their level of life expectancy since 1960. South Asia continues to face challenges with healthcare delivery relative to the rest of the world.

In essence, the low levels of life expectancy should raise alarm about the quality of the health infrastructure in Pakistan. The emphasis raised during the peak of COVID-19 on the quality of the health sector must continue to be pursued with the policymakers. Even though life expectancy is likely to be dictated by several other factors influencing the standards of living in a country, the poor development of health facilities in Pakistan during the previous fifty years is likely to be a major factor in the comparatively low percentage change in life expectancy over time and the subsequent low levels.