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  • Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 


Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 

Pharmacy employees wearing facemasks as a preventive measure against the COVID-19 coronavirus attend to customers in Islamabad on March 23, 2020. (AFP/File)
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Updated 27 January 2024
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Overprescribing antibiotics poses ‘serious’ risk of antimicrobial resistance in Pakistan— health experts 

  • AMR could cause as many deaths as 10 million per year around the world by 2050, warns UN group 
  • OTC sales of antibiotics, incentive-linked prescribing causes surge in drug-resistant microbes, say experts 
Updated 27 January 2024
KHURSHID AHMED   

KARACHI: Pakistan faces a “serious” risk of Antimicrobial resistance (AMR), which refers to the ability of bacteria, viruses and parasites to develop the capability to fight drugs designed to kill them, health experts warned this week, citing indiscriminate prescription of antibiotics by health practitioners as the main reason. 

According to the World Health Organization (WHO), bacterial AMR was directly responsible for an estimated 1.27 million deaths worldwide in 2019 and contributed to 4.95 million deaths indirectly. The misuse and overuse of antimicrobials in humans, animals and plants are the main drivers in the development of drug-resistant pathogens. the international organization says. 

Pakistani health care stakeholders say a serious risk of drug-resistant microbes exists due to Incentive-Linked Prescribing (ILP), the practice of doctors and physicians receiving personal benefits or incentives from pharmaceutical companies for prescribing specific medications. 

They also cite over-the-counter (OTC) sales of antibiotics and self-medication as reasons for the emergence of drug-resistant microbes. 

“90 percent of private doctors meet pharmaceutical sales representatives on a weekly basis, and that accepting or seeking out incentives is normalized in Pakistan,” a recently compiled report by The Aga Khan University and London School of Hygiene and Tropical Medicines, said. 

The report said 40 percent of these doctors agreed to accept incentives and prescribe medicines to patients. The doctors agree to prescribe medicines due to financial pressures and inadequate consequences for breaking rules in the country, it added. 

The UN’s Interagency Coordinating Group on AMR has estimated that by 2050, the AMR could result in the deaths of 10 million people worldwide.

Dr. Abdul Ghafoor Shoro, Pakistan Medical Association’s (PMA) general secretary who is also a member of the Sindh Healthcare Commission, acknowledged that certain doctors, due to conflict of interest, were engaged in prescribing antibiotics and other medicines to increase sales of pharmaceutical companies. 

This, he said, they do in exchange for gifts, offers to go on tours and other financial benefits. 

“Many people are involved, so when you take monetary benefit, you try to pay back,” Dr. Shoro told Arab News. “But in this case, only patients pay back and suffer.” 

Shoro said the resistance level in tuberculosis cases in Pakistan has increased from MDR (multi-drug resistance) to XDR (extensively drug-resistant) while in cases of typhoid, the resistance level has also increased to XDR. 

The world witnessed its first case of XDR typhoid in late 2016 in Pakistan’s Sindh province. 

“You have limited availability of antibiotics and going forward, all [diseases] will be resistant which would be a big problem,” Dr. Shoro warned. 

The PMA official also blamed the presence of around 600,000-800,000 “quacks“— a term frequently used to refer to someone who practices medicine without necessary qualifications, skills, or training— in Pakistan for the indiscriminate use of antibiotics. 

“The big issue is that they don’t have the knowledge themselves about its usage,” Dr. Shoro said. “What they do is that they prescribe antibiotics one day and change [it] another day.” 

The head of the National Institute of Health (NIH) in Pakistan also recognized AMR as a significant public health problem, warning of a “serious burden of multi and multi-drug resistance organism, particularly in hospitals or health care settings.” 

“There are reports of complicated surgeries due to resistant organisms,” Muhammad Salman, acting executive director of the NIH, told Arab News this week. 

“And then other health care-associated infections such as ventilator-associated pneumonia, blood stream infections, catheter-associated infections, and urinary tract infection.”

Dr. Salman said that in communities, it has been observed that diseases similar to XDR typhoid are endemic in Pakistan. “So that actually reflects that the problem is actually very serious in Pakistan.”

NIH, which is responsible for researching and monitoring Pakistan’s health status, is working on a National Action Plan (NAP) developed in 2017 in line with global objectives to contain AMR. 

“AMR containment is a rather difficult task,” Dr. Salman admitted, adding that more efforts had been put in extracting evidence of AMR’s presence in the past five to six years. 

He said collecting evidence was critical as it would generate sufficient evidence to reflect and would help in advocating for more investment to contain AMR. 

When asked to comment on the conflict-of-interest allegations related to health practitioners in Pakistan, Dr. Salman said the institute lacks sufficient evidence. 

“But there are practices, especially unnecessary prescription practices of antibiotics, by the doctors and physicians, both in private and in public sectors,” he conceded. 

Topics: antibiotics Antimicrobial resistance

Pakistan to set up maritime chamber to boost blue economy, promote greener ports

Updated 4 sec ago
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Pakistan to set up maritime chamber to boost blue economy, promote greener ports

  • Maritime minister says new chamber will unite industry to drive sustainable growth and long-term economic resilience
  • Pakistan aims to grow its blue economy through sustainable use of ocean resources for jobs and ecosystem health
Updated 4 sec ago
Ismail Dilawar

KARACHI: The Pakistan government on Saturday announced the creation of a new Maritime Chamber of Commerce and Industry (MCCI) to promote sustainable development in the country’s coastal and marine sectors, saying the initiative would help strengthen the country’s blue economy while addressing rising climate risks at its ports.

Addressing the Pakistan Business Council Forum, Federal Minister for Maritime Affairs Junaid Anwar Chaudhry said Pakistan’s coastal zones were increasingly exposed to environmental challenges such as rising sea levels, extreme weather events and marine degradation.

The new chamber, he noted, would serve as a specialized platform for uniting stakeholders from across the maritime spectrum to pursue greener policies and long-term economic resilience.

“This chamber will not only support investment and innovation in the maritime sector but also prioritize sustainability at ports, promote green technologies and foster carbon reduction strategies,” he told the participants of the forum.

Pakistan is striving to strengthen blue economy by ensuring the sustainable use of ocean resources for economic growth, jobs and ecosystem health.

This requires the authorities to enhance the potential of its ports, fisheries, logistics and marine services while reducing environmental harm.

The new chamber is expected to provide a unified institutional voice for sectors ranging from shipping to coastal tourism, helping to align business incentives with climate adaptation goals.

Pakistan has been pushing to modernize its port infrastructure and expand its role in regional trade by improving cargo handling, digitalizing port operations and encouraging public-private partnerships.

The country has also invited landlocked Central Asian states to use its ports to access global markets, aiming to position itself as a regional trade hub.

The Pakistan Business Council welcomed the announcement, calling the new chamber a critical step toward building a climate-resilient and economically vibrant maritime economy.

Topics: Pakistan Business Council Maritime Affairs Minister

Pakistan PM says Indian bid to set ‘new norm’ thwarted, vows focus on economy and governance

Updated 31 May 2025
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Pakistan PM says Indian bid to set ‘new norm’ thwarted, vows focus on economy and governance

  • Shehbaz Sharif tells military officials in Quetta India suffered setbacks on battlefield and in diplomatic realm
  • He reiterates that New Delhi will not be allowed to ‘weaponize water,’ calling IWT suspension a ‘red line’
Updated 31 May 2025
Usama Iqbal Khawaja

ISLAMABAD: Prime Minister Shehbaz Sharif on Saturday highlighted a range of security threats facing Pakistan days after a military standoff with India, saying New Delhi’s attempt to establish a “new norm” by targeting his country at will had been thwarted, though Pakistan must now focus on strengthening economy and governance.

The remarks came during a televised address to senior military officers at the Command and Staff College in Quetta, where the premier recounted the recent escalation between the two nuclear-armed neighbors.

The flare-up followed an April attack on tourists in Indian-administered Kashmir, which New Delhi blamed on a Pakistan. Islamabad denied the allegation and called for an impartial probe, but tensions rapidly escalated into four days of cross-border hostilities, ending after a US-brokered ceasefire on May 10.

“The threats we face are no longer limited to conventional battlefields,” Sharif said during his address. “They are multifaceted, ranging from kinetic warfare to cyberattacks, economic coercion to disinformation campaigns and hybrid threats that challenge both our borders and our ideological frontiers.”

“The recent Indian aggression against Pakistan, violating our territorial integrity and targeting our innocent civilians, was not merely countered successfully, but instead we succeeded in turning the tables on those who were dreaming of establishing a new norm,” he said.

Sharif added that Pakistan accepted the ceasefire offer “in the interest of peace, progress and prosperity in South Asia,” asserting that India’s claim of a new strategic precedent “was buried for all times to come by our brave armed forces.”

“In fact, it was Pakistan that established the new norm in its relations with India,” he said. “Henceforth, we will not allow her to behave in an arrogant and haughty manner.”

The prime minister said India had suffered “serious setbacks in both warfare and finest diplomacy” during the episode.

Turning to domestic matters, Sharif said while the military had fulfilled its responsibility, Pakistan still faced “major challenges in the field of economy and governance.”

He cited the dire financial situation when his administration took office, saying it compelled Pakistan to seek external assistance from lenders such as the International Monetary Fund (IMF).

However, he maintained the economy had since stabilized and was now on a positive trajectory.

The prime minister also criticized India’s recent move to suspend the Indus Waters Treaty (IWT), a World Bank-brokered water-sharing agreement signed in 1960, reiterating it was unacceptable to his country.

“We will not allow India to weaponize water by holding the Indus Waters Treaty in abeyance,” he said. “This is an absolute red line for us.”

Topics: Pakistan Prime Minister Shehbaz Sharif Pakistan India standoff

Pakistan’s Arshad Nadeem reigns supreme with javelin gold at Asian Athletics Championships

Updated 31 May 2025
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Pakistan’s Arshad Nadeem reigns supreme with javelin gold at Asian Athletics Championships

  • India’s Sachin Yadav won silver with an 85.16m throw, while Japan’s Yuta Sakiyama took bronze by throwing 83.75m
  • Nadeem made history at 2024 Paris Olympics by winning Pakistan’s first athletics gold with a record throw of 92.97m
Updated 31 May 2025
Arab News Pakistan

ISLAMABAD: Pakistani Olympic champion Arshad Nadeem on Saturday won gold with a massive 86.4-meter throw in the men’s javelin final at the Asian Athletics Championships in Gumi, South Korea, Pakistani state media reported.

Nadeem is the first Pakistani in over 50 years to win a gold medal at the Asian Athletics Championships. Pakistan’s Allah Daad last topped the podium in javelin throw and Muhammad Younis won the 800-meter event in 1973.

“Arshad Nadeem has once again made the nation proud by making a massive 86.40 meter throw and led the field in the men’s Javelin final at the Asian Athletics Championship in Gumi,” the state-run Radio Pakistan broadcaster reported.

In Saturday’s event, India’s Sachin Yadav won silver with an 85.16m throw, while Japan’s Yuta Sakiyama took bronze with an 83.75m throw. Both threw their personal best.

Nadeem advanced to the final with a powerful throw of 86.34 meters on his first and only attempt in the A qualification round on Friday.

He made history at the 2024 Paris Olympics by winning Pakistan’s first-ever athletics gold with a record-breaking javelin throw of 92.97 meters. His throw not only set a new Olympic and Asian record but also ended Pakistan’s 32-year Olympic medal drought.

Nadeem has since become a national hero, inspiring millions with his journey from humble beginnings in smalltown Mian Channu to the top of the Olympic podium.

Topics: Arshad Nadeem Asian Athletics Championship

Pakistan voices concern over rise in Islamophobic incidents in India

Updated 31 May 2025
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Pakistan voices concern over rise in Islamophobic incidents in India

  • The reports of increasing attacks against Muslims in India emerged after an April 22 attack on Hindu tourists in disputed Kashmir
  • Pakistan’s foreign office urges the Indian government to uphold the rights and safety of all its citizens, regardless of their faith
Updated 31 May 2025
KASHIF IMRAN

ISLAMABAD: Pakistan expresses grave concern over a rise in Islamophobic incidents across India, the Pakistani foreign office said on Saturday, following reports of attacks against Muslims.

The reports of increasing attacks against Muslims and Kashmiris in India emerged after an April 22 attack on Hindu tourists in Indian-administered Kashmir’s Pahalgam town that killed 26 people.

New Delhi blamed the assault on Pakistan, a charge denied by Islamabad. The attack triggered a four-day standoff between the neighbors this month that killed 70 people on both sides before a truce was announced on May 10.

At least 184 anti-Muslim hate incidents, including murders, assaults, threats and vandalism, have been recorded countrywide in India, Indian media outlets quoted New Delhi-based Association for Protection of Civil Rights as saying this month.

“Pakistan calls upon the Government of India to uphold the rights and safety of all its citizens, regardless of faith,” Pakistani foreign office spokesman Shafqat Ali Khan said, adding that such incidents violate international human rights obligations and vitiate the prospects for communal harmony and regional stability.

Bitter rivals India and Pakistan have fought three wars, including two over the disputed region of Kashmir, since gaining independence from British rule in 1947. Both claim the Himalayan territory in its entirety but rule it in part.

While a conflict between the neighbors feeding minority hatred on either side is not a new phenomenon, critics and rights bodies say Hindu right-wing groups have become emboldened in recent years due to a “culture of impunity.”

“Prime Minister [Narendra] Modi likes to boast of India’s democratic traditions, but it’s become increasingly hard for him to hide his government’s deepening crackdown on minorities and critics,” Meenakshi Ganguly, the deputy Asia director at Human Rights Watch, said in January this year.

“A decade of discriminatory policies and repression has weakened the rule of law and has restricted the economic and social rights of marginalized communities.”

Topics: Srinagar

India lost fighter jets in recent conflict with Pakistan, Indian defense chief confirms

Updated 31 May 2025
Reuters
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India lost fighter jets in recent conflict with Pakistan, Indian defense chief confirms

  • On May 7, Indian jets bombed what New Delhi called ‘terrorist infrastructure’ sites across the border
  • Pakistan has said it downed six Indian planes, including at least three Rafale fighters, in initial clashes
Updated 31 May 2025
Reuters

SINGAPORE: India switched tactics after suffering losses in the air on the first day of conflict with Pakistan earlier this month and established a decisive advantage before the neighbors announced a ceasefire three days later, India’s highest ranking general said on Saturday.

The heaviest fighting in decades between nuclear-armed India and Pakistan was sparked by an April 22 attack in Indian-administered Kashmir that killed 26 people, most of them tourists. New Delhi blamed the incident on “terrorists” backed by Pakistan, a charge denied by Islamabad.

On May 7, Indian jets bombed what New Delhi called “terrorist infrastructure” sites across the border. Pakistan has said it downed six Indian planes, including at least three Rafale fighters, in the initial clashes.

The ceasefire was announced on May 10 after bitter fighting in which both sides used fighter jets, missiles, drones and artillery.

General Anil Chauhan, India’s chief of defense staff, said in an interview that India suffered initial losses in the air, but declined to give details.

“What was important is, why did these losses occur, and what we’ll do after that,” he told Reuters on the sidelines of the Shangri-La Dialogue security forum in Singapore, referring to the Pakistani claim of downing jets.

“So we rectified tactics and then went back on the 7th, 8th and 10th in large numbers to hit air bases deep inside Pakistan, penetrated all their air defenses with impunity, carried out precision strikes.”

The Indian air force “flew all types of aircraft with all types of ordinances on the 10th,” he said.

India has previously said its missiles and drones struck at least eight Pakistani air bases across the country that day, including one near the capital Islamabad.

The Pakistan military says that India did not fly its fighter jets again in the conflict after suffering losses on May 7.

India’s director general of air operations, Air Marshal A.K. Bharti, had told a press conference earlier in the month that “losses are a part of combat” and that India had downed some Pakistani jets.

Islamabad has denied it suffered any losses of planes but has acknowledged its air bases suffered some hits although losses were minimal.

NO NUCLEAR WORRIES

Some of the attacks were on bases near Pakistan’s nuclear facilities, but they themselves were not targeted, media reports have said.

“Most of the strikes were delivered with pinpoint accuracy, some even to a meter, to whatever was our selected mean point of impact,” Chauhan said.

Chauhan, and Pakistan’s chairman of the joint chiefs of staff, Gen. Sahir Shamshad Mirza, have both said there was no danger at any time during the conflict that nuclear weapons were considered.

“I think there’s a lot of space before that nuclear threshold is crossed, a lot of signalling before that, I think nothing like that happened,” Chauhan said. “There’s a lot of space for conventional operations which has been created, and this will be the new norm.

“It’s my personal view that the most rational people are people in uniform when conflict takes place,” he added. “During this operation, I found both sides displaying a lot of rationality in their thoughts as well as actions. So why should we assume that in the nuclear domain there will be irrationality on someone else’s part?“

Chauhan also said that although Pakistan is closely allied with China, which borders India in the north and east, there was no sign of any actual help from Beijing during the conflict.

“While this was unfolding from (April) 22nd onwards, we didn’t find any unusual activity in the operational or tactical depth of our northern borders, and things were generally all right.”

Asked whether China may have provided any satellite imagery or other real-time intelligence to Pakistan during the conflict, Chauhan said such imagery was commercially available and could have been procured from China as well as other sources.

He added that while hostilities had ceased, the Indian government had made it clear it would “respond precisely and decisively should there be any further terror attacks emanating from Pakistan.”

“So that has its own dynamics as far the armed forces are concerned. It will require us to be prepared 24/7.”

Topics: Pakistan India Ties Pakistan India standoff

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