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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 says has introduced ‘historic’ new facilities for Hajj pilgrims

Updated 5 sec ago
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Pakistan says has introduced ‘historic’ new facilities for Hajj pilgrims

  • For the first time, Hajj pilgrims will have access to fully air-conditioned camps in Mina
  • New facilities part of effort to ensure smoother, more comfortable Hajj experience
Updated 5 sec ago
Arab News Pakistan

ISLAMABAD: Director Hajj in Makkah, Azizullah Khan, said on Tuesday Pakistani pilgrims will this year enjoy “historic facilities” in Mashair, sacred sites used during the Hajj pilgrimage, including fully air-conditioned camps in Mina with sofa-cum-beds, and improved accommodation in Makkah.

Over the last few years, Saudi Arabia has launched mobile apps like Nusuk, Hajj Navigator, Tawakkalna and Asefny to streamline services, with the aim to make the Hajj experience smoother by offering real-time guidance and ensuring pilgrim safety.

For the first time, Pakistani Hajj pilgrims will have access to fully air-conditioned camps in Mina and be accommodated in top-of-the-line hotels and buildings in the Azizia and Batha Quraish neighborhoods.

Pilgrims will receive a specially designed bag containing the Pakistani flag, a QR code for identification, and relevant information. A mobile app will provide access to Hajj group information, training schedules, flight details, accommodation details, and live maps and locations during the pilgrimage.

“For the first time in history, Hujjaj will have sofa-cum-beds instead of mattresses while tents are upgraded with gypsum board walls and air coolers have been replaced with air conditioners,” Khan told Radio Pakistan, adding that elevated luggage storage racks had also been introduced to enhance comfort.

“Dedicated sections are overseeing food, health and transport related arrangements round the clock for maximum facilitation of the pilgrims,” he said, adding that 99 percent of pilgrims who had arrived in Saudi Arabia had received Nusuk cards.

The cards are an essential Hajj permit, not just an ID, for pilgrims traveling to Makkah and the holy sites. It facilitates movement and ensures the well-being of Hajj pilgrims by managing logistics and administration. The card also allows pilgrims to access information about their Hajj mission, schedules, and allows for communication with their mission. Additionally, it enables receiving alerts, evaluating services, and filing observations.

Compulsory Hajj training has been made available for all pilgrims in Pakistan, starting from Jan. 18, 2025, with details accessible through the “Pak Hajj 2025 Mobile App.” 

For the government Hajj scheme, the option of three easy installments has been introduced for the first time. 

All Hajj-related financial transactions have also been digitized, ensuring transparency and accountability. 

Pakistan’s Hajj medical mission includes a hospital each in Makkah and Madinah, along with two dispensaries in Madinah and nine in Makkah, all fully functional. 

A Monitoring Cell has been established to address potential issues faced by private pilgrims and provide support to them. Various specialized units, including a Wheelchair Desk, have been set up to cater to the needs of different groups of pilgrims. 

Topics: Hajj 2025 Pakistani pilgrims Saudi Arabia

Pakistan PM prioritizes tax net expansion, vows crackdown on evaders

Updated 21 min 51 sec ago
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Pakistan PM prioritizes tax net expansion, vows crackdown on evaders

  • Tax reform has been a central condition of Pakistan’s ongoing $7 billion IMF loan program
  • Pakistan expects its tax-to-GDP ratio to reach 10.6% by the end of the current fiscal years
Updated 21 min 51 sec ago
Arab News Pakistan

ISLAMABAD: Prime Minister Shehbaz Sharif on Tuesday declared the expansion of Pakistan’s tax base as his administration’s foremost priority, emphasizing the need to take decisive action against tax evaders and the officials who enable them.

Sharif’s remarks came during a high-level meeting in Islamabad focused on enhancing tax collection and broadening the tax net, according to a statement from the Prime Minister’s Office.

Tax reform has been a central condition of Pakistan’s ongoing $7 billion loan program with the International Monetary Fund (IMF), which has asked Islamabad to boost revenue collection.

“Expanding the tax net is the government’s top priority,” Sharif said. “We want to reduce the tax rate to ease the burden on the common man.”

“Individuals and sectors capable of paying taxes but currently outside the tax net must be brought within it,” he added. “Comprehensive action should be taken against tax evaders, and strict accountability must be ensured for officials and personnel who assist them.”

The government has implemented several measures to strengthen the tax collection mechanism, including the digitization of tax monitoring systems and the deployment of track-and-trace technology in key industries.

According to the PM Office, the introduction of these systems in cement plants nationwide has led to significant increases in tax revenue, while the sugar sector saw a 35% rise in tax receipts between November 2024 and April 2025.

Pakistan’s tax-to-GDP ratio, historically among the lowest in the region, stood at 8.8% in the 2023-24 fiscal year.

However, Finance Minister Muhammad Aurangzeb projected it would reach 10.6% by June 2025, marking progress toward the government’s target of 13% by the conclusion of the IMF’s 37-month Extended Fund Facility.

The meeting tax collection, attended by key cabinet members and senior officials from the Federal Board of Revenue (FBR), also addressed the need for timely resolution of pending tax litigation and the completion of digital monitoring systems in sectors such as cement and tobacco by June.

“By the grace of God, the national economy is stabilizing and progressing,” Sharif said. “Everyone must fulfill their responsibilities for the country’s development.”

Topics: Pakistan FBR tax net

‘Can’t believe he’s gone’: Azad Kashmir family mourns newlywed killed by cross-border shelling

Updated 13 min 42 sec ago
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‘Can’t believe he’s gone’: Azad Kashmir family mourns newlywed killed by cross-border shelling

  • Usama Ishrat, 22, was killed in district Bagh due to cross-border attacks less than two weeks after getting married
  • Border residents of Kashmir region bear the brunt of heavy gunfire whenever India-Pakistan tensions escalate 
Updated 13 min 42 sec ago
Usama Iqbal Khawaja

BAGH, AZAD KASHMIR: The walls of late Usama Ishrat’s modest two-room house in Azad Kashmir are pocked with gaping mortar holes, impossible to miss for anyone visiting the family. Shards of glass still cling to a nearby window, a stark reminder of the devastation unleashed by Indian shelling last week.

Residents living near the border in the disputed Kashmir region — administered in parts by bitter rivals India and Pakistan — have long borne the brunt of cross-border fire whenever tensions escalate.

The latest flare-up, from Wednesday to Saturday, saw both sides trade drones, missiles, fighter jets and artillery fire. In just four days, May 8 to 11, at least 31 people were killed and 123 injured across various districts of Azad Kashmir, according to official figures.

Among the dead was 22-year-old Usama Ishrat, a cashier at a local store in Bagh district. The eldest of six siblings, Ishrat had been married only days earlier, on April 26 — less than two weeks before his life was cut short by shelling on Friday.

“I married him off with great joy,” a grief-stricken Shakeela Khanum, Ishrat’s mother, told Arab News. “He was married for just 13 days. With henna still on, the bride and groom got separated like this.”

Usama Ishrat’s mother Shakeela Khanum, speaks during an interview with Arab News outside his home in a border town of Bagh district, in Pakistan’s Azad Kashmir region, on May 10, 2025. (AN Photo) 

Ishrat Mehmood, the father, recalled that the attack took place at dawn on Friday, while he was standing outside his house. As mortar shells rained down, he fell and blacked out. He regained consciousness when his daughter collapsed beside him, and rushed her inside, only to find that his other two daughters had also been wounded.

That’s when he heard his daughter-in-law’s screams.

“I thought, ‘Maybe she got hit too.’ When I went there, I saw my son was drenched in blood,” he added.

Mehmood said his wounded son, bleeding from a large head injury, appeared to look at them once before passing away.

“A little bit of his brain had come out from here,” Mehmood said, gesturing toward his head. “He was martyred right there on the spot.”

Ehsam, Ishrat’s 12-year-old brother, picked up the pillow where Usama drew his final breath. His hand was immediately stained with dried blood. The pillow and its cover had already been separated. When the cover was unfolded, parts of what still appeared to carry the remnants of Ishrat’s brain matter could be seen.

“My brother’s brain…parts of it are still on this,” Ehsam said.

Top view of the house of Usama Ishrat killed during cross-border escalation in a border town of Bagh district, in Pakistan’s Azad Kashmir region, on May 10, 2025. (AN Photo)

From the next room, Ishrat’s wife could be heard sobbing. Her family had arrived to take her back as she prepared for “iddah,” the mourning period women in Islam are required to observe following the husband’s death or in the event of a divorce.

The attack had also wounded Khanum, who said a splinter had injured her leg.

“Don’t know, a fragment or something is still inside,” she said. “Today, I am feeling it is still inside. I didn’t even try to get it out.”

Two of her daughters are being treated at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad.

The world breathed a sigh of relief when US President Donald Trump announced Washington had brokered a ceasefire between the two hostile neighbors on Saturday. After initial accusations of violations by both sides, the ceasefire continues to hold.

But for Ishrat’s family, the damage has been done.

Ajmal Zulfiqar (right) stands at the grave of his deceased cousin Usama Ishrat, killed during cross-border escalation in a border town of Bagh district, in Pakistan’s Azad Kashmir region, on May 10, 2025. (AN Photo)

“I want to say this to the whole world that they agreed to a ceasefire between themselves,” Ajmal Zulfiqar, his cousin, told Arab News. “But our beloved is gone. He is not going to come back.”

Topics: Usama ishrat Pakistan India clash Line of Control (LoC) Azad Jammu and Kashmir de facto Kashmir border

‘No terrorists here’: School damaged in India strikes in Azad Kashmir reopens today

Updated 13 May 2025
Reuters
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‘No terrorists here’: School damaged in India strikes in Azad Kashmir reopens today

  • An Indian strike damaged the Al-Hadi Public School and adjoining Bilal mosque on May 7
  • Authorities confirmed three deaths, one injury in overnight attack on mosque in Muzaffarabad
Updated 13 May 2025
Reuters

Muzaffarabad: The principal of a school adjacent to a mosque hit last week in an Indian strike in Muzaffarabad, the capital of Azad Kashmir, said there were “no terrorists” there contrary to New Delhi’s claim, as the school prepared to reopen today, Tuesday. 

An Indian strike damaged the school and adjoining mosque on May 7 in Muzaffarabad, the main town in the part of the disputed Kashmir region administered by Pakistan. India hit Pakistan and Azad Kashmir with missiles that day and Pakistan, vowing retaliation, said it had shot down five Indian aircraft.

Authorities confirmed three deaths and one injury following the overnight attack on Bilal mosque in Muzaffarabad, part of the worst escalation between the two nuclear-armed rivals in over two decades.

India said it struck nine “terrorist infrastructure” sites, some of them linked to an attack by militants that killed 25 Hindu tourists and one local in Indian-administered Kashmir last month. Islamabad has denied New Delhi’s allegations it was involved. 

“There are no terrorists here. This is a place of worship. People offer prayers here. Our children and all the people in the vicinity say five times prayers here,” said school principal of Al-Hadi Public School, Saima Maqsood, as cleaning work continued at the school.

The schools will re-open today, Tuesday, according to a government notification.

On Monday evening, Indian premier Narendra Modi said Pakistan would have to get rid of its “terrorist infrastructure” if it wants to be “saved,” his first comments on the military clashes with Pakistan since last week’s deadly fighting between the two countries.

The military operations chiefs of India and Pakistan spoke by phone on Monday, the Indian army said, as New Delhi reopened airports and shares rose in both countries following a ceasefire that paused days of intense fighting last week.

“The world knows what happened with India. Now, it will not dare attack again,” said Bilal mosque worshipper Roshan Mughal. 

“The mosque, Allah’s home, will be rebuilt. The sacrifices, the martyrdom of three people here at the mosque, and elsewhere ... have awakened Muslims and they have shown the world that Pakistan has the power to fight. Its armed forces are well prepared to defend the country.”

Topics: Pakistan India Ties azad kashmir Muzaffarabad

Pakistan appoint New Zealand’s Mike Hesson as new cricket white-ball coach

Updated 13 May 2025
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Pakistan appoint New Zealand’s Mike Hesson as new cricket white-ball coach

  • Hesson, currently head coach of Pakistan franchise Islamabad United, has coached Kenya and New Zealand in previous stints
  • Former interim white-ball coach and ex-pacer Aaqib Javed has been appointed as Director of High Performance of Pakistan cricket
Updated 13 May 2025
Shahjahan Khurram

ISLAMABAD: The Pakistan Cricket Board (PCB) announced on Tuesday it had appointed New Zealand’s Mike Hesson as the national cricket squad’s white-ball coach from May 26 onwards. 

Hesson replaces former Pakistan fast bowler and interim white-ball coach Aaqib Javed, who was appointed to the post in November 2024. Pakistan haven’t had a full-time white-ball coach since Gary Kirsten resigned in October last year following disagreements with the cricket board. 

Hesson brings vast coaching experience to the table. He has served as the head coach of various international teams such as Kenya and New Zealand in the past. He is also currently serving as head coach of the Islamabad United franchise, the defending champions of the Pakistan Super League.

“The Pakistan Cricket Board (PCB) today announced the appointment of Mike Hesson, as the white-ball head coach of the Pakistan men’s cricket team effective from 26 May, 2025,” the PCB said in a statement. 

“Hesson comes in to fill the post after evaluation of numerous applications received against the vacancy, which fell vacant after Pakistan men’s team tour to New Zealand in April.”
PCB Chairman Mohsin Naqvi praised the appointment, saying that Hesson brings with him “a wealth of international experience and a proven track record of developing competitive sides.”
“We look forward to his expertise and leadership in shaping the future of Pakistan’s white-ball cricket,” he said in a statement. 
Pakistan’s cricket analysts and commentators have blamed the national team’s lackluster performances over the past couple of years due to frequent changes in the coaching and selection staff. 
Last April, former Australian fast bowler Jason Gillespie was appointed as Test coach on a two-year deal. However, he resigned in December just before Pakistan’s home Test series against South Africa.
Javed, meanwhile, has been appointed by the PCB as Director of High Performance, the board confirmed. Javed will be responsible for leading and overseeing the high-performance cricket program in the country which ensures athletes are equipped to perform under high pressure conditions. 
“His appointment, alongside Mike Hesson as the white-ball Head Coach, marks a significant step forward in our strategic vision for Pakistan Cricket,” the board said.

Topics: Pakistan cricket team Pakistan cricket Mike hesson

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