COVID-19 in Pakistan: Challenges and priorities

Abstract

Abstract: COVID-19 has big health issues which affect worldwide beyond their borders, race, and ethnicity. All the countries faced this pandemic challenge but most of the underdeveloped countries are facing more dangerous situations due to limited financial and health infrastructure to respond against it. Overall, more than 100 million people are affected by the Novel Virus which results in 2.15 million people dying within a small interval of time. The current pandemic has brought unpredicted challenges to societies and also threatened humanity and global resilience. According to the National Command Operation Center, Pakistan, more than 0.534 million people are suffering with COVID-19 with more than 11 thousand deaths across the country. The Government of Pakistan has taken different initiatives like complete and smart lockdown to control the pandemic as much as possible. After the removal of the first lockdown, the high peak was observed across the country and created a panic situation among people and the government again closed all the educational and religious institutions with immediate effect to tackle the second wave of pandemic. Further, the interconnected nature of COVID-19 crises demands an integrated approach and coordination between all stakeholders to handle the pandemic in a significant way. Identifying the best set of policies and guidelines to handle COVID-19 challenges, and align them for the sustainable recovery from pandemic. The basic challenge facing the policy makers of underdeveloped countries is how to utilize limited resources to achieve interconnected goals for managing health recovery, economic crises, and creating environmental sustainability. We present a framework for identifying and prioritizing policy action to address COVID-19 and ensure sustainable recovery. The framework outlines principles and criteria, and shared policy goals, identifying smart strategies, accessing policy compatibility, aligning policy instruments and improving sustainability in short and long term policy decisions. This framework can be helpful for policy makers in the short and long run for mapping policy options and accessing cross-sectoral implementation. This framework is also helpful for policy makers to prioritize policy choice and allocate limited resources in such a way that they are directed toward actions and achieve interconnected solutions of health, economy, and environment.

Keywords:

• COVID-19
• health crises
• underdeveloped countries
• policy makers
• sustainable environment

PUBLIC INTEREST STATEMENT

During COVID-19, most of the underdeveloped countries are struggling to rearrange their resources within the existing infrastructure. The aim of this conceptual research is to provide a framework for the optimum utilization of resources. The framework outlines principle and criteria, and shared policy goals, identifying smart strategies accessing policy compatibility, align policy instruments and improving sustainability in short- and long-term policy decisions. This framework can be helpful for policy makers in the short and long run for mapping policy options and accessing cross-sectoral implementation.

1. Introduction

The current COVID-19 pandemic can hijack the whole world with its systematics global risk (ICIMOD, 2020). The rate of infection by Novel Viruses is very high and a gradual increasing trend is observed all over the world. It does not recognize borders, race, ethnicity, and parameters of our lives and well-being. It affects every area of our daily life like the healthcare system, educational infrastructure, economic growth, and social norms, and threatens billions of lives. It creates unprecedented problems for our society and affects global resilience. All the countries are focused on changing their health and economic policies to control the current pandemic as much as possible. In current health emergencies, most of the underdeveloped countries face the problem of adjusting or optimizing their limited health and economical resources with high poverty. The governments of these countries are trying to respond significantly to control the speedy spreadness of Novel Virus (Rym, 2020).

Most low-income countries do not have a proper health care system; more than 90% of these countries are least prepared for COVID-19 pandemic, the global health security index score of less than 40 out of 100 (Saraceno et al., 2007). In South Asia, Afghanistan has 2800 physicians for one million people, Bangladesh 5300, Bhutan 3800, and Nepal 6500, one tenth as compared to advanced countries. Even Hindustan, which has a health care system more advanced as compared to neighbourhoods, has 7800 physicians per one million people. This condition seems to be worse in Pakistan, which has 980 physicians per one million people and most of local hospitals have no functional health care system and administrative infrastructure (Saraceno et al., 2007; World Health Organization, 2020).

Pakistan is facing acute shortage of doctors and paramedical staff with its increasing population size. The approximate number of registered doctors in Punjab is 79 thousand, Islamabad 65 thousand, Sindh 22 thousand, K-PK 5 thousand, and Baluchistan 4.1 thousand. With current infrastructure and limited human resources, it is a challenging job to control or slow down the spreadness of COVID-19. Most of the people do not have any health care insurance or social security (ICIMOD, 2020). In our country, 66% of workers do not have any job contract and limited or no savings to utilize it for their health care or to fulfil basic hygienic (Saraceno et al., 2007; World Health Organization, 2020) and nutritious needs during lock down without borrowing and selling their assists. Most of the people in Pakistan are facing problems in accessing basic hygienic facilities. According to UNICEF, 5300 children die due to poor water and sanitation systems every year, 70% households still drink bacterial contaminated water and have limited soap for washing hands. Furthermore, most people live below or on the poverty line, having poor hygienic facilities, polluted water, and unhealthy living space which the social distancing is difficult to incorporate. More than 50% of the population is living in rural and scattered areas, which creates the difficulty to facilitate and educate the community about Novel Virus and remaining belonging to urban slum areas make the social distance impossible. Majority of these homes have a huge number of residents, for example, most urban areas in Karachi, Pakistan (2.5 Million population) face this problem. The overcrowded living and working space, limited drinking water, low air quality index, and poor sanitation facilities have made physical distance and isolation difficult and increased the rate of infection and exposure of COVID-19.

With poor hygienic, health, social, and economical infrastructure, strategic thinking and planning, and setting priorities have a significant role in low-income countries to control COVID-19 challenges (ICIMOD, 2020; Rym, 2020; UN-Habitat, 2016). The selection of appropriate priorities and policy instruments is one of the more powerful means for the success of policy (Shishir, 2020). Though decision making and priority-setting has always been a challenging job, the current pandemic can create more complicated health issues. Further, the interconnected crises required an interconnected approach and actions, which complicated the decision making even more complex (Whitmee et al., 2015; World Health Organization, 2010). The basic practical challenge which is being faced by policy makers is how they utilize limited resources to achieve the interconnected goals and well-being (Turnpenny et al., 2008; UN-Habitat, 2016). A well-organized framework is required to align all the basic needs of policy options and prioritizing in development and organizing their response. In this study, our proposed framework is to arrange limited national resources and facilitate policy developers to build a prioritizing process.

2. Prioritizing policies option and improving their consistency

The effective implementation of prioritizing should be to engage, align, and consult the environment between all stakeholders to build consensus on a quick recovery vision for health and financial security, and environmental benefits. The proposed infrastructure is defined in Figure 1 by detailed discussion of key elements. This framework is also helpful to draw the concepts about public administration and health, economic and sustainable development, and also assist policy makers to weigh policy options and prioritizing policy choices within and outside the health sector to facilitate the government about complex interconnected local and global benefits. To engage all stakeholders, there are two prior conditions for inaugurating the framework. A cross-sectoral coordination body is established first and second is to set different standards for evaluation and prioritizing policy activities. The basic principles for preparing priorities are given below on the basics for weighting different policy options. There are five fundamental criteria of developing a framework and associated with all steps. Each element is defined in upcoming sections.

Figure 1. Illustration of key coordination factors

3. Setting-up coordination between all stakeholders

The appropriate coordination and proper mechanism between all stakeholders of a state is very important for effectively dealing with current health crises as well as utilizing the limited resources and implementation of policy actions for achieving global resilience. The development of a combined coordination body can provide dynamic measures by engaging all parent partners and create the consensus between them for implementing policies and maximizing the chance of recovery from health crises. Several departments are working to create awareness among the people about the spreadness and high risk of Novel Virus. Beyond the health department, the living status, hygienic condition, and availability of basic prerequisites play a key role to maintain the health environment in a society (Agbo et al., 2019; Habitat for Humanity, 2017; Lane et al., 2020). The national coordination agency prepared the framework and mechanism for the development of coordination about financial and policy activities among all stakeholders. Furthermore, the basic role of coordination bodies is to create a peaceful and smooth working environment by developing meaningful communication within and outside the body by engaging all agencies. The active administrative communication and management between all stakeholders is the key assumption for preparing the effective and comprehensive policy options about this panic situation. In the current pandemic, the comprehensive discussion between all the key agencies is not feasible, but the coordination working body will be able to facilitate and engage all stakeholders for providing and sharing ideas about the utilization and implementation of limited resources for the quick health recovery. The major partner agencies in coordination bodies are governmental and non-governmental organizations such as the health department, finance division, security agencies, electronic and print media, religious institutions, and all the other related associations and organizations which may facilitate the working body at any stage to complete their task significantly. The mobilized coordination body depends on organizational framework and utilized precise standards to engage all working agencies. All stakeholders coordinate with each other under the cabinet division, national planning commission, or inter-departmental commissions. Moreover, the level of coordination between all agencies will depend upon the economic, geographical, political, and culture capacity (Hammar, 2006).

In Pakistan, the government established a National Command and Operation Center (NCOC) which engaged all stakeholders to create the national consensus and provide the basic infrastructure to control the current pandemic. The working body includes political and financial experts, think tanks, and health workers for preparing better and significant mechanisms to control the pandemic. The aim of NCOC is to investigate, harmonize, and prioritize the different national plans (Rehan et al., 2021). The working body of NCOC is to enhance departmental capability by comprising all the managerial and operational expertise of all stakeholders, and other state and non-state actors (private healthcare agencies, print and electronic media, and NGOs) beyond government. It is required to establish a mechanism of coordination for systematic interaction and communication about their assigned responsibilities among all stakeholders in a way to maintain a peaceful and reliable working environment among all key state agencies. The conceptual analysis of focused group (NCOC members, medical experts, and religious scholars) interviews is elaborated in Tables 1 and 2.

Table 1. Effects of available lockdown options

Lockdown status	Social benefits				External Effects		Overall effectiveness
	Health	Economic	Education	Environment	± ve	- ve	Short	Medium	Long
Normal	-	+	-	-	±	-	±	±	±
Complete	+	-	-	+	±	-	+	-	±
Smart	+	±	±	+	+/o	0	+	+	+
Partial	+	+	+	+	+/o	0	+	+	+

Table 2. Assessment of available policy choices

Lockdown status	Social benefits							External Effects			Overall effectiveness
	Health		Economic		Education		Environment	± ve		- ve	Short		Medium		Long
Enhance health care system	+		+		+		+	+/0		0	+		+		+
Educational growth	+		+		+		+	+/0		0	+		+		+
Increase investment in food and hygienic items	+		+		+		+	+		0	+		+		+
Promote smart/tunnel farming	+		+		+		+	+		0	+		+		+
Subsidize transportation sector	-		+		+		-	-		-	+		+		+
Subsidies chemical industry	-		+		-		-	-		-	+		-		-
Removal subsidies on fossil fuel	+		±		+		+	+		0	+		+		+
Religious awareness	+		+		+		+	+		0	+		+		+

4. Promoting share understanding and objectives

Figure 1 illustrates the key factor of the coordination body, the basic objective in the planning and prioritising is to align all stakeholders to create the national consensus for achieving short and long run benefits of the country. This would also be helpful to minimize misconceptions about common strategies and planning about their social goals. The short, medium, and long objective could be categories, as:

1. Short-Run Objectives

   • Implement COVID-19 standard operating procedures (SOPs)

   • Quick recovery from current pandemic

   • Provide food and other hygiene facilities

   • Minimize mental stress and anxiety

   • Restore educational activities

   • Utilize limited resources in a significant way

2. Medium-Run Objectives

   • Provide financial assistance

   • Job security and job opportunity

   • Engage all stakeholders to restore economic activities

3. Long-Run Objectives

• Reduce social and culture inequalities

• Build global resilience

• Create sustainable economic growth

• Protecting environment

All of these objectives are interrelated and required to implement policy options with proper care and effective administration policies instruments for achieving short-, medium-, and long-run objectives, respectively. These objectives are helpful to prepare the framework and policies for prioritising.

5. Develop consensus among stakeholders

It is a very difficult task to develop consensus among all stakeholders of the country within and outside the health department. This framework involves the contribution of all state and non-state actors including health and financial experts to perform and create the consensus on common nation goals (Whitmee et al., 2015). A national consensus of common social goals not only facilitates prioritising policies and building commitment and dedication among all agencies. Furthermore, all stakeholders have their own interest, Priorities, and problem solving skills, but the coordination body facilitates all of them to build mutual interest and align their interest in social interest (Greer & Lillvis, 2014). The focus of engaging all agencies is to share understanding and align their resources for the quick recovery (WHO, 2013). It provides an opportunity to maximize their interaction among all agencies and provide a forum for open-discussion, mutual understanding, defining statements of the problem, and finding the optimum pathway to restore normal life. The aim of this engagement is to minimize conflicts and disarrangement, and maximize the mutual communication and clarify the partial and major social and organisational responsibilities in a significant way (deLeeuw, 2017; World Health Organization, 2010). The fundamental criteria described in Figure 1, it is critically and analytical important to engage all stakeholder and develop mutual understanding and appreciate open communication and collaboration for prioritising policy to manage/recover from pandemic and achieve sustainable economic growth. In the current pandemic, it is required to work together for quick and sustainable recovery from health and economic crises by making mutual consensus based on basic principles defined above.

6. Consensus priorities setting framework

To build the consensus on priorities setting is a very important practice which involves the optimum allocation of available recourse to achieve the national goals. Their organisational interests, awareness about problems, communication within organization, and diversity in resources of all agencies requires establishing a consensus for setting priorities.

7. Scopes of priorities

This is a complex process and is understood in several dimensions, all agencies must keep it into account. This is a moral, constitutional, and social responsibility of the state to provide a safe, peaceful, and neat living and working environment (Molnar et al., 2016; Qiu et al., 2018). Furthermore, it is the key responsibility of NCOC to provide a plan which will be helpful to save human life, minimize the life threats, enhance the health care system, control the viral COVID-19 pandemic, and provide basic health and hygienic facilities. Thus, policy makers should keep it in mind that we have finite human, financial, and health care resources (Einhorn et al., 1995; Emerson et al., 2012). So, policies are prepared in such ways that are cost effective and have maximum gross social and global benefits. From a domestic perspective, the transparent and equal chance of opportunity is a major factor in policy preparation. In the current COVID-19 pandemic, cost effectiveness is not our top priority to make sustainable financial growth; we have to engage all stakeholders to make quicker recovery as soon as possible beside their cost and utilization of finite resources. These actions are helpful to achieving global and social resilience with better security (Agbo et al., 2019; Bellefleur & Keeling, 2016). Although, our top priority is given to policy options to achieve short, medium, and long run social and global resilience and improve the capacity to handle future challenges.

The key principle is to engage all agencies and create consensus among them for effective and open communication to control/recover from this health crisis. In Figure 1, three fundamental criteria are classified to evaluate policy choices for allocating finite resources.

• Protect human life

• Efficiency and effectiveness

• Systematic growth and resilience

These fundamental criteria may vary from place to place or country to country as per their health care system, geographical locality, economic status, and availability of resources, social and environmental concerns.

8. Explore smart policies

When prioritising criterions are developed, the next phase is to build smart policies to inaugurate and coordinate for the implementation of different smart policies (see Figure 1). It is also essential to illustrate all the pros and cons of policy choices that may fulfil different health and financial objectives at the same time.

Additionally, the other basic criterion for measuring prioritizing, the government of Pakistan is trying to provide equal job opportunities for males and females, food, and basic hygienic facilities. Initially, they invest in the labour and small industries to generate employment opportunities as well to generate revenue for sustainable economic growth. The investment in small business and micro-enterprises will increase the employment opportunity, and improving the use of national products will result in high demand of nationality manufactured/produced goods (Rawls, 1971; Sen, 1999). The positive or negative outcomes of these strategies will depend upon the availability of human and economical infrastructure inside the country.

To achieve COVID-19 smart strategies and challenges, it is required to choose optimal policy options that may also support and maintain the probability of success of other activities (WCED, 1987). The optimized policy options might analyse various strategies, and measure the nature and magnitude of social and global benefits and their trade-offs. For example, the COVID-19 challenges for health may be addressed by the availability of basic hygienic facilities, thus investment should be made to provide job opportunities and minimize the health risk. Correspondingly, investment in the education sector will improve awareness about pandemics and also help to increase social resilience. The human capital will be improved by education and health, which would lead to shape outcomes. In the coming year, most of the low income countries only have 33% healthy and educated workforce (ILO, 2020). The suitable policy choices increase the awareness among people about education and health, and also create new skills, increase hygienic facilities and food availability, reduce social inequalities, recover from health crises, and maintain global resilience (Hepburn et al., 2020; Sen, 1999). For example, promote smart and tunnel farming in rural areas, which will lead to empower poor farmers and increase the food capacity of the country. It’s required to select suitable policy options which do not minimize the other social and global priorities.

9. Consistency in policy enhancement

In real life, the consistency for improving the policy options is required by the regular communication and coordination between all stakeholders to increase the net benefits for society (Lane et al., 2020; Sen, 1999). The critical evaluation of trade-off between consistent improvement and net-social benefits is required and found in the best possible way.

10. Focused group interview

In current pandemic, the NCOC member and medical experts suggest following four options, as:

1. (i) Normal Life: In underdeveloped countries like Pakistan, normal life may provide sustainable economic and social growth but it also increases the risk factor of COVID-19. The increasing trend of communication disease is observed in every country which does not follow SOPs, which results in a huge burden on the health department. The health system in Pakistan is not up to mark and will not be able to bear the load of this pandemic. Most of the hospitals do not have a proper administrative structure and it might collapse within a couple of weeks.

2. (ii) Complete Lockdown: The second option is complete lockdown that can shut down all economic, social, and educational activities. The economic growth index is Pakistan is already below the average due to weak political, financial, and social status. The complete lockdown increases the unemployment rate and increases the poverty index all over the country. Increase in poverty index may lead to increase in domestic problems, crime rate, depression, and anxiety, and it also creates the shortage of food and domestic items. That is not a good option.

3. (iii) Smart Lockdown: The smart lockdown is a good option to enforce complete lockdown on some selected areas where the risk index is high as compared to other localities. The duration of smart lockdown is observed 15 days, but increase or decrease in duration depends on the risk index in that locality. The law enforcement agencies ensure the smart lockdown in mentioned localities. This option is looking good enough as compared to complete lockdown.

4. (iv) Partial Lockdown: The restricted lockdown which leads to open social, economic and educational activities by following strict SOPs. The social structure in underdeveloped countries is not well enough to complete these strict restrictions. In the first wave of pandemic, the government and public show high maturity level and take it seriously to implement COVID-19 SOPs as per the guidelines of the World Health Organization (WHO). So, the risk index has been under control for a few weeks. But from the last few months, the government and public have expressed their soft corner against the pandemic which again increases the risk index of COVID-19. Thus, the second wave of pandemic again creates problems for society. Government closed all the educational institutions and moved on to a virtual learning system (VLS) to engage the students as much as possible. In low income countries, VLS is not a good option because of limited resources and poor technology.

11. Conceptual analysis of focused group interviews

The implementation of partial or smart lockdown seems to be good as compared to other available options. In Table 1, the qualitative assessment of different available policy choices is described, as:

Table 1 reveals the qualitative evaluation of available policy options in low income countries. The smart and partial lockdown have the positive feasibility as compared to other options, but the use of partial lockdown have high positive social and economical benefits in short, medium and long run social and global resilience.

The optimum implementation of available options and limited national resources is to maximize the broad social benefits. In Table 2, qualitative assessment of available resources is defined, as

Table 2 illustrates the external and overall effects of policy options will be helpful to maximize local and global benefits. On major factor which observed in Muslim countries like in Pakistan is the lack of religious awareness about communication disease and use of electronic and technological instrument. In the 21st century, most local religious scholars show a non-serious attitude about the above mentioned factors. In our country, policy makers must take into account the positive participation of religious scholars about communication diseases and inform them about the high risk index of COVID-19.

Furthermore, the policy consistency, rapport, and conformity are also required in addition to above defined potential benefits.

• Consistency: The consistent attitude of all the stakeholders is necessary to achieve the quick health recovery, within and outside the health care system. Thus, the positive participation of all agencies contributes to accomplish local and global resilience.

• Rapport: The local and global compatibility and rapport between policy option and all stakeholders is offered to consistency in implementation of policy choices and externalities and support to achieve well-being.

• Conformity: That expresses the capability of policy options and planning division to engage and share understanding with each other in a mutually and interactive communication environment for achieving non-health-related goals.

12. Improve policy consistency for better policy options

The fundamental responsibilities of government are to align all the policy models (the economical, marketing, and religious instruments utilized to create the awareness between the public) and figure out the structure to get local and global goals (Shishir, 2020). When the policy options are selected with smart strategies, then the best available infrastructure needs to be utilized to attain maximum potential health goals in broad global resilience by following basic principles defined in Figure 1.

13. Improve policy consistency

When the policy instruments are aligned, the next step is to make the policy by the financial, strategic, social, and religious assistance, one sector does not create conflict with another (WCED, 1987; Whitmee et al., 2015). For example, subsidising the transport sector is helpful to create job opportunities and provide financial aid to the country but affect the growth of health and environmental goals. Similarly, the chemical industry may increase the annual gross domestic production (GDP) and per acre yield but it has a negative effect on human life (Agbo et al., 2019). But, when the government promotes investment in smart or tunnel framing it increases the per capita income, job opportunity, per acre yield, and GDP, and has a positive effect on human life and increases the success probability of health and economic related goals.

14. Organization external effects

One of the other possible ways to maintain policy consistency is to organize external effects. The positive and negative effect of external factors may affect the policy choices regarding or engaging direct variables in any situation. For example, honey bees increase the per acre yield by pollinating the surrounding crops when they are kept for the collection of honey. Nevertheless, the use of smartphones is helpful to increase the level of communication and open the new job market but it also damages more than 40 industries/sectors of any developed or undeveloped countries by compacting their features/products in just a single device. Additionally it also affects the social, cultural, and moral values of our society. Everyone is busy on his smartphone without respecting the feelings of his/her socially connected persons. The appropriate use of smartphones is good, but excess of everything creates the problem (physical and mental health issues).

In most cases, external factors arise when the production and consumption of goods and services are considered by the private investor, who does not understand the local and global consequences (Shishir, 2020). Traditionally, the market structure is not designed in such ways to decide the price of the product by taking the social and global aspects and impacts of that product. For example, the cost of careful disposal of medical waste minimizes environmental pollution and transition of disease. Thus, an infrastructure is required which includes this cost; impose extra tax in terms of disposal of medical waste. The fundamental focus is to design the policy options in such a way that maximize the local and global benefits and minimize external effects (Agbo et al., 2019). Thus, policy instruments are engaged in such a way that negative effects are discouraged with taxes and penalties, and positive effects are promoted in terms of rewards, incentives, or fringe benefits.

15. Initiate awareness programs in social interest

Additionally, the private sector does not consider the local and social effects of their decisions and services, their private interests must be fulfilled whether the social interests are achieved or not (Lane et al., 2020; WDR, 2019). Thus, the variability in social and private interest often generates the optimum social benefits such as community health and transportation, good hygienic condition, safe and secure working and living place, appropriate educational infrastructure, and innovative research may produce broad social positive externalities. The rewards of social benefits are not directly captured by private investors, so the private sector is not willing to invest in social benefits. Although low income countries are failing to provide basic social goods and services to achieve social goals, public-private partnership is required to minimize the gap between social needs and the economical capacity of the country. The development of optimum infrastructure required to engage the private sector to participate in social needs and global resilience, including the upgrading of the health department (Soucat, 2019; WDR, 2019). Thus, the policy choices that involve external cost should be recognized carefully and on priority basis. When fringe benefits are not adequate, policy reforms are required that regulate all the inconsistent use of limited resources and provide an appropriate health care system. For example, the removal of subsidies on fossil fuels can help to reduce environmental pollution, while this investment in public health care enhances the capacity of the health sector (Agbo et al., 2019). To engage the private sector in the health care system, different types of policy instruments are required to reform on priority basis.

The policy instruments are critically revised and arranged to build the supportive coordination and mutual cooperation to achieve the health care goals and global resilience. The revision of policy instruments required achieving organisational and local benefits and positive understanding in public-private partnership. Moreover, a careful understanding of cultural and social values/capacity is also required before selecting the policy instruments and operational management because a key never opens every lock.

16. Long-term consistency from policy decision

The impact of policy decisions may be helpful to achieve the short-term goals, but in low income countries the aim of all stakeholders is to prepare such policy instruments which may attain long term sustainability. So, the policy instrument required to solve short-term health issues and also ensure long-term suitability by understanding the basic principles defined in Figure 1.

17. Short term policy consistency

The current pandemic engage all the agencies to revised their policy instruments to provide the sustainable economic and social growth in order to create more local and global resilience. To achieve the long run social, economical, local and global benefits, the strategic and administrative thinkers can align feasible policy options in such a way that the short term or local policy actions/ benefits provide the long-term or global achievements. The supportive environment between all stakeholders improves the social, environmental and health condition of the society. For example, providing the food and other hygiene facilities to low-income societies by following COVID-19 SOPs, thus it may be helpful to cover their vulnerability rather than achieving private benefits. Similarly, investment in the automobile industry to promote electric vehicles (EV) provides an opportunity to save our fuel and maintenance charges in the short run and environmental advantages in the long run.

18. Enhance long-run sustainability and resilience

During COVID-19 pandemic, our focus is to achieve quick health and economic recovery, and restore economic activities as soon as possible because smart or partial lockdown is not a choice to achieve local and global economic goals. Thus, the long-run balance investment is required to engage all sectors of daily life to handle future challenges (Greer & Lillvis, 2014; IOM, 2013; Seymour, 2016). For example, the investment in smart farming, health, religious institutions, education, and technology will increase the job opportunity and financial status in the short term and also return consistent and reliable benefits for our next generations (Habitat for Humanity, 2017; Lane et al., 2020). Additionally, the low-income countries will try to invest in job creation to engage their youth in positive activities, but the minimization of local and global environmental risk is the top priority to protect human life as much as possible. Due to low financial status, most low income countries are struggling in social capital like forest, clean water, fresh air, biodiversity, and climate may facilitate human well-being and achieve long run resilience (IOM, 2013, Gaudin et al., 2019). In the last few years, the government started a project called Green Pakistan and Billion Tree Project to provide the fresh air and control worse conditions of smog, these projects are also helpful to achieve local and global climate benefits.

Moreover, the consistent, sustainable, compatible, and coherence road map is required to make precise alignment and investment of limited resources to address short term challenges and also facilitate long term global resilience.

19. Conclusion

The alignment of policy instruments to handle the current health challenge is very important for the consistent and sustainable recovery from COVID-19 pandemic. The attitude of the government, public, and especially religious scholars is very important for the quick health recovery. The policy priorities, awareness, and coordination between all state and non-state actors will affect the reliability of policy outcomes. Poor policy management and policy instruments may make the entire program ineffective to achieve economic, education, and health goals. The current investigation deals with challenges and policy prioritising actions for quick and sustainable recovery from health pandemic. The outline of this article facilitates the policy makers for accessing the prioritising policy options, planning, and decision building. The principal objective is to align all policy choices, build a shared understanding environment, and consistent economic, health, and educational benefits in short and long run respectively.

In the current COVID-19 pandemic, this prioritising mechanism builds mutual understanding and enables/engages all stakeholders to maximize the positive outcomes and handle all consequences in a more significant way. It is also helpful for low income countries for the optimum allocation of limited resources for the quick health recovery and accomplish their multi-dimension financial, health, educational, and environmental benefits.

It is a complex and difficult task to establish the consensus and mutual understanding between all agencies, the sincere contribution of the government is required to build the national consensus between all stakeholders beside their organizational benefits. The focus of our proposed framework is to develop a coordination body based on all state actors of the country for establishing the consensus on common goals and mobilizing quick health and economic growth. The proposed framework might be further modified by the quantitative research tools and establishing the trade-off as defined Tables 1 and 2. However, this illustration discussed the effective and quick recovery from COVID-19 pandemic; this can also be utilized for building coordination and understanding, problem solving skills, and aligning different policy instruments for different multi-sectoral benefits. Multi-dimensional dynamics requires a mutual collaboration and coordination body to work for interconnected benefits. The comprehensive illustration of policy options demanding the careful understanding of financial, educational, human resource, religious, and political status of the country.

Additional information

Funding

The authors received no direct funding for this research.

Notes on contributors

Fariha Sohil

Fariha Sohil, Ph. D is a social scientist and working as Assistant Professor in the department of Education at The Women University, Multan, Pakistan. The focus of her research is to improve the local and global resilience by optimize the available resources.

Muhammad Umair Sohail

Muhammad Umair Sohail, is data analysis, conceptual writer, and Ph. D. Student at Quaid-I-Azam University, Islamabad, Pakistan.

Javid Shabbir

Javid Shabbir, Ph. D is full Professor at Quaid-I-Azam University, Islamabad, Pakistan.