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Are Prescriptions Easy?

Abdus Samad June 23, 1998

Tags: medicine

Whether we lack sound academic institutions because of our general
disdain for patient research and inquiry or vice versa is a
"chicken and egg" question perhaps not worth discussing
in much detail. What we observe is a simultaneous prevalence of
a disdain for academics and a lack of academic
institutions. The
result is that there is no conception of what learning and inquiry is.

While the academic institutions have been declining in quality, so has
everything else in Pakistan. As many would argue, civil society has
rapidly deteriorated. Even basic rights are no longer available to the
citizenry, as everything from the economy to personal security is
threatened. Meanwhile, corruption and maladministration has further
destroyed all semblance of order in the institutional infrastructure
of the country.

There is a growing impatience as well as helplessness with this sad
situation. Those who cannot benefit from it or those who are
marginalized from the power structures wish to change this at as
rapid a pace as they can. This impels them to activism and towards
finding the easiest available solution.

I have met many young students and professionals over the internet who
claim that there is no time for thought but only for marching in and
doing. "Research and inquiry is not necessary, for that will not
develop change. We need to act and not think." They march with this
motto and blindly indulge in some activism for a few years and then,
when realities of life catch up with them, either migrate abroad or seek a job
with a multinational corporation.

Surprisingly, the same theme is struck by those in power. They may say
it differently but the underlying idea is the same. "You academics
have no solutions that are applicable to us. We know what needs to be
done. There is nothing to read and I have no time between my
shadi/janaza/meeting/political functions." They have no time to read
or understand and they need to justify it by putting down
thought and inquiry.

The political activist creed has recently been given a great boost by
the donor community. They are directly funded by the donors who are
fighting for them to have a place in policy making. Donors are defining
the agenda for these activists and the agenda seems to be heavily in
the favor of activism. I recently heard one of these major donors argue
that "prescriptions are easy", mimicking the activist creed in the
country. The donors know it all. Unfortunately we are not implementing
it. The problem has always been the implementation capacity in the
country and not the prescription.

This is too important an issue to be left unexplored. It has generated
a youth that is neither learned nor inquisitive and decidedly not
prepared for the long haul. Action today, regardless of the direction
that it takes, has become the norm.

Are prescriptions easy?


The donor who considers prescriptions to be easy should look at
his/her own society and tell us if the maxim of "prescriptions are
easy" holds there. In answering this question, the donor may wish to
examine the following three propositions. The enormous infrastructure
that they have created seems to fly in the face of this
maxim. Whatever policy initiative is taken is well researched and
frequently debated. Political parties, even in opposition, maintain
think-tanks for the development of policy initiatives to be used when
they come to power. Is it that they mean that thinking is a luxury
good for which we are not ready yet? Why is it that the policy in the
industrial countries has been following academic thinking and not
activism? They followed Keynesianism and academic school of thought
for a long time and when the academic debate was won by the
neoclassical thinkers, policy was based on neoclassical lines. It
seems that research leads policy and that policy makers do not seem to
rush into the most easily available prescription. If prescriptions
are easy, why is it that the West has not solved its unemployment and
trade cycle problems? Why is there an enormous research effort
underway to solve these problems and why are policy makers looking
toward that research effort for answers?

The Separation of Prescription and Implementation.


Why should prescription and implementation be separated? I grant that
understanding socio-politico-economic systems are extremely
difficult. Often, for convenience of analysis or improved
understanding, we have to look at partial views of the system. But a good analysis
will take into account the prescriptive and implementation aspects of
the particular situation. All analysts worth their merit will examine
the practical aspects of their prescriptions. To separate the two is,
at the minimum, naive.

What most critics of thinking and analysis are implicitly
expressing is a frustration with the lack of political will for a
change. Unfortunately, the impatience and its accompanying disdain
for inquiry and informed analysis, may itself be the reason for the
difficulties with implementation. Perhaps they should examine the two
types of inputs that the policymaker is getting: The activist input
which throws up prescriptions too quickly and cavalierly at the
policy maker without backing it up with a clear analysis of the costs
and benefits and possible pitfalls. Why should all such quick
reactions should be implemented? Who can distinguish between these?
The donor input is based on a similar quick approach that does not
inspire much confidence: hire a retired bureaucrat for a quick
consulting job that presents the donor's favorite viewpoint. That is
then considered to form the basis of reform and policy. The donor's
agenda is visible, the skills of the consultant are apparent, and
therefore the honesty of the inquiry is always questioned. The
policy makers and domestic groups are divided on the issue, if at all
they are interested. Where is the ownership of reform?

Are all Prescriptions Good?


Imagine that you are a policy maker and are willing
to follow the maxim of "prescription is easy," would you follow all
these prescriptions? How do you distinguish between the good and the
bad prescriptions. As I have discussed in my book Governance, Economic
Policy and Reform in Pakistan, the donor too has been wrong in making
prescriptions.

Given our current state of understanding of socio-politico-economic
processes, we should be more humble and inquiring and not claim that
"prescriptions are easy." On the contrary, the hypotheis can be
advanced that the reason that things looks so gloomy in the country,
may be because of our cavalier attitude towards prescriptions and the
prescription-making process. The donor too should adopt the same
humility, and rather than providing us with pat solutions and driving us
away from thinking, should move toward investing in our thinking, analytical
and prescription-generating infrastructure.

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