FROM 2016 TO 2025: PAKISTAN’S LIFELINE STILL GROUNDED – A RENEWED CALL FOR AIR AMBULANCE REFORM

In 2016, legal and policy expert Hassan Rasheed Siddiqui recommended the creation of a Pakistan national air ambulance to provide emergency medical services during crises and in rural areas with poor healthcare infrastructure. This paper looks back on Mr. Siddiqui’s call, describes the continued public fallout from policy inaction, and recommends a framework to establish a national air ambulance system informed by international best practices. Pakistan’s geography, with its mountainous terrain, rural populations and the difficulties they can experience in finding even basic health services, has increased the urgency for fast-evacuation MEDEVAC facilities. The existing algorithms (military helicopters, private charter companies and ad hoc NGOs efforts) are insufficient and this results in vulnerable groups not receiving timely medical attention. In 2016, Mr. Siddiqui foresaw the establishment of an air medical network that would resolve the shortage of trained airborne paramedics, uniform protocols and inter-agency coordination. Yet not withstanding these explicit recommendations, in Pakistan’s fragmented healthcare infrastructure, there is no functional air ambulance system for the larger public. Models and experiences from other countries including India, Turkey, and South Africa are worth consideration for Pakistan. Pakistan can model and adapt these systems by developing an integrated, cost-effective and equitable aero medical evacuation system which caters for urban and rural populations. A number of recommendations are provided for Pakistan, such as development of national legislation, regulatory authority under the CAA, fleet partnering, and aerial paramedical training programs as a panacea to the article. Incorporating digital dispatch and GIS technology will also be critical to minimizing air ambulance response times, particularly in rural areas. Taking these actions is necessary for providing lifesaving public health services that do not discriminate based on geography or wealth.