Express Tribune Editorials 4th January 2026

Cervical cancer vaccine

Sindh’s HPV vaccine push faces resistance rooted in deep-seated public mistrust, misinformation

Pakistan has always had a turbulent history with vaccines. That history is once again catching up with the state. Sindh's decision to include the Human Papillomavirus vaccine in the Expanded Programme on Immunisation is medically and administratively necessary. But it enters a public space shaped less by science and more by suspicion.

Cervical cancer is preventable. That is not in dispute. What is in doubt is whether the state has learned anything from its repeated failures to carry the public along in vaccination efforts. The inclusion of this vaccine in routine immunisation should have been uncontroversial. Instead, it arrives burdened by the legacy of a recent campaign that faltered amid suspicion and misinformation. That experience should serve as a warning. The earlier drive, aimed at girls between nine and fifteen, ran into resistance despite official assurances and a visible media campaign. AI-generated videos and false claims spread faster than factual corrections. As a result, many parents refused the vaccination.

By formally embedding the HPV vaccine within the EPI, the Sindh government has taken the right administrative step. Routine programmes tend to carry greater legitimacy than one-off campaigns. Free availability at designated centres lowers access barriers. Dedicated funding over three years provides continuity. These decisions reflect the seriousness of intent. Yet administrative inclusion does not erase social hesitation.

Vaccination in Pakistan remains vulnerable to rumour, and trust cannot be outsourced to advertisements or circulars. It has to be earned through sustained engagement at the community level.

The state's challenge is therefore not medical but political in the broadest sense. Parents must believe that the programme is safe, monitored and in their children's best interest. Misinformation must be tackled, and trust must be rebuilt locally from the ground up.

Trapped at kitchen table

Pakistan's economic crisis: survival takes precedence as food, housing, utilities consume 63% of income

When households are forced to spend two-thirds of their income on food and electricity, the economy is no longer about growth. It is about survival. The latest Household Integrated Economic Survey confirms that living in Pakistan has become an exercise merely in staying afloat.

Food alone now absorbs more than a third of household spending. Another quarter goes into housing, electricity and gas. Together, these basic needs consume 63% of total expenditure. This is the direct result of prolonged inflation and policy choices that have steadily raised the cost of essentials. Incomes have risen on paper. They have not kept pace in reality. While average monthly earnings have increased over the past six years, household spending has risen faster. What families gain in nominal income is eroded by higher prices.

The purchasing power of the rupee continues to shrink. The real damage shows up in what households can no longer afford. Spending on education has dropped to just 2.5%. It is now less than half the cost of housing and utilities. Health and recreation together make up barely a few percentage points. A society that cuts back on learning and well-being is paying for stability today by mortgaging its future.

This is not resilience. It is fragility disguised as coping. What can be done? First, stabilising the cost of food and power must become an economic priority, not an afterthought. Second, inflation control must move beyond interest rates. Supply-side failures in food markets need fixing. And third, education and health spending need insulation from economic shocks. Household budgets are under siege. If policy continues to treat survival as an acceptable equilibrium, the long-term costs will be far greater than today's fiscal discomfort.

The fall of Maduro

Trump’s move in Venezuela risks fueling anti-US sentiments, destabilising the region

Washington's aggression over Caracas is a daredevil episode of violation of national sovereignty. President Donald Trump took a departure from his vision of non-intervention in others' affairs as he abducted Venezuelan President Nicolas Maduro and his wife, in an operation that the US attorney claimed to be 'lawful'. The charges against the deposed president include narco-terrorism, cocaine importation and conspiracy to possess destructive weapons against the US.

The assault was uncalled for under the canons of International Law, and seems to have united a politically divisive Venezuelan society that nursed severe grievances against Maduro, as he stands blamed for manipulating the 2024 elections. This interposition in Latin America has refreshed the sordid memories of the invasion of Panama in 1989, carried out under the edicts of the Monroe Doctrine that opened vistas of gunboat diplomacy.

Trump's impulsive personality and his quest for assertiveness seem to have come full circle with this Venezuelan misadventure. It has left a bitter taste and will come to ruin the incumbent's so-called reconciliation efforts in Ukraine and the Middle East. Moreover, with South America once again on the US radar, it will breed radicalism in the region, providing impetus to anti-US sentiments throughout the world.

The belligerence dubbed as "brilliant" by the White House coincided with a judgmental 'X' post from the Secretary of State Marco Rubio, who wrote: "Maduro is not the President of Venezuela and his regime is not the legitimate government." This is nothing but a negation of the values the US cherished recently under NSS 2025, promising to stay away from influencing foreign governments.

While Venezuela has called for an emergent UNSC meeting over "criminal aggression committed by the US government", there are not many serious listeners, though. The opposition under Nobel laureate Maria Corina Machado has refused to comment, and regional states are apparently in a state of shock and awe. For many, it is a déjà vu of America coming to rule their homeland through force and dictation. Colombian President Gustavo Petro is on the spot, expressing fears of a humanitarian crisis, resulting in more lawlessness and chaos.