Health on the brink

Pakistan is teetering on the edge of a major public health disaster, and frankly, it’s largely brought on by its own doing. Just this week, the Global Fund to Fight AIDS, Tuberculosis and Malaria – an international financing organisation – decided to cut over $27 million from the money set aside for Pakistan to fight HIV, tuberculosis (TB) and malaria. This couldn’t have come at a worse time. HIV infections are spiking, with more than 1,200 new cases popping up every month, and likely thousands more going unnoticed. TB continues to devastate communities, with over 600,000 new cases each year, many of them drug-resistant. Malaria is making a comeback because of climate change and poor control of mosquitoes, especially in rural areas that are often forgotten. On top of all this, the national programmes for HIV, TB and malaria don’t even have permanent, full-time leaders.

The Global Fund has mentioned ‘global funding pressures’ as one reason for their decision, but donor representatives also pointed directly to Pakistan’s ongoing poor performance, delays and mismanagement. The federal Common Management Unit, which is supposed to coordinate national disease responses, still doesn’t have a head. How can any country expect continued international help when it can’t even get its basic administration in order? Such failures directly lead to human suffering: thousands of children under five die every day in Pakistan, mostly from preventable causes. The number of mothers dying during childbirth is still shockingly high, with 27 women dying every day from pregnancy-related problems. Malnutrition silently affects millions. And polio, which was almost gone, is dangerously resurfacing. A recent Unicef report paints a bleak picture, showing a country that isn’t just failing to protect its children, but actually pushing them deeper into cycles of poverty, sickness and neglect.

This is an even bigger tragedy when you consider the government’s incredibly low health spending. There’s still time to fix this, but not much. Some of the deadlines have already come and gone. If something is not done now, it will cement donor mistrust and could lead to even more funding losses. Long-term reform is absolutely essential. Health shouldn’t be treated as a minor issue. The government must prioritise basic healthcare, nutrition, maternal and child health, and healthcare infrastructure that can adapt to climate change. It also needs to confront the false information and social stigma that are still derailing vaccination and treatment efforts. Pakistan is rapidly reaching a point where international partners might start seeing it not just as a country in need, but as one that wastes opportunities. That’s a dangerous reputation to build when donor money is shrinking and countries are competing for aid. The children dying today from preventable diseases, the mothers perishing in childbirth, the young adults newly diagnosed with HIV: they are the price we’re already paying. And things will only get worse if Pakistan fails to use this critical moment to truly reform.