Going by various reports and surveys published over the past few years, Pakistan’s health sector is in a deeply troubling state. Among these, the Pakistan Medical Association (PMA), in its Health of the Nation Report 2025, highlighted the multifarious challenges confronting the country’s health system, including alarmingly high maternal and child mortality rates and the persistent threat posed by preventable diseases. The PMA also strongly criticised the government for failing to ensure the provision of fundamental human necessities, such as access to clean drinking water and the proper disposal of liquid and solid waste.
According to the PMA, the state has effectively deprived citizens of their right to healthcare. Today, a large segment of the population can neither afford medicines for common ailments nor bear the cost of even minor surgical procedures. Official records show that over the past few years, drug prices have increased at least 15 times, rendering most essential medicines unaffordable for the majority of people across the country.
The gravity of the situation is further underscored by international assessments. The World Health Organisation (WHO) ranked Pakistan 125th out of 170 countries surveyed last year due to the poor state of its public health system. It is estimated that contaminated water alone accounts for nearly 40 per cent of annual deaths in Pakistan, while poor water quality is responsible for approximately 30 per cent of all diseases nationwide.
Communicable diseases continue to take a heavy toll. Hepatitis B and C are widespread, affecting more than 15 million people, with an estimated 150,000 new cases emerging every year. Malnutrition remains a major public health challenge, affecting one in three children under the age of five. Diseases such as tuberculosis and malaria are also common, particularly in rural and underserved areas where access to basic healthcare services remains severely limited.
Pakistan has one of the highest burdens of tuberculosis in the world, ranking fifth globally in terms of TB prevalence. It is also reported to have the fourth highest prevalence of drug-resistant tuberculosis (MDR-TB). Maternal health indicators paint an equally disturbing picture. According to recent surveys, around 14 per cent of pregnant women are undernourished, while 42 per cent suffer from anaemia, significantly increasing the risk of complications and low birth weight. Deficiencies in calcium, vitamin D and protein further undermine maternal health. Among newborns, nearly 18 per cent have low birth weight, leading to long-term growth and developmental problems. Stunting affects about 40 per cent of children under the age of five, reflecting the enduring consequences of poor maternal and child nutrition. Pakistan also bears a high burden of non-communicable diseases, including cancer, cardiovascular illnesses and mental health disorders, compared to many other countries.
The financial consequences of an ailing health system are equally devastating. The Universal Health Coverage (UHC) Monitoring Report 2024 revealed that more than 13.4 million people were at risk of falling into poverty due to emergency health expenditures. The latest UHC Monitoring Report 2025, released by the government last month, presents an even grimmer picture: 14.8 million people are now facing catastrophic health expenditures, while 11.1 million have been pushed below the $2.15-a-day poverty line due to out-of-pocket (OOP) health payments.
The Pakistan National Health Accounts 2021–22, which included a special OOP health expenditure survey covering 24,809 households across urban and rural areas, offered further insight. The findings were alarming: 82.79 per cent of OOP health spending was directed towards the private health sector, while nearly 73 per cent of total OOP expenditures were incurred on outpatient services, essentially primary healthcare.
There is ample evidence to suggest that one of the principal reasons for the progressive deterioration of Pakistan’s health sector is the chronic neglect of preventive healthcare. Experts estimate that providing access to clean drinking water alone could reduce up to 60 per cent of water-borne diseases, while effective mosquito control could lower the incidence of vector-borne diseases by nearly 40 per cent. However, rapid population growth, coupled with declining public funding, has further weakened an already fragile healthcare system.
The situation is characterised by chronic underfunding, poor governance, widespread mismanagement and a growing burden of disease. According to the WHO, Pakistan spends only 2.6 per cent of its GDP on healthcare — one of the lowest ratios in the world. Consequently, the country’s healthcare infrastructure remains grossly inadequate to meet the needs of a fast-growing population.
Another critical dimension of Pakistan’s health crisis is the widening disparity in access to healthcare services. While major urban centres such as Karachi, Lahore and Islamabad offer quality healthcare to those who can afford it, vast rural areas remain largely neglected. The absence of functional healthcare facilities forces rural populations to travel long distances for basic treatment, resulting in delayed care and avoidable complications. Public hospitals, intended to serve the common citizen, are overcrowded, underfunded and chronically understaffed, leaving patients without timely or adequate medical attention.
There is an urgent need not only to increase funding for the health sector but also to establish robust mechanisms to ensure that resources are utilised efficiently and equitably. Greater investment is required to improve healthcare infrastructure, expand the pool of trained healthcare professionals, and ensure the availability of essential medicines and treatments. Strong administrative reforms are also imperative to curb corruption and eliminate mismanagement within the public health system.
Strict monitoring and accountability of hospital management, along with the elimination of wasteful expenditure, are essential to ensure that every rupee allocated to healthcare delivers maximum public benefit. At the same time, the government should consider offering incentives and subsidies to private healthcare providers to encourage them to serve rural and low-income populations.
Healthy citizens form the foundation of a healthy nation. It is time the government recognised the severity of the crisis and took decisive action to address the deep and persistent gaps in Pakistan’s health sector — a sector that, at present, is far from healthy.