Propose structured transition frameworks with priority, including the establishment of a national health financing forum
Patients line up for medical help at a health camp. Photo: Express
Cuts in development aid and funding pose a significant threat to the country’s health sector and its functioning, according to a report by think tank Tabadlab.
In a press release issued today, the think tank said its new report warns that “Pakistan’s health system faces functional collapse in critical programs as official development assistance (ODA) withdraws — a crisis that cannot be solved by budget increases alone.”
The report, titled: “Beyond Dependence: Understanding the Impact of ODA Cuts on Pakistan’s Health System”, was published last week and authored by the think tank’s Shahab Siddiqi, Behzad Taimur and Syeda Farwa Qamar Jaffri.
The press release said it documented how recent donor reductions disrupted specific system functions that domestic budgets only partially covered: commodity procurement, diagnostic capacity, supply chain management and specialist staffing.
It added that the report drew on interviews with dozens of development practitioners and public health officials across federal and provincial governments, along with analysis of budget and ODA data.
“The evidence is already visible. USAID’s suspension closed over 60 facilities, disrupting care for 1.7 million people. A $27.2 million global cut cut TB surveillance in half in Punjab and Khyber-Pakhtunkhwa, reduced funding for diagnostic kits, and put treatment for tens of thousands of HIV-positive patients at risk. These disruptions will only intensify if the ODA government’s transit plans fail to reinforce effective transit plans,” said release.
“This is a functional problem, not just a fiscal problem,” said Siddiqi, Tabadlab’s director of human capital.
“Pakistan’s public budgets fund salaries and facilities. ODA funds vaccines, medicines, diagnostics and supply chains. When ODA contracts, services retain staff but lose the operational core that makes the programs work,” he said.
The press release said the pressure was further compounded by Pakistan’s “chronically low health investment” of just 0.9% of GDP, “well below” the World Health Organization’s recommended minimum of 5%.
“In Pakistan, grant-based aid has fallen by 59% since 2017, while OECD projections indicate a further 5.9% decline in global ODA by 2026, signaling a structural shift rather than a temporary hiatus.”
The press release said the report proposed a structured transition framework with immediate priorities that include establishing a national health financing forum, developing a national ODA registry and designing a risk matrix to classify functions by substitutability and criticality.
“Medium-term actions focus on time-bound transition plans for tuberculosis, HIV-AIDS and immunization programs, regulatory reforms for flexible procurement and employment, and raising public health spending to 3% of GDP.
“Long-term reforms center on technical capacity improvement and progressive integration of vertical programs into primary care,” the press release concluded.
