Proposes a structured transition framework with the creation of a national forum on health financing as a priority
Patients queue for medical assistance 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 today, the think tank said its new report warned that “Pakistan’s health system faces a functional collapse of critical programs as official development assistance (ODA) withdraws – a crisis that cannot be resolved through budget increases alone.”
The report, titled “Beyond Dependency: Understanding the Impact of ODA Cuts on Pakistan’s Health System,” was released last week and authored by Shahab Siddiqi, Behzad Taimur and Syeda Farwa Qamar Jaffri of the think tank.
The press release says it documents how recent donor cuts were disrupting specific system functions that national budgets only partially covered: commodity procurement, diagnostic capacity, supply chain management, and specialized personnel.
He adds that the report draws on interviews with dozens of development practitioners and public health officials from federal and provincial governments, as well as analysis of budget and ODA data.
“The evidence is already visible. USAID’s suspension closed more than 60 facilities, disrupting care for 1.7 million people. A global fund cut of $27.2 million halved TB surveillance 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 government is failing to develop effective transition plans while ODA continues to contract,” the press release said.
“This is a functional problem, not just a fiscal one,” Siddiqi, Tabadlab’s chief human capital officer, was quoted as saying.
“Pakistan’s public budgets fund salaries and facilities. ODA funds vaccines, medicines, diagnostics and supply chains. When ODA contracts, services retain their staff but lose the operational core that makes programs run,” he said.
The press release said the pressure is further compounded by Pakistan’s “chronically low investment in health”, at just 0.9% of GDP, “well below” the World Health Organization’s recommended minimum of 5%.
“In Pakistan, grant aid has declined by 59% since 2017, while OECD projections indicate a further 5.9% decline in global ODA for 2026, signaling a structural change rather than a temporary disruption.
The press release states that the report proposes a structured transition framework with immediate priorities that include the creation of a national health financing forum, the development of a national ODA registry and the design of a risk matrix to classify functions by substitutability and criticality.
“Medium-term actions focus on time-bound transition plans for TB, HIV-AIDS and immunization programs, regulatory reforms for flexible procurement and recruitment, and an increase in public health spending by up to 3% of GDP.
“Long-term reforms focus on strengthening technical capacity and gradually integrating vertical programs into primary care,” the press release concludes.
