ON World Kidney Day this past Thursday, the Pakistan Medical Association raised the alarm on Pakistan’s “escalating kidney failure crisis”. One hopes that both civic authorities and public representatives took note. The numbers presented by the Association are staggering. The country is projected to see nearly 25,000 to 50,000 new end-stage kidney disease cases by the time this year is done, according to the PMA. This means an alarming 25,000-50,000 more patients will be putting strain on our already stretched healthcare system; they will require lifesaving dialysis or transplantation. What is more upsetting is the fact that most of these cases may be completely preventable. According to a PMA representative, by some accounts, up to 80pc of our population lacks access to safe drinking water, and consumption of contaminated water is now the primary driver of kidney failure in the country. This puts the responsibility for this mushrooming crisis squarely on the heads of civic authorities, who have consistently failed to provide this basic facility to Pakistani citizens.

End-stage renal disease is one of the most expensive health conditions to manage. The cost of dialysis alone can cost families dearly. The underprivileged are currently priced out of private specialised care, meaning many of these projected 25,000-50,000 new patients this year will either go untreated or bankrupt their families. Only the lucky few may be able to receive sustained professional care thanks to the charity of those kind souls who support kidney disease treatment programmes at various welfare facilities out of their own pocket. When considered at scale, it seems much cheaper for Pakistan to provide clean water to its people than for society to incur the cost of having thousands of patients on dialysis. Yet, because the ‘visible cost’ of renal disease is borne by individuals and not policymakers, clean water does not seem to be a priority for decision-makers. This is the tragedy at the heart of the crisis.

Published in Dawn, March 14th, 2026