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• Official Development Assistance fell globally by 23pc in 2025, says Tabadlab report
• System plagued by ‘under-investment’ as inflation sharply reduces real value of budgetary allocations
ISLAMABAD: As international funding for the health sector continues to decline and major foreign donors expected to suspend most grants by 2030, Pakistan could face serious health risks unless the government takes urgent action.
Shrinking foreign assistance could threaten disease control programmes, immunisation efforts, and institutional capacity across the country. Once funding stops, it could significantly affect district-level monitoring, community outreach interventions, diagnostic testing capacity, and workforce training programmes.
These were the key findings of a report titled Beyond Dependence: Understanding the Impact of ODA Cuts on Pakistan’s Health System.
The report, prepared by Islamabad-based think tank Tabadlab, outlines the impact of declining Official Development Assistance (ODA) on Pakistan.
ODA refers to grants and concessional loans provided to support development in low- and middle-income countries. The report says global ODA fell by 23pc in 2025 and warns that continued aid cuts could cause millions of additional deaths worldwide by 2030.
Weak health indicators
The report paints a bleak picture of Pakistan’s health outcomes, describing the country as burdened by both communicable and non-communicable diseases. Tuberculosis, diabetes, cardiovascular diseases, malaria, HIV/AIDS, and child health complications continue to strain the healthcare system. Despite modest gains in life expectancy, Pakistan still lags behind regional countries on several key indicators.
Life expectancy in Pakistan stands at 68 years, nearly four years below the South Asian average. Infant mortality remains among the highest in the region at 50.1 deaths per 1,000 live births — more than double the rates observed in Bangladesh and Nepal.
The report says Pakistan continues to under-invest in healthcare, with total health spending at 2.9pc of GDP and public sector spending at just 0.9pc, both below regional and international benchmarks.
Although federal and provincial health budgets increased from Rs530.8 billion in FY2019-20 to Rs1.4 trillion in FY2025-26, the report notes that inflation has sharply reduced the real value of these increases. After adjusting for inflation, health spending increased by only 25pc over six years.
Provincial disparities
The report also highlights disparities in per capita healthcare spending among the provinces. In Punjab, Rs2,043 ($12) is spent per person annually. In Balochistan, the figure is Rs2,680 ($16), while Khyber Pakhtunkhwa spends Rs3,136 ($18). Sindh spends the highest amount, at Rs3,203 ($19) per capita.
The report says institutions such as The Global Fund and Gavi play a critical role in supporting Pakistan’s vaccines, diagnostics, disease surveillance, and other public health programmes.
It warns that shrinking ODA could weaken Pakistan’s technical capacity, as agencies like the World Health Organisation, Unicef, and World Food Programme provide key support in disease surveillance, outbreak response, and technical assistance.
Cuts to these programmes could weaken Pakistan’s ability to respond to epidemics and cross-border disease threats.
The report says recent funding cuts by The Global Fund, including a $27.2m reduction in 2025, mainly affected tuberculosis and HIV/AIDS programmes in Pakistan.
Tabadlab’s findings state that, once implemented, these cuts could significantly affect district-level monitoring, community outreach interventions, diagnostic testing capacity, and workforce training programmes in Punjab and Khyber Pakhtunkhwa.
Structural reforms
The report warns that Pakistan must reduce its reliance on external health funding or risk rising disease burdens, higher mortality, and weakened human capital development.
It recommends establishing a National Health Financing Forum and strengthening financial planning, resource mobilisation, technical capacity, and healthcare governance.
Published in Dawn, May 13th, 2026
