THE Lancet Countdown’s latest findings should change how Pakistan thinks about illness as much as how it thinks about climate change. The report estimates that heat contributed to 710,000 deaths worldwide in 2023. In Pakistan, a patient arriving at a clinic with dehydration, kidney injury or breathing difficulties may be experiencing the effects of extreme weather without that connection ever entering the medical record. A child treated for diarrhoea after flooding, or an elderly person whose heart condition deteriorates during prolonged heat, becomes another isolated case rather than part of a wider pattern. The result is a dangerous knowledge gap. Without reliable information on where climate-related illnesses occur, who is most affected and how many lives are lost, health authorities cannot judge the scale of the problem. Climate change is already altering the demands placed on medicine; Pakistan’s healthcare planning has yet to catch up.

This is where the warning from former health officials deserves closer attention. Rather than producing another catalogue of vulnerabilities, the government should begin with what hospitals and clinics can actually record, diagnose and treat. Provincial health departments could require major facilities to track heatstroke, dehydration, acute kidney injury and other conditions aggravated by extreme weather, with data reviewed alongside local temperature and rainfall trends. Primary-care staff need practical guidance for recognising heat illness early, especially among children, older people and patients taking medicines that affect hydration. Hospitals should examine whether their emergency departments can cope with seasonal surges, and whether essential treatment can continue when power or water supplies fail. None of this requires waiting for another international declaration. It requires health officials to treat climate exposure as a routine part of patient care. Public reporting would also reveal which districts lack the staff, equipment and referral arrangements to respond. Pakistan has spent years describing itself as vulnerable to climate change. The Lancet findings present a more immediate challenge: can its health system identify the people being harmed, offer them treatment and learn enough from their cases to prevent avoidable deaths?

Published in Dawn, November 2nd, 2026