Islamabad: In a move that underscores the collapse of Pakistan’s national health security system, the Ministry of National Health Services has appointed Dr. Sadia Akhtar, a medical officer with a diploma in ophthalmology and no experience in public health, as Chief of Communicable Disease Control (CDC) at the National Institute of Health (NIH), the country’s most critical position for disease surveillance and outbreak response.
For the past two and a half years, NIH has been functioning without a Board of Governors (BoG), leaving the institution without a permanent Chief Executive Officer and effectively run by acting directors and section officers of the ministry. This leadership vacuum has crippled Pakistan’s frontline defence against infectious diseases, even as outbreaks of dengue, malaria, diarrheal illnesses, skin infections and other epidemics intensify across the country.
The crisis comes just months after the outgoing NIH Board of Governors released its final report for 2021–2024, urging amendments to the NIH Act 2021, release of long-delayed strategic funds, and speedy appointment of senior officials to rescue reforms. The Board said that while some milestones were achieved, NIH remained hobbled by systemic bottlenecks, weak financing and bureaucratic hurdles, warning that reforms would not deliver without sustained political ownership and resources.
Among its recommendations were clarifying federal and provincial roles in disease surveillance, inclusion of Finance and Establishment Division representatives on the Board, filling long-vacant senior positions including the Executive Director, and release of the PKR 50 billion strategic fund promised under the Act. It also called for a National Health Fund, annual health surveys, timely execution of pending PC-1s, and streamlining of departments by 2025.
The post of Chief CDC, once held by seasoned public health leaders such as Dr. Rana Muhammad Safdar, who led Pakistan’s COVID-19 response, now rests with an officer whose background is in ophthalmology and who only completed an MPH last year, with no significant experience in field epidemiology or outbreak control.
Insiders at the ministry and NIH allege Dr. Sadia relied on political connections, claiming ties to influential figures in the present government, to secure postings first at Shaheed Benazir Bhutto Hospital Rawalpindi and later at NIH Islamabad. Unsatisfied with an earlier deputation as Director Admin, she maneuvered for the CDC chief position, a role that requires global-level expertise to advise the government on epidemic prevention, control and compliance with International Health Regulations (IHR).
The absence of a BoG has paralyzed NIH’s governance, senior officials and experts said. Planning Minister Ahsan Iqbal and State Health Minister Dr. Malik Mukhtar Ahmed Bharath had finalized a list of BoG members, which was approved by the Prime Minister, but the health minister abruptly recalled the summary from the cabinet months ago. Since then, the country’s premier biomedical research and surveillance body has been run on an ad hoc basis, with acting appointments and no long-term direction.
The consequences of this vacuum are severe. Recruitment under NIH’s Integrated Disease Surveillance and Response (IDSR) project has been frozen for months by the health ministry, leaving the system dangerously understaffed at a time when Pakistan is facing repeated waves of waterborne and vector-borne diseases. Key divisions of NIH including vaccine production, virology, microbiology and health security labs are also without permanent heads, deepening the institutional crisis.
Public health experts warn that at a time when epidemics are exploding, Pakistan’s primary custodian of health security is itself in disarray, unable to provide effective surveillance or timely response.
Despite repeated attempts, ministry officials including the health secretary, director general and spokesman did not provide their version on the situation. The Director General Health said she was unaware of the development, while the secretary stated the PRO would respond. However, even after 24 hours, no official statement was issued.
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