Islamabad: Pakistanis live for an average of 66 years but spend nearly nine years in illness, disability or injury, while heart disease alone is estimated to kill around 223,000 people annually as around 43% adults aged 30 to 79 have hypertension, newly released World Health Organisation data show.
The WHO country data portray a health system under pressure from two directions: rapidly rising non-communicable diseases such as heart disease, stroke, diabetes, obesity and chronic lung disease, alongside continuing deaths from tuberculosis, respiratory infections, diarrhoea and preventable complications in newborns.
Pakistan’s life expectancy at birth was 65.99 years in 2021, according to WHO estimates. Healthy life expectancy, however, was only 56.89 years, showing that an average Pakistani could expect to live about 9.1 years in less than full health because of disease or injury.
Women had a higher overall life expectancy than men, 66.93 years compared with 65.08 years. But healthy life expectancy was 56.69 years for women and 57.10 years for men, indicating that women, despite living longer, may spend a greater proportion of their lives with health problems.
Ischaemic heart disease was the leading cause of death in Pakistan in WHO’s 2021 estimates, with a mortality rate of 90.2 per 100,000 population. Applied to Pakistan’s 2023 population of 247.5 million, the rate is equivalent to approximately 223,000 deaths in a year.
Covid-19 was the second-leading cause in the pandemic year of 2021, with an estimated rate equivalent to around 135,000 deaths when applied to the country’s current population. Stroke followed with an estimated annual toll of about 118,000 deaths.
The combined estimated toll from heart disease, Covid-19 and stroke comes to about 476,000 deaths. These are population-based calculations from WHO’s 2021 mortality rates, rather than official registered deaths in a single year, but they show the scale of the challenge confronting Pakistan.
The data also indicate that cardiovascular risk is widespread. WHO estimated that 43.2 percent of Pakistanis aged 30 to 79 had hypertension in 2019, including 44.8 percent of women and 41.6 percent of men.
The prevalence means that more than four in every 10 people in this age group were living with raised blood pressure, a major but often symptomless risk factor for heart attacks, stroke, kidney failure and heart failure.
Obesity, another important driver of hypertension and diabetes, affected 23 percent of Pakistani adults aged 18 years and above in 2022. The estimated prevalence among women was 26 percent, compared with nearly 20 percent among men.
WHO estimated that a Pakistani aged 30 had a 25.5 percent probability of dying from cardiovascular disease, cancer, diabetes or chronic respiratory disease before reaching 70 years of age. Put simply, roughly one in four people entering middle age faced the risk of premature death from one of these four major non-communicable diseases.
Diabetes mellitus was associated with an estimated 57,000 deaths annually, while chronic obstructive pulmonary disease, often linked to tobacco exposure and air pollution, was associated with around 71,500 deaths. Kidney diseases accounted for an estimated 35,500 deaths and cirrhosis of the liver for more than 46,000.
Other major causes included congenital anomalies, associated with around 50,000 deaths annually, road injuries with about 29,000, hypertensive heart disease with nearly 24,600 and drowning with close to 24,000 deaths, when WHO’s 2021 rates are applied to the 2023 population.
Pakistan’s burden of infectious diseases remains substantial. Lower respiratory infections were associated with an estimated 67,000 deaths annually and diarrhoeal diseases with around 58,000, while tuberculosis was linked to nearly 55,000 deaths.
WHO’s latest TB estimate puts Pakistan’s incidence at 266 cases per 100,000 people in 2024. Applied to the population figure of 247.5 million, this suggests that around 658,000 people developed TB during the year, although the agency’s estimate has a wide uncertainty range.
Malaria remains another major public-health concern. WHO recorded an incidence of 11.1 cases per 1,000 population in 2022, equivalent to an estimated 2.74 million cases if applied to Pakistan’s 2023 population.
The data also show that maternal and newborn health remains a serious concern despite gradual improvements in several indicators. Preterm birth complications were associated with an estimated 99,000 deaths annually, while birth asphyxia and birth trauma were linked to around 90,000 deaths.
Neonatal sepsis and other newborn infections were associated with a further estimated 19,000 deaths. These figures show that complications around pregnancy, delivery and the first month of life continue to account for a major share of preventable deaths.
Pakistan’s under-five mortality rate stood at 58.5 deaths per 1,000 live births in 2023. This means that, on average, nearly 59 children died before reaching their fifth birthday for every 1,000 babies born alive.
The neonatal mortality rate was 37.6 deaths per 1,000 live births in 2023, meaning that almost two-thirds of under-five deaths occurred during the first 28 days of life. The maternal mortality ratio was estimated at 155 deaths per 100,000 live births.
Pakistan’s current health expenditure was equivalent to 2.91 percent of GDP in 2021, according to the WHO country page. The agency lists Pakistan, with a population of 247.5 million in 2023, as a lower-middle-income country in the Eastern Mediterranean region.
The latest WHO figures are drawn from different years because disease surveillance, mortality modelling and household surveys are updated at different intervals. The agency cautioned that Pakistan’s death-registration data are incomplete or unreliable, meaning its leading-cause figures are statistical estimates based on available national, international and scientific data.
Nevertheless, the data show that Pakistan is not dealing with one health emergency. It is simultaneously confronting a large and growing burden of chronic disease, high risks to mothers and newborns, and persistent infectious diseases that require stronger primary care, prevention, screening, vaccination, safe childbirth services and reliable disease surveillance. data.who.int
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