Islamabad: Deadly genetic disorders, life-long mental health problems, and deaths of children before they even reach puberty are striking Pakistani families at alarming rates — and experts say the single biggest culprit is the country’s obsession with marrying first cousins.
Around 68 percent of marriages in Pakistan are between blood relatives, and half of these are between first cousins, a pattern scientists warn is doubling the risk of neonatal and infant deaths and fuelling a silent epidemic of inherited diseases.
Speaking at the OIC-COMSTECH Hybrid Symposium on Preventing Inherited Disorders in Consanguineous Populations, Prof. Dr. Shahzad Ali Khan, Vice Chancellor of the Health Services Academy (HSA), said the genetic fallout of these marriages is devastating.
“In the Middle East and North Africa, consanguinity often occurs within tribes but not necessarily between first cousins. In Pakistan, first-cousin marriages are extremely frequent — and they are a leading cause of rising genetic disorders, mental health problems, and early deaths,” he warned.
According to recent research, such unions greatly increase the risk of severe genetic diseases including thalassemia, cystic fibrosis, sickle cell anemia, spinal muscular atrophy, beta-thalassemia major, primary microcephaly, congenital heart defects, metabolic disorders, and inherited forms of blindness and deafness.
Many of these conditions cause profound disability or prove fatal in childhood. “These are no longer rare diseases here — they are becoming disturbingly common,” Prof. Shahzad Ali Khan stressed.
The problem extends beyond physical illness. Genetic predispositions from consanguineous unions are also contributing to an increase in psychiatric and neurodevelopmental disorders in later life, including depression, bipolar disorder, schizophrenia, learning disabilities, and epilepsy. “We are not only shortening lives, we are compromising the quality of the lives that remain,” he said.
Prof. Shahzad Ali Khan cited the Pakistan Demographic and Health Survey data showing that infant and neonatal mortality rates are almost double among couples related by blood compared to unrelated couples. He warned that without urgent action, the country will face an even greater health crisis in the coming decades.
“Thalassemia is under control in much of the world through strict premarital screening and awareness campaigns — but in Pakistan, it is still on the rise,” he noted, calling for evidence-based advocacy to discourage cousin marriages.
He pointed to examples from Islamic countries like Iran, Saudi Arabia, and the UAE, where mandatory premarital genetic testing, religious engagement, and public awareness campaigns have significantly reduced the prevalence of inherited disorders while respecting cultural norms.
HSA, he announced, will intensify nationwide awareness efforts using clear and culturally sensitive messaging to explain the health risks of cousin marriages. “We must tell people the facts — without stigma, but without sugarcoating — that marrying close relatives puts future generations at serious risk. Protecting health is part of our faith and a moral responsibility,” he said.
Prof. Dr. Muhammad Iqbal Choudhary, Coordinator General of OIC-COMSTECH, said tackling the crisis requires regional cooperation in genomic medicine. “Collaboration and knowledge sharing across Muslim countries is vital to reduce the burden of inherited disorders,” he said. Prof. Dr. Shahid Mahmood Baig, Adviser COMSTECH, added, “We have the evidence — now we need to turn it into policy and action.”
The symposium brought together experts from Pakistan, Europe, and the US to share the latest research on genetic diseases and strategies to prevent them. The consensus was clear: without decisive action to reduce first-cousin marriages, Pakistan will continue to pay a heavy price in lost lives, suffering, and economic cost.