Islamabad: Childhood pneumonia is emerging as a silent national emergency as low routine immunization, weak primary healthcare and widespread misuse of antibiotics continue to push young children into hospitals, experts and officials warned on Wednesday.
They said the disease is entirely preventable and easily treatable with low-cost tools including early initiation of breastfeeding, yet continues to claim thousands of lives every year.
Speaking at a national dialogue on combating childhood pneumonia, Director General Health Dr Ayesha Majeed Isani said Pakistan is witnessing a yearly rise in pneumonia cases because hundreds of thousands of children remain unprotected.
She said over 400,000 children are still zero-dose while many more receive only partial immunization, leaving them vulnerable to severe infections. Fluctuating weather, worsening environmental conditions and rising seasonal viruses are contributing to an increasing number of pneumonia cases among young children every year, she added.
“We have some of the best pediatricians and tertiary hospitals, but children are dying of a disease that can be stopped through routine immunization. Pneumococcal vaccine is available. The tragedy is that we are not preventing what we can prevent,” she said.
Dr Isani said Pakistan’s healthcare system remains overly focused on hospital-based sick care instead of strengthening primary care. She praised Federal Health Minister Syed Mustafa Kamal for repeatedly acknowledging this structural gap, adding that preventing pneumonia requires strong PHC facilities that can deliver vaccines, diagnose early and refer complicated cases without delay.
Prof Jamal Raza, Executive Director of the Sindh Institute of Child Health and Neonatology, said pneumonia is one of the most preventable childhood killers, yet continues to claim lives because basic preventive steps are being ignored.
He said breastfeeding, full immunization, good nutrition and preventing chronic infections like HIV are fundamental shields for children.
“Pneumonia is very easy to treat if caught on time. Pediatricians and physicians must look for early signs and use the right antibiotics only when needed,” he said.
Citing recent research, he warned that irrational antibiotic use has reached alarming levels. “Recent reports show 94 percent of children are receiving antibiotics even where they are not required. The private sector is overusing antibiotics and there is nobody regulating them,” he said, adding that rising antimicrobial resistance will make pneumonia far harder to treat in the coming years.
Chief of Health UNICEF, Dr Gunter Boussery, said Pakistan’s financing for health is declining and remains far below what is required to protect children.
He urged political leaders to increase allocations for primary healthcare, expand immunization coverage and ensure uninterrupted supplies of essential medicines, oxygen and diagnostic tools. He said that without domestic investment, pneumonia and diarrhea targets under the global GAPPD framework will not be achieved.
MNA Zahra Wadood Fatimi said preventable diseases including pneumonia, diarrhea and HIV have become threats to Pakistan’s national health security. She said lawmakers must treat child health as a priority because “a nation cannot grow with malnourished, unprotected and sick children.”
Dr Yasir Bin Nisar of WHO Geneva shared global perspectives on pneumonia management, emphasizing the need for community-based care, antibiotic stewardship and equitable access to diagnostic and treatment services.
Data presented during the dialogue showed that pneumonia remains one of the leading killers of children under five in Pakistan despite the availability of vaccines, antibiotics and oxygen therapy.
Observational studies from Islamabad, Rawalpindi, Thatta and Lahore revealed weak adherence to IMCI protocols, lack of basic tools such as pediatric pulse oximeters, poor follow-up by caregivers and inconsistent triage and referral systems.
Researchers found that most PHC facilities struggled with training gaps, shortages of essential medicines such as amoxicillin and inconsistent implementation of pneumonia guidelines.
Another nationwide analysis shared at the meeting showed that pneumonia risk factors are poorly addressed in policy documents, while case management remains highly variable, with different providers offering different treatments for the same classification.
Experts said reducing pneumonia deaths requires a decisive shift toward prevention, including exclusive breastfeeding for six months, universal coverage of PCV and Hib vaccines, and early recognition of danger signs by families. They said strengthening PHC facilities to diagnose and treat pneumonia close to home is the most cost-effective strategy for saving lives.
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