Karachi: Pakistan cannot rely on producing more physicians, surgeons and hospitals while preventable diseases continue to overwhelm the health system, health experts said on Wednesday, warning that diabetes, hypertension, infections, malnutrition and mental illness require far greater investment in prevention and primary care.
The International Diabetes Federation estimates that 34.5 million Pakistani adults aged 20 to 79, or 31.4 percent, have diabetes, while WHO estimates show 43 percent of adults aged 30 to 79 have hypertension. About nine percent of the population is affected by hepatitis C, while Pakistan remains among the world’s highest-burden countries for tuberculosis, maternal and child deaths and stunting. A recent national survey found mental or behavioural disorders in 32.3 percent of adults. IDF Atlas
The concerns were voiced at the opening of the three-day First International Conference on Public Health Governance and Sustainable Health Systems 2026 at the HEJ Research Institute Auditorium, University of Karachi. The University of Karachi and Al-Kawthar University are holding the conference under the theme, “Governing for Health: Equity, Resilience, and Innovation Towards a Sustainable Public Health Future.”
Health Services Academy Islamabad Vice Chancellor Prof Dr Shahzad Ali Khan, in his keynote address, said Pakistan’s health system remained focused on treating people after they became ill instead of preventing illness.
Using the analogy of people repeatedly drowning in a river, he said doctors and surgeons were kept busy pulling patients from the water, while few people looked upstream to find out why they were falling in. Pakistan needed a “fence” through prevention, healthy living, clean environments, regulation and strong primary healthcare, rather than depending only on the ambulance after disease strikes, he added.
Prof Shahzad said Pakistan had around 290,000 doctors, 130,000 hospital beds, 108,000 community health workers and 16,000 health facilities, but coverage and access remained inadequate. He said the public health system effectively became private in the evening when many public-sector health professionals opened private clinics.
He said 89.9 percent of health spending was paid directly by patients, while government spending accounted for 34 percent of total health expenditure and private spending 64.4 percent. Pakistan’s per-capita health expenditure stood at about $45, compared with $75 in India and $127 in Sri Lanka, while public health spending remained between 0.7 and one percent of GDP.
He said 90 percent of Pakistanis had no recreational physical activity, around 90 percent consumed fewer than two servings of vegetables daily, and tobacco use affected 38 percent of men and nine percent of women. Pharmacies, laboratories and private clinics were expanding, he said, but prevention, regulation and health promotion had not received comparable attention.
Chairman Sindh Higher Education Commission Prof Dr Tariq Rafi said there was no equity in Sindh’s health sector, where sophisticated services were concentrated in Karachi and other large cities while rural populations struggled for basic care, staff and diagnostic facilities.
He said health policies should be shaped by health professionals, researchers and evidence rather than bureaucratic considerations alone. He also regretted the lack of credible health data, saying weak information systems hampered policy-making. Referring to China’s development model, he called for Pakistan to spend three times more on health and education than on defence.
Conference patron Prof Dr Syed Shabib ul Hasan said the meeting had brought together doctors, academicians, professional associations, policymakers and federal and provincial representatives to develop recommendations for the government. He said bodies including the Pakistan Islamic Medical Association, universities and public institutions had been involved to work jointly for society’s benefit.
ICCBS Director Prof Dr Muhammad Raza Shah said public health must become a national priority, while research institutions could support prevention through biomedical research, clinical trials, drug development and evidence for policy.
Dr Saif ur Rehman, Principal Secretary to the Sindh Governor, stressed surveillance, sewage monitoring, vaccination coverage and rapid laboratory testing as essential tools for preventing outbreaks.
NICVD Executive Director Prof Dr Tahir Saghir said his institution was strengthening quality assurance and governance. NICVD provides emergency cardiac care, angiography, angioplasty, open-heart surgery, paediatric cardiac services, rehabilitation and preventive cardiology free of charge across its network.
Prof Dr Iqbal Afridi highlighted mental health as essential to a healthy society. Prof Dr Raza ur Rehman, professor of psychiatry at Hamdard University, said Pakistan had only about 500 psychiatrists, leaving roughly one specialist for every 400,000 people.
Pakistan Islamic Medical Association president-elect Dr Ahmed Salman Ghori said prevention could improve life expectancy and reduce pressure on hospitals. Other speakers included Prof Dr Minhaj Qidwai, Prof Dr Shahana Urooj Kazmi, Prof Dr Nabeel Akhtar and Prof Dr Muhammad Wasay.
The conference continues until October 9 with sessions on health governance, community health, climate change, digital health, traditional medicine and public-health policy.
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