Islamabad: Pakistan’s tuberculosis, HIV/AIDS and immunisation programmes are facing serious risks due to shrinking international aid, with a new report warning that several critical public health functions could collapse if the government fails to develop urgent transition plans.
The report, released by Islamabad based think tank Tabadlab, says the country’s health system is not only facing financial pressure but also operational disruptions as donor support contracts. It warns that the crisis cannot be addressed merely by increasing budget allocations because several core health system functions currently depend heavily on foreign assistance.
According to the report, the suspension of USAID support led to the closure of more than 60 health facilities, disrupting healthcare services for around 1.7 million people. It further states that a reduction of US$27.2 million in Global Fund financing has already halved tuberculosis monitoring activities in Punjab and Khyber Pakhtunkhwa, reduced funding for diagnostic kits and placed treatment for tens of thousands of HIV positive patients at risk.
The analysis says donor assistance in Pakistan finances vaccines, medicines, diagnostics, supply chains and specialist staff, while domestic public sector budgets mainly cover salaries and infrastructure. As a result, even when facilities and staff remain in place, essential services become dysfunctional once operational funding declines.
“This is a functional problem, not just a fiscal one,” the report quoted Tabadlab’s Director for Human Capital Shahab Siddiqi as saying. “Pakistan’s public budgets finance salaries and facilities. ODA finances vaccines, medicines, diagnostics and supply chains. When ODA contracts, services retain staff but lose the operational core that makes programmes work.”
The report notes that Pakistan spends only around 0.9 percent of its GDP on health, far below the World Health Organization’s recommended minimum of five percent. It adds that grant based international assistance to Pakistan has declined by nearly 59 percent since 2017, while global projections suggest further reductions in development assistance during 2026.
The authors warned that without immediate reforms and structured transition planning, Pakistan could face worsening disruptions in disease control, immunisation and HIV treatment programmes in the coming years.
The report recommends the establishment of a National Health Financing Forum, creation of a national registry for international aid, and development of a risk classification system to identify health functions most vulnerable to donor withdrawal.
It also calls for time bound transition plans for TB, HIV/AIDS and immunisation programmes, regulatory reforms to improve procurement and hiring flexibility, and gradual enhancement of public health spending towards three percent of GDP.
The authors further stressed the need to strengthen technical capacity within the public sector and progressively integrate donor supported vertical programmes into the primary healthcare system to reduce long term dependence on external financing.
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