Development funding cuts jeopardise country's health sector: report

Cuts in development assistance and funding pose a significant threat to the country's health sector and its functioning, according to a report by think tank Tabadlab.

In a press release issued today, the think tank said its new report warns that "Pakistan's health system faces functional collapse in critical programmes as Official Development Assistance (ODA) withdraws — a crisis that cannot be solved by budget increases alone."

The report, titled: "Beyond Dependence: Understanding the Impact of ODA Cuts on Pakistan’s Health System", was published last week and authored by the think tank’s Shahab Siddiqi, Behzad Taimur and Syeda Farwa Qamar Jaffri.

The press release said it documented how recent donor reductions were disrupting specific system functions that domestic budgets only partially covered: commodity procurement, diagnostic capacity, supply chain management, and specialist staffing.

It added that the report drew on interviews with dozens of development practitioners and public health officials across federal and provincial governments, alongside analysis of budget and ODA data. 

"The evidence is already visible. USAID's suspension closed over 60 facilities, disrupting care for 1.7 million people. A $27.2m global fund reduction halved TB monitoring in Punjab and Khyber-Pakhtunkhwa, cut diagnostic kit financing and placed treatment for tens of thousands of HIV-positive patients at risk. These disruptions will only intensify if the government does not develop effective transition plans as ODA continues to contract," the press release said.

"This is a functional problem, not just a fiscal one," Siddiqi, Tabadlab’s director for human capital, was quoted 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," he said.

The press release said the pressure was further compounded by Pakistan's "chronically low health investment" at just 0.9% of GDP, "far below" the World Health Organisation's recommended minimum of 5%.

"In Pakistan, grant-based assistance has contracted by 59% since 2017, while OECD projections indicate a further 5.9% decline in global ODA for 2026, signalling a structural shift rather than a temporary disruption."

The press release said the report proposed a structured transition framework with immediate priorities that include the establishment of a national health financing forum, developing a national ODA registry, and designing a risk matrix to classify functions by substitutability and criticality.

"Medium-term actions focus on time-bound transition plans for TB, HIV-AIDS and immunisation programmes, regulatory reforms for flexible procurement and hiring, and raising public health spending towards 3% of GDP.

"Long-term reforms centre on technical capacity enhancement and progressive integration of vertical programmes into primary care," the press release concluded.