Pakistan is in the throes of a deepening public health crisis, and the Pakistan Islamic Medical Association (PIMA) has issued a critical alert urging immediate government intervention. In a strongly worded statement, the association outlined a disturbing landscape marked by a dramatic spike in HIV-related deaths, widespread undiagnosed drug-resistant tuberculosis, and a surge in malaria cases all signaling a failing healthcare system teetering on collapse.

The crisis is not only rooted in the rise of infectious diseases but also stems from poor governance, politically motivated appointments, systemic negligence, and lack of accountability in public health management. According to PIMA, if immediate and decisive action is not taken, the country risks facing irreversible damage to its already fragile healthcare infrastructure.

400% Increase in HIV Deaths

One of the most alarming figures revealed by PIMA is the 400% increase in HIV-related deaths in Pakistan over recent years. This staggering surge indicates a catastrophic failure in HIV surveillance, diagnosis, and treatment systems. HIV patients are either not being diagnosed early enough or are falling through the cracks of a disorganized health infrastructure that fails to provide follow-up care and antiretroviral therapy.

PIMA has stressed that this increase is not just a statistical anomaly it reflects a genuine public health disaster. The disease is spreading silently in high-risk populations, and stigma, lack of awareness, and insufficient testing facilities are worsening the situation. The unavailability of timely intervention is resulting in preventable deaths, posing long-term social and economic consequences.

Drug-Resistant Tuberculosis Cases Undiagnosed

Even more concerning is the revelation that approximately 70% of drug-resistant tuberculosis (DR-TB) cases in the country remain undiagnosed. Tuberculosis is already endemic in Pakistan, but the rise of drug-resistant strains makes the situation far more dangerous and difficult to control.

Undiagnosed DR-TB means infected individuals continue to spread the disease unknowingly, creating public health time bombs in both urban and rural communities. PIMA emphasized that the failure to expand diagnostic infrastructure and enforce patient tracking systems is severely undermining the country’s national TB control program.

This neglect is enabling the disease to mutate and evolve, becoming harder and costlier to treat—while putting the lives of frontline health workers and vulnerable populations at high risk.

Spike in Malaria Cases Signals Broken Surveillance

Malaria, a disease long considered manageable with proper vector control and seasonal preparedness, is again on the rise in Pakistan. PIMA’s report cites a noticeable increase in malaria infections, especially in flood-affected and underdeveloped regions, as a sign of declining public health responsiveness.

With climate change, water stagnation, poor urban sanitation, and mismanaged disaster responses playing their part, the outbreak potential of malaria has been significantly amplified. The absence of proactive preventive measures, along with supply chain issues for medication and test kits, has left healthcare workers struggling to contain outbreaks before they spiral into full-blown epidemics.

Politicized Appointments Undermine System Integrity

Central to PIMA’s concern is the erosion of institutional integrity caused by politically motivated appointments. The association cited specific examples where key leadership roles such as the Deputy Coordinator of the National TB Control Program were filled by individuals lacking the requisite qualifications and experience.

These appointments, according to PIMA, violate court orders, disregard merit, and undermine the transparency and efficiency of national health programs. In many cases, public advertisements for such posts were completely bypassed or manipulated to favor politically connected candidates.

This has created a climate of disillusionment among professional healthcare workers, who feel marginalized and demotivated. The net result is a deterioration in service delivery, loss of faith in public institutions, and a widening gap between policy and implementation.

Marginalization of Healthcare Professionals

PIMA also voiced concern about the exclusion of qualified public health professionals from policy-making circles. Decisions regarding critical national health strategies particularly in provinces like Punjab and Khyber Pakhtunkhwa are being made without adequate consultation with those who possess the expertise and field experience to guide such policies.

This exclusion, according to PIMA President Prof. Atif Hafeez Siddiqui, is a systemic flaw that has only worsened under successive governments. He notes that healthcare professionals are being used as figureheads while actual decision-making is controlled by political operatives, NGO consultants, or bureaucrats with no direct health background.

PIMA’s Call for Urgent Reforms

To mitigate the crisis, PIMA has issued a list of concrete demands that they believe are essential for putting the country back on track:

  1. High-Level Independent Inquiry
    PIMA is calling for an immediate, impartial, and independent inquiry into the management failures identified in audits such as those conducted by The Global Fund. This inquiry must investigate misallocation of resources, breakdown in oversight, and accountability failures.
  2. Merit-Based Appointments Across All Programs
    No leadership role in any national health initiative should be given without a rigorous, transparent, and meritocratic recruitment process. PIMA demands that all politically motivated appointments be reversed and that only professionals with the right qualifications, skills, and experience be allowed to lead.
  3. Elimination of Political Interference
    All forms of political interference in public health decision-making must end. Ministries should function under professional leadership, and health strategy must be driven by medical evidence and epidemiological data rather than political expedience.
  4. Inclusion of Health Experts in Policymaking
    PIMA urges federal and provincial governments to institutionalize the involvement of experienced doctors, public health officers, and field epidemiologists in advisory and policy roles. Their insights are essential for crafting realistic, community-centric, and science-based public health responses.

Conclusion: A Crossroads for Pakistan’s Health System

Pakistan is facing a profound public health emergency, the scale and severity of which demand immediate and systemic reform. The insights and demands presented by the Pakistan Islamic Medical Association serve not only as a wake-up call but also as a roadmap for meaningful action.

The country’s health system cannot afford further delays or excuses. The time for reactionary measures has passed; now is the time for proactive governance, professional leadership, and a unified commitment to the well-being of every citizen.

Unless these steps are taken urgently and with sincerity, Pakistan could be on the verge of a health crisis with generational consequences.