Floods, Diseases, and Policy Gaps – Why Pakistan Must Rethink Health Security

Pakistan today stands at the intersection of policy ambition and climate-driven urgency. For years, health experts have argued that the country lacks a dedicated National Health Security Policy. Instead, health security has been approached piecemeal through two key documents: the National Health Vision (NHV) 2016-2025 and the National Action Plan for Health Security (NAPHS) 2024-2028.

Each has its merits and demerits. The NHV provided a strategic framework to improve governance, access, and equity across the health system, while the NAPHS introduced a costed, operational roadmap designed to prevent, detect, and respond to public health threats. But as the devastating floods of 2025 unfold, the limitations of this fragmented approach are plain to see.

Health security in Pakistan has always been fragile. Even before the floods, the country faced a convergence of risks: persistent poliovirus circulation, recurring dengue outbreaks, rising antimicrobial resistance, and a dangerously underfunded health system that spends barely one percent of GDP on public health. Add to this the chronic shortages of frontline workers, supply chain vulnerabilities, and weak federal-provincial coordination, and the foundations of national preparedness already looked shaky.

The monsoon floods of 2025 have now turned these structural weaknesses into acute emergencies. Record rainfall and river swelling have left millions displaced, hundreds dead, and thousands of health facilities damaged or cut off. The risks are not hypothetical. Contaminated water supplies are driving diarrhoeal disease outbreaks, disrupted immunization services heighten the threat of measles and polio resurgence, and malnutrition is worsening as food systems collapse under the weight of crop losses.

For the time being, overstretched relief camps and mobile clinics struggle to plug the gaps left by broken primary-care networks. This crisis illustrates a dangerous pitfall in Pakistan’s health governance; treating floods as isolated disasters rather than as recurring, structural threats to national security. The NHV set broad goals, but it lacked operational teeth. The NAPHS has costed activities and international backing, but implementation is too slow and uneven.

The central pitfall is clear; Pakistan continues to threat floods as episodic disasters instead of predictable threats that require permanent preparedness. Neither framework has yet succeeded in embedding climate resilience into the heart of the health system. The result is that each monsoon season, we scramble for short-term humanitarian fixes instead of executing a coordinated, pre-financed national plan.

The way forward is clear; Pakistan must bridge the gap between vision and action by fully operationalizing the NAPHS while aligning it with the NHV’s equity and universal-access commitments. That means ring-fenced health security financing, not just donor-dependent emergency appeals. It means embedding climate modeling and disaster-risk triggers into budgetary release systems so provinces receive funds before – not after floodwaters rise.

At the front lines, priorities should be sharply defined. Emergency medical kits and clean water supplies must be pre-positioned in vulnerable districts. Mobile vaccination teams should be deployed with solar-powered cold chain equipment to prevent secondary epidemics. Surveillance systems need to be modernized into real-time, interoperable networks that flag outbreaks early. Above all, the health workforce – the nurses, vaccinators, and community health workers who anchor any response must be supported with hazard pay, housing, and mental health care to sustain their service in the toughest conditions.

What, then, must be done? Pakistan should move toward a single, consolidated National Health Security Policy that harmonizes strategic vision with operational readiness. It should also enshrine legal clarity in federal and provincial roles during emergencies, so coordination is not improvised in the middle of a disaster. Without such consolidation, progress will remain piecemeal, reactive, and vulnerable to reversal.

The floods of 2025 are not an aberration; they are the face of a climate-changed future. Treating health security as a marginal issue or a donor-driven agenda will leave Pakistan perpetually unprepared. What is needed now is political recognition that health security is national security – central to economic stability, social cohesion, and resilience in the face of climate extremes.

To cut a long story short, if Pakistan seizes this moment to merge its vision and its action, to put resources behind words, and to put climate resilience at the core of health planning, then the current tragedy can catalyze lasting reform. If not, each monsoon season will continue to deliver avoidable death, disease, and despair.