ISLAMABAD: In a major blow to Pakistan’s fight against infectious diseases, the Global Fund to Fight AIDS, Tuberculosis and Malaria has cut its financial aid by over $27 million, citing limited global resources and concerns over governance and inefficiency in the country’s health programmes.

The decision comes at a time when Pakistan is battling a rapid increase in cases of HIV, tuberculosis (TB), and malaria — with experts warning that the country’s disease response systems are critically underperforming.

Major Funding Cuts

According to an official communication from the Global Fund, Pakistan’s allocation under Grant Cycle 7 (GC7) has been reduced from $250.8 million to $223.6 million. This reduction affects nearly every component of the country’s national response efforts.

• National TB Control Programme: Cut from $145.7 million to $129.9 million
• HIV/AIDS Programmes: Reduced by over $4 million
• Malaria Control Initiatives: Also suffered cuts across various implementing agencies

These funds are crucial for prevention, diagnostics, and treatment services delivered by both local and international partners.

Management Failures and Lack of Leadership

The cuts highlight not only donor limitations but also internal challenges within Pakistan’s public health infrastructure. The Common Management Unit (CMU) — responsible for coordinating all HIV, TB, and malaria programmes — currently operates without a permanent head. Moreover, all three disease control programmes lack full-time national programme managers.

Health sector insiders and donor representatives have repeatedly raised concerns about poor financial oversight, delays in project execution, and low performance. As a result, there’s growing distrust in Pakistan’s ability to effectively use donor funds.

While the Ministry of National Health Services has advertised for new leadership roles, experts caution that unless competent and honest individuals are selected through a transparent process, Pakistan risks further reputational and financial setbacks.

A Worsening Health Crisis

The funding reduction comes as disease rates climb:

• HIV: Over 1,200 new cases are officially reported each month, though health professionals suspect the real figure could be over 3,000, due to underreporting and a weak surveillance system. Pakistan remains one of the fastest-growing HIV-affected nations in the Asia-Pacific.
• Tuberculosis: The country sees more than 610,000 new TB cases annually, ranking among the top five TB burdened nations globally. Drug-resistant TB is also on the rise.
• Malaria: Often overlooked due to its rural concentration, malaria is resurging — fueled by climate change, floods, and inadequate vector control.

Urgent Need for Reform

The Global Fund’s letter also urges Pakistani authorities to maximize use of the remaining funds and mobilize domestic resources to fill gaps. The Country Coordinating Mechanism (CCM) has been directed to submit revised funding plans by July 14, 2025. If not submitted on time, the revised reduced funding structure will be enforced automatically.

Civil society organisations, health workers, and international partners are sounding the alarm. One senior official working in the HIV programme remarked, “We are not just losing funding — we are risking human lives. Without qualified leadership and proper oversight, more cuts could follow.”

The Way Forward

The situation underscores the urgent need for Pakistan’s Ministry of Health to regain credibility, rebuild institutional capacity, and ensure accountability at all levels. With funding reduced and disease burden increasing, delays in reform could lead to dire consequences — not only in terms of public health but also in international trust and support.