The overall health situation in Pakistan has improved substantially since 1947. Health indicators such as life expectancy and infant mortality bear witness to these improvements.

However, political instability, population growth and a reluctance to push ahead with development efforts are impacting profoundly on the demographic, epidemiological, social and managerial dimensions of health care. Devastating natural disasters, such as the earthquake in 2005 and the extensive flooding in 2010, repeatedly cause a large number of injuries and fatalities.

The health situation is characterised by a so-called ’double burden of diseases’ with communicable and non-communicable diseases both posing an enormous challenge to the health care sector. Public and private providers are finding it difficult to address current health needs. And as the demand for health services rises, so the severe inadequacies that prevail in the delivery systems of both the public and private health services are becoming more apparent.

One of the main reasons for Pakistan’s inadequate health care situation is that the public health system does not have enough human resources. Trained health sector workers are particularly scarce in rural and crisis areas. And those human resources that are available are not always used efficiently. The bulk of health service delivery is in the hands of the private sector which, to date, has not been put through any kind of systematic quality control. In addition to infectious diseases such as tuberculosis, Pakistan is seeing a strong increase in the number of so-called civilization diseases throughout the population. This puts the national health system under even more pressure.

On behalf of the German Federal Ministry for Economic Cooperation and Development (BMZ), GIZ is assisting Pakistan to meet its national health policy targets and to achieve the Millennium Development Goals. GIZ advises on policy, supports legislation and is helping put policies into practice. Innovations designed to improve health service delivery are being tested and evaluated, and positive achievements transferred to other regions of the country.

Cooperation involves:

• supporting the planning and roll-out of health sector reforms
• providing basic and further training for health managers and staff, with a view to improving managerial and technical skills
• helping to build up quality management systems and promote evidence-based practices at all levels
• assisting with the development of efficient HR planning
• improving access to specific health care services, such as tuberculosis tests and safe blood transfusions, especially for the poor
• assisting in the analysis and development of sustainable social financing systems to safeguard people’s material security in the event of illness

GIZ’s health care programme is recognised by not only the Government of Pakistan but also other donor organisations. To make the best possible use of resources and to foster their reciprocity, the programme works closely with various other projects and programmes engaged in German international development cooperation as well as with international development organisations. In this way, German development cooperation is also lending clout to health programmes by other donors.