Sindh health budget draws PMA criticism

Association says the emphasis on grants and tertiary care comes at the expense of disease prevention

IV Report

KARACHI: The Pakistan Medical Association (PMA) has expressed concern over the Sindh government's health budget for the 2026-27 fiscal year, arguing that the allocation places excessive emphasis on grants to specialised institutions while neglecting preventive and primary healthcare services.

In a statement issued on Thursday, PMA Secretary General Dr Abdul Ghafoor Shoro said the Rs393.16 billion health budget reflected a healthcare strategy focused largely on treatment rather than disease prevention and community-based care.

The association said a significant portion of the allocation had been directed towards grants for non-governmental organisations, public-private partnerships and specialised healthcare institutions providing tertiary-level treatment. While acknowledging the role played by such organisations, the PMA argued that the government was overlooking the need to strengthen public health systems aimed at preventing disease and reducing pressure on hospitals.

According to the PMA, large segments of the health budget continue to be consumed by recurring administrative expenses, bureaucratic structures and salary expenditures instead of being invested in vaccines, medicines, diagnostics and grassroots healthcare services.

"It is highly tragic that the government's primary budget strategy relies heavily on outsourcing its core responsibilities to public-private sectors and NGOs," Dr Shoro said. "While specialised curative centres are doing commendable work, where is the vision for public health? Where is the budget for preventing waterborne diseases, malnutrition, polio, tuberculosis or maternal-fetal crises at the early tiers?"

The association maintained that focusing primarily on tertiary care was financially unsustainable and warned that the absence of strong preventive measures would continue to increase the burden on major hospitals.

Citing examples from regional countries, the PMA said improvements in health indicators had largely been achieved through sustained investments in primary healthcare networks. It noted that countries such as Bangladesh, Sri Lanka, Thailand and Iran had strengthened community-level health services, immunisation programmes and maternal care systems, leading to reductions in mortality rates and improved health outcomes.

The PMA further argued that the current spending pattern sidelines Sindh's network of Basic Health Units (BHUs) and Rural Health Centres (RHCs), particularly in underserved districts.

The association called on the provincial government to reassess its healthcare priorities and increase investment in frontline health facilities. It urged authorities to upgrade BHUs and RHCs, ensure adequate supplies of medicines and medical equipment, and direct greater resources towards preventive healthcare programmes.

"The government cannot run away from its constitutional duties by merely writing cheques to selective specialised NGOs and service providers," the statement said.

The PMA urged Chief Minister Syed Murad Ali Shah and provincial health authorities to reform the spending structure and adopt a more proactive healthcare model focused on prevention, early intervention and equitable access to primary healthcare services across Sindh.

Infographics courtesy: Department of Finance, Sindh.