"PRIORITISE" · 총 60건
필터 보기현재 지수
50.3
0 = 부정 우세
50 = 중립
100 = 긍정 우세
최근 7일 기준 85,023건을 분석한 결과, 뉴스 심리지수는 50.2(균형)입니다. 긍정 4,230건(5.0%)·중립 78,689건(92.6%)·부정 2,104건(2.5%)이며, 중립 비중이 뚜렷하게 높습니다. 성향 지수는 종합 14.8(중도 균형)입니다.
High Court in Kedah says the Child Act is a self-contained framework that prioritises rehabilitation over punitive sentencing for juvenile offenders.
In 2018, Pakistan produced the widest survey in its history on how much nutrition its people were getting. The NNS or National Nutrition Survey was the fifth such epic exercise to be undertaken since 1965, and the first ever to show us the numbers from the districts. It was the most comprehensive data-gathering effort in Pakistan’s history and is regularly cited today in policymaking. The NNS results painted such an alarming picture at the time that the government should have declared a national emergency. Instead, I find myself writing this seven years on with a question as Finance Minister Muhammad Aurangzeb tables an estimated Rs17.1 trillion federal budget for fiscal year 2026-27: What did Pakistan’s budget-makers do with the population nutrition evidence? No prizes for guessing the answer was scant little. What we got instead is a story of policy documents without funding to see through on the ground, bodies meant to coordinate without the mandate or teeth, and a government that continues to treat nutrition as a humanitarian footnote rather than the country’s economic foundation it actually is. The FY2025–26 federal budget offered a clear indication of where nutrition stood among national priorities. Health spending was reduced by 16 per cent, while no dedicated nutrition allocation was included in the federal budget architecture. Child Nutrition Quiz Quiz: Is this child malnourished, stunted or wasted? Look at the photo carefully, then choose your answer below. Malnourished Stunted Wasted Healthy How others answered Wasted0% Malnourished0% Stunted0% Healthy0% Be the first to answer Image: UNICEF Pakistan This poll accompanies Prism's reporting on childhood malnutrition in Pakistan. Stunting, wasting and malnutrition are clinical conditions defined by measurement — height-for-age, weight-for-height and weight-for-age respectively — and cannot be reliably diagnosed from a single photograph. This exercise is intended to illustrate how easily these conditions are misread by sight alone, not to diagnose any individual child. What the survey told us The 2018 National Nutrition Survey was an extremely big deal in health and policy circles. It was done by the Ministry of National Health Services that teamed up with the Aga Khan University and Unicef to survey over 115,600 households and, for the first time, drill down into district-level breakdowns, adolescents, and water quality. The data it produced was both authoritative and devastating. Four out of every 10 children under five years in Pakistan were stunted or too short for their age. This means that about 12 million children were suffering from chronic malnutrition. Wasting was 17.7pc, the highest recorded in Pakistan’s history and well above the WHO’s 15pc emergency threshold. More than half of children aged six to 59 months were anaemic. Among women of reproductive age, 42.6pc were anaemic and 46.9pc of pregnant women were iron-deficient. A staggering 81.2pc of pregnant women were vitamin D deficient. Meanwhile, the country was simultaneously confronting the other end of the malnutrition spectrum: overweight prevalence had nearly doubled in seven years, and 13.9pc of women of reproductive age were obese. The NNS 2018 was also the first survey to reveal the burden of stunting and wasting happening at the same time in children: 5.9pc of under-fives are affected, and they live mostly in Pakistan’s south. Boys are worse off than girls, and children in cities were more wasted and stunted than commonly assumed. Also, 58pc of Pakistan’s household water supplies were contaminated with coliform bacteria. Malnutrition and unsafe water are not separate crises. They are the same crisis. Infogram taken from the National Nutrition Survey 2018 Key Findings Report. This data was published, cited in international fora, incorporated into global nutrition dashboards, and referenced in at least four major national strategy documents. What it did not do was translate into a budget line. What we decided to spend on the 2025-26 budget Pakistan’s federal budget for the soon ending financial year, 2025-26, was Rs17,573,000,000,000 Nearly half, Rs8.2 trillion, goes to debt servicing Defence has been allocated Rs2.55 trillion, a steep 20pc increase The Benazir Income Support Programme receives Rs716 billion, a 20-21pc increase, covering 10 million families. These are not illegitimate expenditures at all, but they do tell us where our political priorities lie when fiscal space is compressed. Health has not been spared in the compression. The health budget for 2025-26 stands at Rs46.1 billion — a 16pc reduction from the previous year’s Rs54.87 billion allocation. No new health schemes appear in the Public Sector Development Programme for this fiscal year. Within this already-reduced health envelope, the share dedicated specifically to nutrition is not separately reported because, in Pakistan’s federal budget architecture, nutrition does not have its own line. It is submerged within health, within social protection, within agriculture, invisible, untracked, and unaccountable. The estimated budget requirement for nutrition from 2023 to 2030 is Rs1.79 trillion. For the current fiscal year alone, the requirement is Rs227.9 billion. Against this need, Pakistan allocates a fraction which is declining. It is hard to describe this as a funding gap and easier to call it a choice. The rule is that when a subject has no budget line, it will have no accountability because spending on it will not be tracked. If you can’t measure the impact of money being spent, then you cannot improve on your performance. What cannot be improved condemns the next generation before they even begin. The weight of inaction The NNS 2018 documented a country already in nutritional distress. Since then, the conditions have worsened in almost every dimension. The floods of 2022, which were among the most catastrophic in Pakistan’s history, disrupted nutrition services in 84 flood-hit districts at the exact moment when millions of women and children were most vulnerable. The World Bank now projects Pakistan’s poverty rate to remain persistently high, between 40pc and 42.4pc, with an additional 1.9 million people pushed below the poverty line. Over two-thirds of the population cannot afford a nutritionally adequate diet on a daily basis. The infogram, on complementary feeding practices in Pakistan, is taken from the National Nutrition Survey 2018 Key Findings Report. Climate change is not an abstract future threat but an active, present accelerant for Pakistan’s nutrition crisis. We contribute less than 1pc of global greenhouse gas emissions but consistently rank among the world’s most climate-vulnerable nations. Floods, heatwaves, and agricultural disruption reduce food availability, drive up prices, and destroy the supply chains that deliver micronutrient-rich foods to rural and peri-urban communities. Every flood season that passes without a nutrition-crisis response protocol is a policy failure with measurable consequences — in wasted children, in anaemic mothers, and in preventable deaths. Infogram taken from the National Nutrition Survey 2018 Key Findings Report. Nutrition International’s Cost of Inaction Tool estimates that Pakistan loses at least $17 billion (about Rs4.7 to Rs4.8 trillion) per year as a direct consequence of undernutrition — through lost productivity, increased healthcare costs, reduced cognitive development, and premature mortality. The 2024 World Bank Nutrition Investment Framework calculates that every dollar invested in proven nutrition interventions generates approximately $23 in economic return. Meeting the 2030 global target on stunting reduction alone would avert 855,000 cases annually, prevent 48,000 deaths, and save 8.8 million IQ points and 1.4 million school years. The economic saving: $6.6 billion per year. From one intervention target. A graveyard of good intentions It would be unfair to say Pakistan has done no work on this front. In the years since the survey, we have come up with a substantive architecture of nutrition strategies, such as the Pakistan Multisectoral Nutrition Strategy (2018–2025), the Multisectoral National Nutrition Action Plan (2023–2030), the Pakistan Maternal Nutrition Strategy (2022–2027), and a separate Adolescent Nutrition Strategy. Three provinces have enacted mandatory food fortification legislation and Pakistan has committed to the Nutrition for Growth summits, aligned with the UN Food Systems National Pathway, and signed the Sustainable Development Goals. The multisectoral convergence PANI (Pakistan Nutrition Initiative) project has secured initial support from the Islamic Development Bank. These are real achievements and they must be acknowledged but they are achievements in aspiration, not in implementation. The Pakistan National Nutrition Coordination Council, which is the top coordinator for all this work, is essentially inactive. The Nutrition Advisory Group does not meet regularly and does not have a working reporting mechanism. Analysis from Sindh suggests that funding gaps for nutrition-specific and nutrition-sensitive interventions stand at approximately 75pc. No systematic financing gap analysis has been conducted at the federal level. We do not fully know, as a government, what we are not spending on whom, and with what consequence. This is the paradox of our nutrition governance. We look good on paper with an impressive policy architecture, but it sits on an empty treasury and dud institutions. What could be done now I am putting down the minimum Pakistan needs to do to actually execute its own strategies, honour its international commitments, and put to use the evidence its own National Nutrition Survey produced. We need to set up dedicated nutrition budget lines in the federal PSDP and the Annual Development Plan, with mandatory nutrition-tagging of relevant spending across health, education, WASH, agriculture, and social protection. Without visible expenditure, there is no accountability. We should reactivate the Pakistan National Nutrition Coordination Council and the Nutrition Advisory Group with a formal mandate, quarterly convening schedule, and public reporting requirements. Multisectoral coordination must move from aspiration to documented practice. We should urgently commission someone to do a financing gap analysis for federal-level nutrition financing, modelled on the Sindh exercise, so we can establish, for the first time, what Pakistan is actually spending on nutrition and what the true shortage is. We should get the Ministry of Finance involved in decision-making as a stakeholder. Finance officials should receive regular, evidence-based briefings on the economic return on nutrition investment, framed in the language of productivity, GDP, and human capital, not humanitarian obligation. We should aggressively mobilise climate-linked development financing for nutrition from the Asian Development Bank, World Bank, Islamic Development Bank, and the Child Nutrition Fund. This will position Pakistan’s nutrition crisis explicitly within the climate justice framework it legitimately occupies. This is what the provincial governments should do The 18th Amendment to the Constitution made health and nutrition primarily the job of the provincial governments. The federal budget for 2025-26 acknowledges this explicitly, with over 60pc of provincial ADP allocations directed toward social sectors. But acknowledging the structural reality of devolution is not the same as executing against it. Provincial governments must move from passive recipients of national strategies to active architects of their own nutrition financing. Each province must develop a costed provincial nutrition action plan that is aligned with the national framework but rooted in local epidemiology, particularly the district-level data the NNS 2018 uniquely provides, and integrated into the Annual Development Plan with ring-fenced allocations. Provincial finance departments must introduce nutrition budget tagging in their own PLAS (Provincial Loan Accounting System) and ADP tracking systems, enabling real-time monitoring of nutrition-relevant expenditure across sectors. Provinces with enacted food fortification legislation (Punjab, Sindh, and Khyber Pakhtunkhwa) must urgently close the implementation gap between legal mandate and actual market compliance, including funding for inspection, enforcement, and public awareness. Infogram taken from the National Nutrition Survey 2018 Key Findings Report. Sindh and Balochistan, which carry the heaviest burden of acute malnutrition and where the NNS 2018 recorded the highest wasting rates, should prioritise nutrition as a cross-cutting emergency response theme within their respective climate adaptation and disaster risk financing frameworks. Provincial health and planning departments must nominate dedicated nutrition focal persons with budget authority (not merely technical advisors) and convene quarterly multisectoral nutrition coordination meetings with documented minutes and action trackers. The verdict of the NNS 2018 Seven years after Pakistan’s most comprehensive nutrition survey delivered its verdict, the children it counted are no longer under five years of age. Many of the stunted children of 2018 are now in school or not, because impaired cognitive development in the first 1,000 days is not recovered by a later enrollment. The wasted infants of 2018 are now children whose immune systems remain compromised by early malnutrition. The anaemic adolescent girls of 2018 are now young women approaching their own reproductive years, carrying the nutritional deficits of one generation into the next. Pakistan cannot build the competitive, educated, productive workforce it aspires to be on a foundation of chronic malnutrition. It cannot achieve the 4.1pc GDP growth target in its own budget while losing $17 billion per year to preventable undernutrition. It cannot claim to be a serious development partner on the global stage while its apex nutrition coordination body remains inactive and its budget carries no nutrition line. The 2018 National Nutrition Survey gave Pakistan’s policymakers everything they needed: the evidence, the geography, the scale, and the moral urgency. The 2025-26 federal budget gives us the answer to what they did with it. The question now is not whether Pakistan can afford to invest in nutrition. The question is whether it can explain, to the 12 million stunted children counted in its own survey, why it chose not to. Header image from Reuters
Unemployment has fallen since last summer, but the number of long-term unemployed people in Sweden remains high. The Public Employment Service has been criticised for not doing enough to help people get a job, or to offer training for professions where there are jobs available. The agency's director general, Maria Hemström Hemmingsson, says that they have relied too much on digital channels in the past. Now they will prioritise to meet in person with people who are, or who risk becoming, long-term unemployed.
[The Conversation Africa] The first shipment of Lenacapavir, a long-acting injectable that prevents HIV with two shots a year, arrived in South Africa from the United States in early April 2026. Clinical trials showed close to 100% efficacy. The rollout, expected to begin in June 2026, prioritises adolescent girls and young women, pregnant and breastfeeding women, transgender people, sex workers, men who have sex with men, and people who inject drugs.
The federal government recently announced a Rs22 per litre reduction in petrol and high-speed diesel prices. The decision lowered petrol prices from above Rs403 per litre to approximately Rs381.78 per litre and was presented as a measure to provide relief to consumers facing persistent economic pressures. Yet the public response was far from enthusiastic. Instead of celebrations, many citizens reacted with scepticism. Others questioned whether the reduction would make any meaningful difference in their lives. The reason is simple: while petrol may have become cheaper than it was a few weeks ago, life itself remains expensive. Petrol still costs nearly Rs382 per litre, plus the prices of food, electricity, gas, medicines, transportation, and housing remain elevated. Consequently, many households do not perceive the reduction as a visible improvement. Public sentiment is also shaped by recent memory. Before regional tensions involving Iran disrupted global energy markets, petrol prices in Pakistan were substantially lower. Earlier this year, consumers were paying nearly Rs250-270 per litre. The subsequent surge in international oil prices pushed domestic fuel prices above Rs400 per litre. Although recent reductions have lowered prices somewhat, consumers naturally compare current rates with pre-crisis levels rather than with the record highs of recent weeks. From people’s perspective, the latest reduction appears less like meaningful relief and more like a partial reversal of earlier price increases From their perspective, the latest reduction appears less like meaningful relief and more like a partial reversal of earlier increases. Citizens evaluate economic conditions through their lived experiences. They judge affordability when purchasing vegetables, paying school fees, visiting hospitals, or receiving monthly utility bills. If these expenses remain, improvements in selected indicators rarely generate optimism. When fuel prices increase, transport operators often raise fares almost immediately. Traders cite higher transportation expenses to justify price increases. Manufacturers pass additional costs on to consumers. Yet when fuel prices decline, prices rarely move downward at the same pace. Prices rise rapidly but fall slowly. Consequently, households experience the full burden of inflation while receiving only limited benefits when costs begin to moderate. The food sector provides a clear example. Fruits, vegetables, grains, dairy products, and livestock products all rely on transportation networks that connect farms to markets. During periods of rising diesel prices, transportation costs contribute to higher retail prices. Yet when diesel becomes cheaper, consumers often see little immediate change in the prices displayed at local markets. Part of the explanation lies in the broader inflationary environment. Businesses face multiple cost pressures simultaneously, including labour expenses, electricity tariffs, financing costs, rents, and regulatory charges. Once prices are adjusted upward, they are rarely reduced unless competitive pressures force businesses to do so. As a result, inflation tends to leave a lasting imprint on household budgets. Transportation expenses represent only one component of monthly budgets. Electricity bills, gas charges, school fees, healthcare costs, internet services, and housing rents continue to exert pressure on household finances. Even if lower petrol prices save a commuter a few hundred rupees per month, those savings can easily be offset by rising expenditures elsewhere. Perhaps the most telling indicator of affordability challenges emerged during Eidul-Azha this year. Anecdotally, many people observed that some families who traditionally performed qurbani every year either opted for smaller shares in collective sacrifices or chose not to participate at all because of economic constraints. When households begin reassessing even deeply valued annual practices because of affordability concerns, it serves as a powerful reminder that economic challenges extend far beyond the price of petrol. There is also a psychological dimension to affordability. Years of inflation have changed consumer behaviour. Families have become more cautious about spending. Businesses have delayed investments. Consumers increasingly prioritise necessities while postponing major purchases. Such behaviour reflects not only current economic conditions but also uncertainty about the future. Pakistan’s dependence on imported petroleum products further complicates the situation. While recent declines in international crude oil prices have created room for domestic reductions, future volatility remains a constant possibility. The writer is affiliated with the School of Management, Jiangsu University, Zhenjiang, Jiangsu P.R. China, and the Department of Agribusiness and Entrepreneurship Development, MNS-University of Agriculture, Multan, Pakistan. Published in Dawn, The Business and Finance Weekly, June 1st, 2026
A military official from Pakistan has said that the country’s “resolute response” to India during the May 2025 conflict had effectively debunked the notion of space for war in South Asia. Commander I Corps Lieutenant General Nauman Zakria made these remarks during a special session at the Shangri-La Dialogue in Singapore on Saturday. In May 2025, a four-day conflict between Pakistan and India was sparked by an attack on tourists in occupied Kashmir, which New Delhi, without evidence, linked with Pakistan. Islamabad strongly denied responsibility while calling for a neutral investigation. After New Delhi launched deadly air strikes in Punjab and Azad Kashmir on May 7, Pakistan said it downed five Indian planes in air-to-air combat, later raising the tally to eight. After tit-for-tat strikes on each other’s airbases, it took American intervention on May 10 for both sides to finally reach a ceasefire. Speaking at the Shangri-La conference, Lieutenant General Zakria said strategic stability in South Asia remained shaped by nuclear deterrence, conventional asymmetry, enduring political tensions, and unresolved territorial and ideological disputes between India and Pakistan. And despite the complexities of great power contestation, China constituted a constructive and stabilising factor, contributing to strategic balance, regional connectivity and economic cooperation, he added. Lt Gen Zakria said the May 2025 conflict demonstrated Pakistan’s effective multi-domain operations, which were enabled by tri-service synergy, integrated use of cyber, electronic warfare, intelligence, surveillance and reconnaissance, space-based capabilities and synergetic information manoeuvre, generating cross-domain effects. “Pakistan’s resolute response has effectively debunked the notion of space for war in South Asia,” he said. “Postconlict dynamics have further constrained the prospects for conventional war. However, continued Indian militarisation coupled with persistent adversarial rhetoric and absence of robust crisis management mechanisms continue to undermine regional stability,” he added. In this evolving environment, he said, South Asia’s strategic equilibrium was increasingly contingent upon escalation control and effective crisis communication frameworks. “Navigating the complex challenges of a fast-transforming geopolitical environment warrants a shift from competition-only postures to cooperative risk management across multiple domains, while remaining committed to upholding international norms,” he stressed. Firstly, he said, states must prioritise responsible governance of emerging technologies. “Technological innovation cannot be divorced from ethical responsibility and strategic accountability.” States should work towards internationally accepted norms regarding the military use of artificial intelligence, autonomous systems, cyber operations and space technologies. Human oversight must remain central in decisions involving the use of force, especially in systems with strategic implications, he said. Lt Gen Zakria added that confidence-building measures, transparency mechanisms and technical dialogues among states were essential to reduce misunderstanding and prevent destabilising arms races. Secondly, he said, institutionalised crisis management mechanisms and strategic communication channels needed to be strengthened, he said. “Even during periods of geopolitical rivalry, dialogue must never collapse. History repeatedly demonstrates that strategic stability is preserved not only through deterrence but through communication as well.” Thirdly, he said, nations needed to collaborate in codifying norms regarding space testing, prohibitions on attacks on civilian infrastructure, and human oversight requirements for autonomous weapon systems. “Norms do not discourage competitiveness, but they do set boundaries that make deterrence more calculable. “International law and multilateral institutions must be adaptive to emerging realities. Technological transformation is outpacing our existing institutional and legal frameworks,” he said. Lt Gen Zakria said that strengthening global cooperation on cyber governance, responsible AI development, space security, digital ethics and information integrity was imperative to maintaining the geostrategic equilibrium. “No country, regardless of its size or technological sophistication, can manage the emerging multifaceted risks alone. The challenges we face are transnational by nature and therefore require collaborative responses,” he asserted. Moreover, strategic stability was not only about military capability but also about societal endurance, he pointed out. “Countries must strengthen cyber resilience, protect critical infrastructure, improve digital and technical literacy and build institutional credibility. “Public trust is a strategic asset. Resilient societies are far less vulnerable to external manipulation and internal destabilisation through misinformation, polarisation, and technological disruption,” he said. At its core, strategic stability was ultimately about responsible statecraft, he added. “Technology itself is not inherently destabilising. But the real challenge lies in how technologies are governed, integrated, and employed. Human judgement, political wisdom, and international cooperation for the greater good remain indispensable. “We must resist the temptation for the greater good. We must resist the temptation to view every technological breakthrough solely through the lens of competition and militarisation, rather as a function of balance between innovation and responsibility, national security and global stability, strategic competition and collective survival,” he said. Lt Gen Zakria added, “Let us remember that peace and stability have never been involuntary outcomes of technological progression. They have always depended on political responsibility, strategic restraint and sustained international engagement.” Earlier in his address, he said the operationalisation of the emerging domains alongside the legacy domains had significantly complicated the strategic stability landscape. “Rapid advances in AI, autonomous systems, cyber capabilities, quantum technologies, and multi-domain operations are transforming military decision making, command and control structures, and strategic competition, while simultaneously introducing new vulnerabilities, risks of miscalculations, attribution challenges, and unintended escalation,” he said. As states, societies, and critical infrastructures become increasingly dependent on interconnected technological ecosystems, the erosion of predictability and compression of decision-making timelines were fundamentally reshaping the nature of inter-state conflict and strategic deterrence, he added. Lt Gen Zakria said the information was becoming increasingly fragmented, as digital platforms, AI-generated content, and disinformation campaigns eroded trust, distorted narratives and compressed decision-making timelines. “In this evolving landscape, the control of information and data integrity has emerged as a critical determinant of strategic stability, alongside conventional military balance,” he stressed.
Mr Obi said his administration would prioritise partnership with Mr Kwankwaso, his running mate, to move Nigeria forward. The post Peter Obi reels out a plan for Nigeria, says Kwankwaso won’t be ‘a spare tyre’ appeared first on Premium Times Nigeria.
A military official from Pakistan has said that the country’s “resolute response” to India during the May 2025 conflict had effectively debunked the notion of space for war in South Asia. Commander I Corps Lieutenant General Nauman Zakria made these remarks during a special session at the Shangri-La Dialogue in Singapore on Saturday. In May 2025, a four-day conflict between Pakistan and India was sparked by an attack on tourists in occupied Kashmir, which New Delhi, without evidence, linked with Pakistan. Islamabad strongly denied responsibility while calling for a neutral investigation. After New Delhi launched deadly air strikes in Punjab and Azad Kashmir on May 7, Pakistan said it downed five Indian planes in air-to-air combat, later raising the tally to eight. After tit-for-tat strikes on each other’s airbases, it took American intervention on May 10 for both sides to finally reach a ceasefire. Speaking at the Shangri-La conference, Lieutenant General Zakria said strategic stability in South Asia remained shaped by nuclear deterrence, conventional asymmetry, enduring political tensions, and unresolved territorial and ideological disputes between India and Pakistan. And despite the complexities of great power contestation, China constituted a constructive and stabilising factor, contributing to strategic balance, regional connectivity and economic cooperation, he added. Lt Gen Zakria said the May 2025 conflict demonstrated Pakistan’s effective multi-domain operations, which were enabled by tri-service synergy, integrated use of cyber, electronic warfare, intelligence, surveillance and reconnaissance, space-based capabilities and synergetic information manoeuvre, generating cross-domain effects. “Pakistan’s resolute response has effectively debunked the notion of space for war in South Asia,” he said. “Postconlict dynamics have further constrained the prospects for conventional war. However, continued Indian militarisation coupled with persistent adversarial rhetoric and absence of robust crisis management mechanisms continue to undermine regional stability,” he added. In this evolving environment, he said, South Asia’s strategic equilibrium was increasingly contingent upon escalation control and effective crisis communication frameworks. “Navigating the complex challenges of a fast-transforming geopolitical environment warrants a shift from competition-only postures to cooperative risk management across multiple domains, while remaining committed to upholding international norms,” he stressed. Firstly, he said, states must prioritise responsible governance of emerging technologies. “Technological innovation cannot be divorced from ethical responsibility and strategic accountability.” States should work towards internationally accepted norms regarding the military use of artificial intelligence, autonomous systems, cyber operations and space technologies. Human oversight must remain central in decisions involving the use of force, especially in systems with strategic implications, he said. Lt Gen Zakria added that confidence-building measures, transparency mechanisms and technical dialogues among states were essential to reduce misunderstanding and prevent destabilising arms races. Secondly, he said, institutionalised crisis management mechanisms and strategic communication channels needed to be strengthened, he said. “Even during periods of geopolitical rivalry, dialogue must never collapse. History repeatedly demonstrates that strategic stability is preserved not only through deterrence but through communication as well.” Thirdly, he said, nations needed to collaborate in codifying norms regarding space testing, prohibitions on attacks on civilian infrastructure, and human oversight requirements for autonomous weapon systems. “Norms do not discourage competitiveness, but they do set boundaries that make deterrence more calculable. “International law and multilateral institutions must be adaptive to emerging realities. Technological transformation is outpacing our existing institutional and legal frameworks,” he said. Lt Gen Zakria said that strengthening global cooperation on cyber governance, responsible AI development, space security, digital ethics and information integrity was imperative to maintaining the geostrategic equilibrium. “No country, regardless of its size or technological sophistication, can manage the emerging multifaceted risks alone. The challenges we face are transnational by nature and therefore require collaborative responses,” he asserted. Moreover, strategic stability was not only about military capability but also about societal endurance, he pointed out. “Countries must strengthen cyber resilience, protect critical infrastructure, improve digital and technical literacy and build institutional credibility. “Public trust is a strategic asset. Resilient societies are far less vulnerable to external manipulation and internal destabilisation through misinformation, polarisation, and technological disruption,” he said. At its core, strategic stability was ultimately about responsible statecraft, he added. “Technology itself is not inherently destabilising. But the real challenge lies in how technologies are governed, integrated, and employed. Human judgement, political wisdom, and international cooperation for the greater good remain indispensable. “We must resist the temptation for the greater good. We must resist the temptation to view every technological breakthrough solely through the lens of competition and militarisation, rather as a function of balance between innovation and responsibility, national security and global stability, strategic competition and collective survival,” he said. Lt Gen Zakria added, “Let us remember that peace and stability have never been involuntary outcomes of technological progression. They have always depended on political responsibility, strategic restraint and sustained international engagement.” Earlier in his address, he said the operationalisation of the emerging domains alongside the legacy domains had significantly complicated the strategic stability landscape. “Rapid advances in AI, autonomous systems, cyber capabilities, quantum technologies, and multi-domain operations are transforming military decision making, command and control structures, and strategic competition, while simultaneously introducing new vulnerabilities, risks of miscalculations, attribution challenges, and unintended escalation,” he said. As states, societies, and critical infrastructures become increasingly dependent on interconnected technological ecosystems, the erosion of predictability and compression of decision-making timelines were fundamentally reshaping the nature of inter-state conflict and strategic deterrence, he added. Lt Gen Zakria said the information was becoming increasingly fragmented, as digital platforms, AI-generated content, and disinformation campaigns eroded trust, distorted narratives and compressed decision-making timelines. “In this evolving landscape, the control of information and data integrity has emerged as a critical determinant of strategic stability, alongside conventional military balance,” he stressed.
KAPIT, May 31 — Those returning to their hometowns and villagers for gawai Dayak must always prioritise safety and...
Minister says a 100-day programme will be announced on June 5 to address multiple issues including human-wildlife conflict
Countries: Democratic Republic of the Congo, Ethiopia, Somalia Source: ELRHA In the first blog introducing this series, Adrienne Testa, from the UK Humanitarian Innovation Hub and Elrha discussed how fundamental it is to measure excess mortality if response actors want to understand the severity of a humanitarian crisis and guide aid prioritisation. In our second blog we focus on the work of a consortium led by IMPACT Initiatives. This consortium is drawing attention to the roles that national and local actors play in mortality data collection and use by decision-makers and what is needed to design more localised mortality estimation systems in humanitarian contexts. The structural barriers we need to talk about Many of the challenges for local and national actors to collect mortality data and inform responses are well known, but poorly documented. They have fewer opportunities for technical training; face inequitable access to financial resources for activities; and structural barriers limit their representation in coordination forums where decision-making occurs about whether mortality data should be collected, who collects it, and what findings can mean. Meanwhile, international actors frequently have a seat at the table, and therefore control the narrative, deciding what data matters and how it will shape response priorities. Yet, local and national actors – including non-governmental organisations (NGOs), universities, and public health institutes – are often ideally placed to collect mortality estimates and inform response decisions. They have established connections and access to affected communities and contextual understanding of how to appropriately and effectively operate. They understand political sensitivities and how to navigate these so that mortality estimation findings will carry legitimacy with key stakeholders and decision-makers. Crucially, locally-led mortality estimation initiatives challenge long-standing power imbalances associated with colonial, top-down approaches to humanitarian assistance. Recognising this, three partners in our consortium, Evidence for Change, London School of Tropical Hygiene and Tropical Medicine and SIMAD University, were funded by the Humanitarian Innovation Hub in 2024-25 to imagine what an ideal mechanism might look like to systematically trigger mortality data collection for accountable decision-making in crises. Consultation with global humanitarian stakeholders confirmed: If we want better mortality data, we must widen the pool of people able to generate it. This starts with investing in and strengthening the capacities of local actors. Funding local actors’ priorities and strengthening capacities With follow-on funding from UKHIH-Elrha in 2025-26, our consortium expanded. We teamed up with IMPACT Initiatives along with their partners at Addis Ababa and Mekelle Universities in Ethiopia and World Needs and Help, an NGO in the Democratic Republic of Congo (DRC). Together, we’re working to better understand real-world opportunities and obstacles faced by national actors when implementing mortality estimation activities. Our goal is to use this evidence to strengthen advocacy for approaches that support and prioritise local actors in this vital work. Rather than imposing a predefined research plan, each national partner has selected, tailored and implemented a mortality estimation activity to their context. Our consortium operates a ‘help desk’ to foster peer-learning and strengthen capacities across contexts. Activities include: Somalia: New approaches in a fragmented landscape Our previous work in Somalia demonstrated the effectiveness of well-designed data collection exercises to influence humanitarian decision-making - when findings were communicated - in a timely fashion and to the right people. However, we also saw how fragmented the current data landscape is, with mortality data not always collaboratively shared between institutions, and major gaps in mortality data coverage, particularly in areas outside government control. SIMAD University is therefore running a qualitative study with community burial attendants in hard-to-reach areas of Somalia, exploring what would be needed for this to become a feasible and acceptable mechanism of mortality reporting to bridge data gaps. Drawing on a nutrition and mortality surveillance system originally developed in the NGO sector, Evidence for Change is training female health workers to collect mortality data within a large-scale community-based government programme. Ethiopia: Regional partnerships for regional aid prioritisation Previously, universities across Ethiopia ran demographic surveillance sites in their local areas, with mortality and other data flowing to government authorities. Conflict dismantled many of these surveillance programmes. Addis Ababa and Mekelle Universities, which previously ran surveillance sites, are now partnering with regional health authorities in drought-affected Somali region and conflict-hit Tigray to conduct mortality surveys to help guide regional aid prioritisation. Mekelle University is also including a verbal autopsy component to describe the causes of death, something regional authorities found particularly valuable about the pre-war surveillance system because it helped them monitor the health of populations. Democratic Republic of Congo: Navigating insecurity and mistrust Engagements with both formal and informal authorities in eastern Congo can create tension or mistrust, complicating operational permissions and community access. Nevertheless, World Needs and Help is initiating a mortality survey in a conflict‑affected North Kivu region, to document the human toll of ongoing violence and displacement. While the organisation has no prior experience in mortality estimation, our consortium helped them expand their technical skillset. Their experience supporting needs assessments among various partners across the east means they are well positioned to navigate the complex challenges to ensure mortality estimation is possible. Alongside these activities, we are documenting how teams have approached the process, keeping a close eye on context. We are building on social science methodological approaches we developed in phase 1 to help us understand how politics, institutional identities and other evolving challenges shape the ways mortality actors work. Equitable and sustainable systems change None of these challenges have quick fixes. Building an equitable and sustainable approach to mortality estimation will require the concerted efforts of many stakeholders, working together to drive change. Our own consortium is part of that broader momentum. By documenting barriers and testing solutions today, our hope is to inform the strategy that will address these challenges tomorrow, supporting UKHIH’s drive for true systems innovation in humanitarian action.
Country: Democratic Republic of the Congo Source: ELRHA Author Jennifer O’Keeffe, Augustin Gang Karume and Paul Spiegel This blog series accompanies the Mortality Estimation Systems Innovation Partnership (SIP), supported by UKHIH-Elrha, which brings together diverse partners to strengthen how mortality data is collected, interpreted, and used across humanitarian crises. Earlier blogs in this series highlighted why excess mortality measurement is critical for understanding crisis severity, as well as exploring how to maximise local and national actors' leadership in the mortality estimation ecosystem. In this third blog, we turn to Eastern Democratic Republic of the Congo, where Rebuild Hope for Africa and the Johns Hopkins Center for Humanitarian Health share how their work is making mortality estimation more accurate, accessible, and feasible for national actors best placed to do this work, even in the most challenging settings. “As an indicator, a mortality rate tries to evaluate the size and scale of a crisis in a single metric.” The Public Health Aspects of Complex Emergencies and Refugee Situations, 1997, Michael Toole, Ronald Waldman In 2023, the Humanitarian Congress in Vienna released a statement saying, "The humanitarian imperative is an absolute moral obligation to save lives and alleviate human suffering on the basis of need, without discrimination”. Yet**,** when resources are constrained, allocation is often based on geopolitical interests, media coverage, or how relatable a population may be to high-income donor countries. In short, human lives are valued differentially. The disconnect is not theoretical. In 2022, Rebuild Hope for Africa (RHA) led a nationwide mortality survey in the Central African Republic which estimated up to 5% of the population had died during the previous year. Despite the scale of these findings, the study received little media attention and did not lead to meaningful changes in donor policy. In conflict-affected settings, various, often compounding, factors make primary data collection difficult or impossible. These include forced displacement, insecurity, system failures, poor infrastructure, limited capacity, and restricted access. In practice, mortality is often not measured at all. And as threats to healthcare workers grow, international agencies have become understandably risk averse, collecting data only safer, accessible areas, where death rates are usually lowest. Without reliable data, decision makers and responders depend on fragmented sources and non-robust estimates. The result is a biased and misleading picture of crisis severity, that often portrays crises as less severe than they are. The magnitude of these biases and their effects on decisions by humanitarian actors, governments, and donors who rely on such data, remain largely unexamined. Our partnership between Rebuild Hope for Africa (RHA) and the Johns Hopkins Center for Humanitarian Health (CHH) is working to change this. Eastern Democratic Republic of the Congo - An Unquantified Crisis Few places demonstrate the challenges of mortality estimation more than the Democratic Republic of the Congo (DRC), one of the world’s most enduring humanitarian crises. The crisis worsened drastically in January 2025 when the country suffered a devastating double shock: the abrupt withdrawal of USAID funding and a violent military offensive by the Rwandan-backed rebel group M23. The M23 seized large swathes of territory, killing and displacing an unknown number of people in the process. With the departure of many international agencies and a vacuum in humanitarian response, the population has been left vulnerable to the worst effects of the conflict. A year later, the true human cost remains unknown. We recognise that without reliable data, it becomes even harder to mobilise the support that people living in Eastern DRC urgently need. Placing Data and Decision-Making in Congolese hands Augustin Gang Karume, one of the authors of this blog, was born and raised in Eastern DRC, where he still lives and works today. In 2008, he founded RHA to place data and decision-making back in Congolese hands. He understood then that national actors are the future of sustainable humanitarian response. Rooted in the community and living with the long-term consequences of decision-making, national actors have a strong incentive to prioritise community needs over institutional agendas. Using local networks and knowledge, they are the best equipped to conduct primary data collection in insecure settings. While international actors have scaled back amid funding austerity, national organisations like RHA have remained in place, continuing to work for and within their communities. These actors are also proving to be far more cost-effective and efficient. Without international overhead, they can often deliver results at a fraction of the cost of international organisations. As an example, RHA’s 2022 nationwide mortality survey in the Central African Republic, cost a total of 50,000 USD, whereas a single district SMART survey may cost upwards of 15,000 USD*. National actors are the first responders in nearly all crises and remain present long after international attention and funding fade. Bridging Local Leadership with Technical Expertise With funding from the UK Humanitarian Innovation Hub’s Systems Innovation Partnership, we are bridging RHA’s local leadership with technical expertise from the CHH, combining community trust with advanced epidemiological and statistical training. Together RHA and CHH are collaborating on a study to assess potential biases in mortality estimation through both primary data collection and innovative use of statistical approaches. We’re working to make mortality estimation more accurate, credible, and efficient, with the intent to apply the findings across humanitarian settings. In the primary data collection component, our study is comparing three different methods of mortality estimation: a retrospective household survey, rapid key informant listing, and a full census. Using a common reference population and recall period, the study aims to identify where biases arise, quantify which deaths are missed, and assess relative performance of a light-, medium- and resource-intensive approach to mortality measurement. In the statistical component, we are applying innovative use of established causal and design-based methods to assess biases. We are testing the utility and feasibility of these methods to answer questions like: to what extent are hard to capture deaths, such as neonatal and violent deaths, systematically missed; can fewer survey clusters still provide estimates precise enough for decision making; and can analytical adjustments be used to address known biases? We are also supporting localisation by building field-ready guidance tools designed to make mortality estimation more accessible to operational actors. These tools include an algorithm to help teams choose a method, an operational readiness checklist, and a guide to data validation, triangulation, interpretation. Our aim is to make mortality estimation practicable in even the most challenging settings, without compromising quality. As the best-placed actors to assess mortality, we hope to pilot the guidance with national actors in the DRC and elsewhere to ensure it is user-friendly, actionable, and scalable for use in any crisis. Looking Ahead: Making Mortality Count Without credible mortality data, humanitarian response risks being inefficient, inequitable, and disconnected from reality. We cannot respond appropriately to crises we do not understand. When those with the greatest capacity to measure mortality have the least stake in the results, the system fails. The best way to ensure efficiency and effectiveness is to place local organisations at the centre. Connecting local expertise with technical knowledge offers a path toward a fairer humanitarian sector, where the reality of a crisis is described by those living through it. *2017 estimate adjusted for inflation.
Esther Okereke, who was elected at the party’s 2027 convention and presidential primary election, on Friday, promised to prioritise responsible leadership if elected president. The post 2027: NRM elects presidential candidate appeared first on Premium Times Nigeria.
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Governor Arlekar says UDF government will prioritise strengthening public healthcare, elderly care and modernisation of hospitals across the State
Measles in the US, a cholera outbreak in the DRC, TB patient registration drops in Cambodia, Kenya, and Mozambique and closer to home, HIV outbreaks in children have all been linked to what doctors have warned are cuts to programmes and disastrous policy changes. Global funding has shrunk for healthcare across countries that need it the most which is why experts in Pakistan are really getting worried. The effects are immediately clear on the ground. In the busy streets of Lyari, Karachi, Amna Sualeh once navigated confidently through her community as a health worker with the Greenstar Social Marketing’s Sitara Baji (star sister) programme. Women trusted her to provide affordable intrauterine devices (IUDs), counselling on how to space out their children, and basic reproductive health services. “Before, with donor support, we could perform IUD insertions for just Rs500,” she says. “Now it costs up to Rs10,000 in private clinics. Many simply can’t afford it anymore.” Her clients, mostly working-class mothers, have begun skipping visits or turning to unsafe alternatives. As Pakistan’s macroeconomic crisis stretches out, many women have stopped coming altogether as their incomes have shrunk. This refrain is repeated across the provinces as overseas development assistance, once an indispensable backbone of the country’s public health system, contracts sharply. While not a principal focus of the global conversation on the impact of the Great Aid Recession, Pakistan enters the second quarter of the 21st century with its health system already stretched thin. It spends just 0.9 per cent of its GDP on public health, far below the WHO’s 5pc benchmark for universal health coverage. Life expectancy is 67.3 years, which is four years below the South Asian average, and conversely, infant and maternal mortality remain stubbornly high at 50.1 deaths per 1,000 live births and 155 deaths per 100,000 live births, respectively, more than double the rates of neighbours such as Bangladesh and Nepal. These outcomes reflect chronic underinvestment, rigid budgetary structures, and a system that has long relied on overseas technical and financial assistance for crucial health functions that domestic resources have not historically covered. For years, overseas development assistance, including both on-budget funds that flowed through government budgets and off-budget funds directed to NGOs, helped bridge key gaps in the system. While it comprised only a small proportion (around 1pc) of public health spending, much of this assistance was for crucial system functions that have historically been underserved in government budgets and policy. This is particularly true for funding from Global Health Initiatives (GHIs), specialised international financing mechanisms that support priority health programmes around the world, through organisations such as the Global Fund for TB, AIDS and Malaria and Gavi. In Pakistan, this support included the less visible aspects of health, such as supply chain logistics, cold chain management and storage, commodity procurement, monitoring support, and technical capacity building across key programmes like mother and child health, family planning, immunisation, HIV-AIDS, malaria and TB. As laid out in a recent report by think tank Tabadlab, the unprecedented global aid retrenchment crisis that has enveloped the world since 2025 has hit many of these programmes hard. USAID’s suspension led to the closure of over 60 UNFPA-run health facilities in Khyber Pakhtunkhwa, directly disrupting care for 1.7 million people and halting HIV-AIDS programmes in Sindh that were providing life-saving medications to patients. Screengrab from Tabadlab research paper on aid cuts. This was followed by reductions in financial commitments in Pakistan from multilateral GHI donors such as Gavi and The Global Fund, as finances were redistributed across regions and priorities. Drawdowns in Gavi affected vaccination programmes caused layoffs of over 200 vaccinators in Lahore alone. A $27.2 million Global Fund reduction halved TB support in multiple provinces, cut diagnostic kit financing by 75pc, and placed treatment for over 42,000 HIV-positive patients at risk. Across the board, these cuts are eroding important nodes of the health system for which ODA had earlier provided the systemic architecture and connective tissue. Preventative healthcare’s invisible erosion Preventative health programmes—long under-prioritised in domestic health budgets and rarely accorded priority by local politicians and policymakers who tend to focus resources on visible infrastructure—have been disproportionately impacted. Organisations like the Global Fund helped develop monitoring and surveillance systems and trained thousands of frontline workers to prevent and monitor the spread of communicable diseases. Over the past year, many of these programs have been terminated. Dr Ilyas Gondal, former director general of health in Punjab, oversaw the administration of these programmes firsthand. “Preventative healthcare has not been given its due importance here,” he observes. “Donors filled critical gaps in programmes such as the Expanded Programme for Immunisation (EPI), AIDS, Hepatitis and TB through support for training, outreach, health awareness, literature, and logistics. Now, most of that work has stopped across all of these programmes.” Dr Gondal fears that progress on coverage for vaccine-preventable diseases could be reversed if no arrangements are made for alternative financing. Ejaz Mahmood, a community health worker at Indus Hospital in Faisalabad, worked with the Global Fund-supported Infection Prevention and Control (IPC) programme, which trained 10,000 frontline workers in standard operating procedures for infection prevention across the country and developed IPC committees following the Covid-19 pandemic. He describes how most of those IPC committees have now become non-functional, and critical infection prevention training has been abandoned. “No one is there to train health workers anymore. We are already seeing needle-stick injuries rising, with over 111 such cases in Faisalabad this year, along with rising cases of HIV-AIDS and Hepatitis B.” Screengrab from Tabadlab research paper on ODA cuts on Pakistan’s health system. Some of the fallout of such crucial programmes being abandoned may already be contributing to disease outbreaks. Over the past year, Pakistan has witnessed one of the fastest-growing HIV epidemics in the WHO Eastern Mediterranean region, with a 200pc rise in infections between 2010 and 2024. Recent media investigations in Punjab and Sindh uncovered multiple HIV outbreaks originating from health facilities that disproportionately affected children, with the reuse of syringes, non-screening of blood samples, and other unsafe medical and waste management practices identified as the causes. As donors that were crucial in enabling preventative interventions and programmes draw down support, the risk of such outbreaks is likely to increase, unless the funding and institutional structures for these programmes are sustained or replaced with domestic capacity and resources. Tuberculosis detection and treatment in jeopardy Pakistan ranks fifth globally in TB burden, with nearly 650,000 cases and 70,000 deaths annually; over half of cases go undetected. Provincial TB control programmes have long depended on donors for the bulk of programme funding. While provincial governments contribute brick-and-mortar infrastructure for these projects, organisations like The Global Fund financed everything from service delivery to detection and surveillance to commodity stocks. Dr Sher Afghan, director of the TB Control Programme in Balochistan, is direct about the scale of the crisis: “We currently face an 80pc funding gap.” The cuts resulted in a 50pc reduction in programme human resources. “We have had to halve monitoring and surveillance staff, postpone prevalence surveys, and capacity building programmes that were training 800 workers a year.” In resource-strapped provinces with unique geographical access challenges like Balochistan, this has made TB detection increasingly difficult. Programme administrators like Dr Afghan are concerned about the increased risk of undetected transmission. “Every TB-positive patient who is not treated spreads the disease to 12 people on average. Thus, every undiagnosed case means potentially 13 undiagnosed cases.” The Global Fund cut has also triggered a 50pc reduction in district-level monitoring and community interventions staff in Punjab and Khyber Pakhtunkhwa, alongside a 75pc cut in diagnostic testing kits and the elimination of capacity-building. Utilisation of USAID in Pakistan’s healthcare system Life and healthcare programmes; primary healthcare in erstwhile FATA and frontier regions; childhood and neonatal support; malaria control. Screengrab from PIDE research paper on foreign aid, donors and consultants. Babar Shigri, former programme management specialist with USAID Pakistan, observed the impact of donor withdrawal firsthand. In Khyber Pakhtunkhwa and Sindh, USAID supported TB programmes with contact tracing, pharmaceutical products, community mobilisation and management information systems that improved detection rates. “It’s not about funding alone,” he says. “When USAID left, work slowed down overall as one of the main actors driving and coordinating advocacy was gone.” In Balochistan, Dr Sher Afghan is cautiously optimistic that the government will step up to the challenge and is working on creating budgetary space for the programme. But with the sudden shock to a system long dependent on donor-led systems, there is a risk of systemic collapse to the programme unless there is rapid action to create fiscal and institutional mechanisms for transitional planning. Family planning being priced out of access Family planning programmes have been among the hardest hit. Through off-budget ODA, donors like USAID supported access by underwriting everything from supply chains to capacity building for large non-governmental family planning providers such as Greenstar Social Marketing and Rahnuma FPAP. When funding evaporated, the effects were immediate. Dr Syed Azizur Rab, CEO of Greenstar Social Marketing Pakistan, describes a donor-supported network that enabled underserved rural and working-class communities to access contraceptives and SRH services nationwide. “Donor support covered functions ranging from commodity subsidies, training, and logistics to community outreach and monitoring,” he explains. With that support gone, clinics have had to raise fees to cover costs and scaled back services. Screengrab from PIDE research paper on foreign aid, donors and consultants. Access to contraceptives, particularly long-acting ones like IUCDs and implants has been severely affected. According to Dr Rab, due to a lack of domestic production and rising costs of imports, “without donor subsidies, implants and IUCDs in private are simply commercially non-viable.” This effect has been compounded by increased taxes on contraceptives by the government as a revenue measure, further pricing them out of reach amid a prolonged inflationary crisis. Greenstar-affiliated clinicians such as Amna Sualeh now watch clients weigh the increased cost of an IUCD against tighter household budgets. Many are now forgoing modern contraceptive methods altogether and having unintended pregnancies as a result. In Mardan, Khyber Pakhtunkhwa, Noreen Nasir, a lady health visitor and midwife with over two decades of experience, worked for years as a family planning provider with USAID’s now-terminated Building Healthier Families programme. The project supported training and diagnostics, IUCDs, injections and implants for women in working-class neighbourhoods. “We used to be able to provide these commodities and services at a very minimal cost because of donor support,” she says. “Now we have to charge for them and face frequent shortages of implants and injections. At times, I pay for delivery kits out of my own pocket because the client can’t afford them and the delivery would be riskier otherwise.” As a result of the loss of support, she says, increasing numbers of women are turning to unqualified providers and stocks of key family planning products have fallen short. According to Noreen, the loss of access to affordable natal and post-natal care is also affecting infant nutrition, with reduced breastfeeding rates and rising underweight deliveries in the community she serves. Rahnuma FPAP, one of the country’s largest reproductive health networks, has closed dozens of centres. District Programme Manager Farrukh Bashir is pessimistic in his assessment: “When the funding stopped, all project beneficiaries lost access, and we had to close all donor-supported clinics. In facilities where we used to have three doctors, we now have just one. Doctor-client ratios have worsened across the board, and thousands of women from working-class communities have lost reliable sexual and reproductive health care.” Mother and child health fragile gains at risk The cuts have also severely impacted mother and child health programs and services in a country that has long had some of the worst maternal, neonatal and child health outcomes in Asia. Donor financing for these programmes was critical in reducing maternal mortality across the country (from 276 per 100,000 births in 2006 to 155 by 2024). ODA for it was particularly important for remote and marginalised regions of provinces such as Balochistan, where access to facility-based maternal and child healthcare is limited amid resource and geographical access challenges. Community health worker Shazia Ahmad worked with the EU-ECHO project, which helped upgrade basic health units and hospitals in underserved districts, and provided delivery kits, folic acid, nutrition advice, breastfeeding support and health awareness sessions. “The project was very well received in the communities, and we registered over 100,000 women. We were conducting health screenings for mothers and children while also providing nutrition supplements in districts with the highest malnutrition rates in the country.” Screengrab from PIDE research paper on foreign aid, donors and consultants. But with the termination of the project, medicines and services have been halved, and more layoffs are planned. Shazia worries about reversing the substantive gains they had made in rural communities in Balochistan. “The project was very popular with communities, and we were already seeing genuine behavioural change. Now all that work is at risk, and we are unable to follow up on the healthcare needs we had identified.” In a Rahnuma clinic in a working-class neighbourhood in Faisalabad, Punjab, Dr Amna Ehsan once operated under a “no refusal” policy with low charges for marginalised women. Donor funds allowed subsidised medicines and gynaecological OPD services. Now services are being privatised, and fees are rising. “We had very low charges and could provide low-cost medicines which were affordable for the marginalised communities we work in,” she says. Patient volumes, faced with increased fees for services and medicines, have slowed to a trickle. Systemic vulnerabilities and the transition challenge These individual stories of the struggles of health workers and administrators in the face of ODA cuts illustrate the broader structural problems documented in recent analyses of Pakistan’s health system and financing. As is clear, the impact is not just fiscal but functional. ODA, particularly off-budget flows through Global Health Initiatives, were critical for crucial health system functions that public budgets cover only partially or not at all. Bilateral cuts such as the USAID suspension have produced “cliff-edge” disruptions—abrupt programme discontinuities without transitional periods or buffers. Multilateral financing reductions have eroded the infrastructure of vertical disease programmes, including for commodities, diagnostics, surveillance and field operations. Commodity supply chains are particularly vulnerable. Donors handled pooled procurement that secured steep discounts on vaccines, TB drugs and diagnostics. As things stand, domestic systems lack the fiscal flexibility, technical capacity and regulatory agility to absorb these functions quickly. Further, technical assistance withdrawal is eroding surveillance, monitoring, data systems and planning capacity. The result is not total collapse or catastrophe but precise ruptures: stockouts, shortages, laid-off outreach workers, broken referral chains and rising exposure to out-of-pocket costs that can push families deeper into poverty and raise the underappreciated risk of disease outbreaks. While the risks are very real, the current moment also presents an opportunity for the kind of structural change that Pakistan’s health system has long needed. However, the government’s response must move beyond emergency and ad-hoc plugging of gaps and outbreak controls towards transition planning. If governments demonstrate adequate initiative and come together to coordinate, assess and fill these financing gaps, we can secure and build on the fragile health gains of recent years. At Greenstar, Dr Azizur Rab sees this moment as a reform opportunity that could build on what already exists: “The federal and provincial governments will have to look at the models already created with donor money and scale them up. However, this requires government ownership and political will.” If Pakistan seizes the crisis as a catalyst for functional transition—from donor dependence to resilience and sustainability—it can build a fully domestically financed health system capable of protecting the most vulnerable while also preventing outbreaks and creating effective local referral systems and commodity supply chains. The choice, and the cost of inaction, will be measured in lives and in the hard-won public health gains now hanging in the balance.
The Manchester Mayor handed over £33,000 of taxpayers' cash to the city's Superbia initiative, an arts and culture programme which prioritises projects by the 'Wider trans communities'.
The quality of a government complex proposed to be built in Kwu Tung North should be high, as befits an investment in Hong Kong's civic pride and its being a flagship for the Northern Metropolis, said a member of the Sub-Committee on Planning and Land Conservation on Friday. Barry Wilson's remarks came after a HK$9.9 billion development plan was proposed for a 35-storey office block that would see the middle and upper floors primarily used for government offices and the ground and lower levels housing community facilities such as a district library, a post office and a kindergarten. Speaking on an RTHK radio programme, he said the building was important as it would be the "civic icon" for the Northern Metropolis. Wilson said the building should prioritise quality and functionality as it will become the centre of "a 15-minute walkable transit-oriented design community" and stressed a need on the part of the government to balance costs with community needs. "This is a building we hope will be around in a hundred years that society will be proud of, that society will have used endlessly and will have proven good value for money," he said. Addressing concerns over the the proposed costs of the project, Wilson believed that the investment will be worth it in the long term. "If we're going to attract talent, if we're going to attract business, if we're going to attract tourists, if we're going to create civic pride and create cohesive communities, I think it wouldn't be outrageous to spend a bit more," he said. He noted that the suggested building plan of 380 parking spaces could be reduced in a walkable neighbourhood environment, saying that might be an area where cost savings could be made. Edited by Thomas McAlinden
With one week to go until Leaving Cert students sit their Maths Paper 1 exam, they may be wondering what to prioritise studying over the coming days.
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