SDG 3: Good Health and Well-being — Pakistan’s Struggle for a Just and Humane Healthcare System
Introduction: What Is SDG 3?
SDG 3: Good Health and Well-being commits the global community to “ensure healthy lives and promote well-being for all at all ages.” It is one of the most comprehensive and ethically charged goals among the 17 Sustainable Development Goals.
Its core targets include:
- Reducing maternal and infant mortality
- Combating infectious diseases like HIV, TB, and malaria
- Promoting mental health
- Reducing substance abuse and traffic injuries
- Ensuring access to affordable, quality healthcare services and essential medicines
- Strengthening health financing, health workforce, and emergency preparedness
In principle, SDG 3 is not about luxury hospitals. It is about making health a universal, inclusive, and rights-based service.
Why SDG 3 Matters Globally
Health is a human right — and the basis of all productivity, dignity, and social participation. A sick population cannot learn, work, or contribute. Without health:
- Poverty multiplies
- Inequality deepens
- Social unrest increases
- National resilience collapses
Globally, over 5 million children under age five died in 2023 — most from preventable causes like diarrhea, pneumonia, or malnutrition. Maternal deaths remain high in many low-income countries. Mental illness is now a leading cause of disability worldwide.
In this light, SDG 3 is not optional — it is foundational to civilization.
Health in Pakistan: A Nation on the Sickbed
Despite decades of planning, Pakistan’s health indicators are poor — not because of lack of knowledge, but due to structural neglect:
- Life expectancy: ~66 years (well below global average)
- Infant mortality: 55 per 1000 live births (double that of regional peers)
- Maternal mortality: ~178 deaths per 100,000 live births
- Health expenditure: Less than 1.5% of GDP
- Doctor-patient ratio: 1 doctor per 1,300 people (WHO recommends 1:1000)
From tribal belts to urban slums, health is not guaranteed. It is rationed, often by class, geography, or politics.
Five Core Problems in Pakistan’s Health System
- Urban-Rural Health Divide
Most doctors, specialists, and equipment are concentrated in cities. In contrast:
- Rural Basic Health Units (BHUs) are often non-functional
- Staff absenteeism is rampant
- Emergency care is unavailable
- Ambulances are rare or private
This creates a cruel reality: your chances of survival depend on your postal code.
- Privatization Without Protection
With the public sector failing, private hospitals and clinics now dominate. But:
- They are unregulated
- Medical errors go unpunished
- Overcharging is common
- Ethical malpractice (e.g., unnecessary tests or C-sections) is rising
Even in cities, a hospital visit can bankrupt a poor family. There is no national insurance system that protects against catastrophic health costs.
- Maternal and Child Health Neglect
Pakistan remains one of the most dangerous countries to give birth in. Why?
- Lack of trained birth attendants in villages
- Cultural taboos delaying hospital visits
- Inadequate nutrition among mothers
- Unhygienic conditions during delivery
Additionally, nearly 40% of Pakistani children are stunted due to malnutrition and untreated infections. This is a public emergency, not a private misfortune.
- Mental Health Crisis
The mental health burden in Pakistan is massive and unspoken:
- Depression and anxiety are widespread
- Suicide rates are rising, especially among youth
- Post-traumatic stress is common in conflict zones and among displaced people
- Drug abuse is rising, especially among men in lower-income areas
Yet there are fewer than 500 psychiatrists for a population of over 240 million. Mental health is still seen as a “taboo,” not a medical reality.
- Lack of Preparedness and Disease Control
COVID-19 exposed the fragility of Pakistan’s health system:
- Inadequate ICU capacity
- Weak disease surveillance
- Lack of lab infrastructure
- Delayed procurement of vaccines and PPE
Beyond COVID, diseases like dengue, hepatitis, and tuberculosis continue to claim thousands of lives annually — despite being entirely preventable.
Is SDG 3 Viable in Pakistan’s Current Framework?
The short answer: Not fully — without structural reform.
Yes, some progress has been made:
- Polio is close to eradication
- COVID vaccination coverage surpassed 70% in many districts
- Sehat Sahulat Cards have expanded insurance for some families
But these are islands of success in an ocean of neglect. Systemic issues remain:
- Weak health governance after the 18th Amendment
- Corruption in procurement and licensing
- Lack of investment in preventive care
- No strategic roadmap for health equity
Economic Perspective: Is Universal Healthcare Affordable?
Yes — if resources are managed and corruption is curbed.
Pakistan can:
- Divert funds from elite subsidies (VIP convoys, tax breaks, white elephant projects)
- Cut wastage in procurement and drug imports
- Invest in community health programs rather than concrete buildings
- Use technology (telemedicine, mobile health units) to reach far-flung areas
Universal healthcare is not cheap, but neither is national instability, disease burden, or economic collapse from a sick workforce.
Strategic Recommendations for a Healthier Pakistan
The recommendations here are not final policies but strategic options — they need pilot implementation, local adaptation, and public feedback before scaling up.
✅ 1. Rebuild the Public Health System
- Make primary health centers functional with 24/7 basic services
- Enforce attendance and accountability in rural health posts
- Build a career track for rural service with incentives
- Modernize infrastructure with solar power, digital records, and mobile apps
✅ 2. Legalize and Regulate the Private Sector
- Establish a Medical Consumer Protection Authority
- Make billing transparent; enforce penalties for unethical practices
- Mandatory malpractice insurance for hospitals
- Ensure minimum wage and safety for nursing and paramedical staff
✅ 3. Invest in Maternal and Child Health
- Train and deploy Lady Health Workers (LHWs) more widely
- Expand midwifery schools and birth training programs
- Provide free iron, folate, and nutrition kits to pregnant women
- Launch a national campaign for birth spacing and hygiene
✅ 4. Recognize and Treat Mental Health
- De-stigmatize mental illness through TV, mosques, and schools
- Train primary doctors in basic psychological care
- Integrate counselors in high schools and universities
- Expand addiction treatment centers — especially for youth
✅ 5. Create a National Health Insurance Grid
- Expand Sehat Sahulat Card to all citizens, not just those below poverty line
- Partner with provincial governments and private hospitals
- Digitize health records for easy claims and tracking
- Offer free screening for common diseases (BP, diabetes, cancer)
✅ 6. Integrate Religious and Community Support Systems
- Mobilize mosques, seminaries, and faith-based NGOs to promote hygiene, vaccination, and mental health
- Offer medical camps and health awareness through zakat and waqf institutions
- Treat health as part of collective ibadah (worship through service)
Conclusion: Healing Pakistan Is a National Duty
SDG 3 shows us what a just and dignified health system can look like — one that serves the poor, uplifts the vulnerable, and treats every citizen not as a customer, but as a human being.
Health is not just a medical issue. It is a moral, economic, and spiritual imperative.
For Pakistan, a healthier future demands more than charity or charity hospitals — it requires courage, reform, and a new vision of public service.
