80pc adults have dangerous waistlines, experts warn
Experts also revealed that 50 percent of adults are hypertensive, and one in three is diabetic, conditions directly linked to weight gain and inactivity.
At a health awareness camp organized by the Karachi Press Club (KPC) in collaboration with Getz Pharma, specialists from Aga Khan University Hospital (AKUH) and Jinnah Postgraduate Medical Centre (JPMC) warned that obesity is now killing Pakistani men at younger ages, causing infertility in women, and setting children on a path toward chronic disease.
Most troubling, they said that the majority of people remain unaware of these risks and continue to lead dangerously inactive lifestyles.
'We are raising a generation that is both obese and malnourished,' said Dr. Asma Ahmed, endocrinologist at AKUH, citing national data that shows 35 percent of women and 28 percent of children in Pakistan are obese. 'Obesity is not a cosmetic issue—it's a chronic disease that leads directly to hypertension, diabetes, infertility, and organ failure,' she warned. She pointed out that excessive screen time, junk food, and irregular routines are among the main reasons for this surge in obesity among children. 'Many people don't even know they are hypertensive, and unchecked blood pressure is silently damaging their kidneys, hearts, and brains,' Dr. Asma added.
She urged families to prioritize home-cooked, nutritious meals and reduce their intake of processed and fast food. 'Sleeping late, lack of physical activity, and poor diet are pushing the nation toward a health disaster,' she said.
Dr. Nazish Butt, Head of Gastroenterology at JPMC, echoed these concerns, noting that obesity is now a leading cause of diabetes, high cholesterol, strokes, and heart attacks in the country. 'People have simply stopped exercising. In Karachi, we're seeing particularly high obesity rates among women and children due to sedentary habits and increased consumption of frozen and junk foods,' she said, calling for urgent community-level lifestyle reforms.
Dr. Wajiha Javed, Public Health Expert at Getz Pharma, shared findings from the Pak Sehat baseline demographic survey—the first mini-Framingham study and bio bank of the South Asian population—which found that over 80 percent of women and 70 percent of men in Pakistan are obese. 'Fifty percent of adults also suffer from hypertension, and one in every three is diabetic,' she said. To address these alarming trends, she announced a three-year national initiative titled PREACH, launched by Getz Pharma, aimed at early detection, disease awareness, and referral pathways through private community health workers. Dr. Wajiha also mentioned the availability of semaglutide and tirzepatide—newer medications now available in Pakistan for patients with a BMI above 30, or above 27 with weight-related conditions like diabetes and hypertension. 'Under our Med One umbrella, we're partnering with healthcare stakeholders to promote screening and public awareness about metabolic disorders,' she added.
The screening camp at KPC provided free consultations for journalists and their families, many of whom were tested for obesity, diabetes, and hypertension.
The event was attended by KPC Joint Secretary Muhammad Munsif, Health Committee Secretary Hamid-ur-Rehman, and Getz Pharma representatives including Mikail Soomro, Agha Sadiq, and Head of Public Health Kashif Amin.
On the occasion, experts called for national-level public health campaigns, better food education, physical activity in schools and workplaces, and recognition of obesity as a serious chronic disease rather than a mere lifestyle issue.
Copyright Business Recorder, 2025
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The missed diagnosis
In a country where patients often arrive at hospitals only when their condition turns critical, where public health infrastructure remains chronically underfunded, and where even routine illnesses can become life-threatening due to delays, the cracks in Pakistan's healthcare system are no secret. But while treatment gaps and medicine shortages dominate headlines, a quieter crisis continues to erode outcomes: the failure to diagnose early, or accurately. Diagnostics are the starting point of any effective treatment journey. They help identify diseases before symptoms become severe, guide doctors toward the right course of action, and save lives through timely intervention. But in Pakistan, diagnostics have long remained on the periphery of healthcare planning. Dr. Suleman Alvi, Country Head of Martin Dow Specialties Private Limited, believes the problem is structural, rooted in slower policy reforms, systemic inefficiencies, and a lack of prioritisation. 'We do not have enough functional labs, especially in the rural belt and even in urban setups,' he says. 'You'll often find a good hospital but not a good diagnostics department attached to it. That's a huge gap.' He further adds that the issue is not that we don't have enough people or even labs. 'The problem is the infrastructure, the availability of proper devices, quality control, trained manpower, and policy priority.' Pakistan ranks 130 out of 195 countries in laboratory systems, according to the Global Health Security Index, lower than all its South Asian neighbors. Despite the increasing burden of non-communicable diseases like diabetes, hypertension, and cancer, and the persistence of infectious diseases such as hepatitis, TB, dengue, and even polio, the role of diagnostics in shaping healthcare outcomes is yet to be fully recognised. Professor Dr. Naila Tariq, a senior pathologist and head of laboratories at both JPMC and JSMU, has seen the cost of this neglect play out for decades. 'Diagnostics are central to the treatment because without diagnostics, we cannot reach to any conclusive diagnosis and then the treatment would be random and erratic,' she says. In her view, it's not just one issue, it's a matrix of challenges. 'Is it accessible? Yes, in Pakistan, it is nearly everywhere. Is it affordable? No, it's not affordable. Do you think people have got awareness about it? I think no, they don't have the awareness. And the problem is that we have sprawling laboratories. We don't know which is the right one, what they are doing, how they are doing.' She added that even the consultants are not aware of exactly what test needs to be done and in what order. 'These are very important issues. Access is there, but they're extremely expensive. And now, the running of a business is only gauged through the laboratory and the diagnostics. It's not giving the answer which we should have exactly for diagnostics.' The invisible crisis In healthcare, what isn't seen often becomes what's ignored. That's especially true for diagnostics. Their role is foundational, yet, unlike a hospital bed shortage or a medicine stockout, the damage caused by unreliable or absent testing unfolds quietly. 'Unfortunately, we don't treat diagnostics as a priority in policymaking,' says Dr. Alvi. 'They're usually an afterthought when planning facilities, budgeting for healthcare, or even when setting up hospitals. But in reality, diagnostics should be the starting point, they're the eyes of the healthcare system.' The impact of this neglect can be devastating. Missed or late diagnoses mean diseases like TB, hepatitis, diabetes, and cancer are often caught when the patient's condition is already deteriorating. What could've been addressed with preventive care turns into long-term treatment and lifelong financial strain. 'It's not just about having labs, it's about having the right tools and trained staff to deliver accurate results,' Dr. Alvi explains. 'You'll find places calling themselves diagnostic centers, but the equipment is outdated, the staff undertrained, and there's no standardised procedure.' And while patients suffer the consequences, the system often fails to even recognise the root cause. 'In many cases, wrong treatment is blamed on the doctor or the medicine. But the problem started before that, with diagnostics. If the test was flawed, the treatment never stood a chance,' he adds. Dr. Naila echoes the concern from a lab practitioner's perspective. 'The market is flooded with kits of varying quality, there's no reliable check on what's being used where. So precision, specificity, accuracy, all become challengeable.' Without accountability, even the most basic tests can lose clinical value. And without early, affordable, and reliable diagnosis, the entire healthcare chain, from doctors to patients, is flying blind. Systemic barriers Pakistan's diagnostic sector is tangled in more than just weak infrastructure, it's burdened by outdated procurement rules, unnecessary red tape, and a regulatory environment that, rather than facilitating improvement, often adds friction. Among the many structural challenges, Dr. Alvi also acknowledges some recent efforts that signal progress. 'Credit where it's due, DRAP has taken steps in the right direction,' he says. 'Their digitalisation initiative for regulatory approvals is a welcome move. It has made some processes more transparent and efficient. This is the kind of policymaking we need more of, responsive, technology-driven, and focused on reducing friction.' While much of the sector remains bogged down in inefficiencies, Dr. Alvi believes that some policymakers have shown willingness to reform. 'It's important to acknowledge that not all is stagnant,' he says. 'There are individuals and departments trying to push things forward, despite systemic constraints. But they need more support, autonomy, and continuity of policy to truly make a difference.' Still, Dr Alvi believes, 'The biggest challenge is the import process. It's a long, complex procedure, you need to go through various departments, and approvals are delayed. Even when you're importing something as basic as reagents, it takes months. If you're trying to bring in new technology, the process is even more cumbersome.' The delays affect more than just the hospitals and labs. They have a direct impact on how soon, and how accurately, patients are diagnosed. 'This delay in availability results in either test results not being done at all or done after the clinical window has passed,' he says. 'You cannot run an efficient diagnostic setup like this.' Even when devices and kits do arrive, there's little assurance that what's available in the market is up to standard. 'Unfortunately, quality is not prioritised,' he adds. 'There's no uniform check or regulatory mechanism to ensure that imported products are functioning to the level that's required. Sometimes substandard products slip through just because they are cheaper and clear customs faster.' Still, Dr. Alvi insists that affordability doesn't have to come at the expense of quality. 'China offers equipment across a range, from subpar to world-class. The key is knowing what you're buying,' he explains. 'When we partner with Chinese manufacturers, we make sure they're certified either by the European Union or the U.S. FDA. If a device can be sold legally in the U.S. or Europe, it should absolutely be good enough for Pakistan.' According to him, many of these Chinese products are certified to international standards and are also far more cost-effective than their Western counterparts. 'We are representing several such Chinese companies in Pakistan whose devices are affordable and meet global quality benchmarks. But despite this, public procurement policies in many government hospitals still block Chinese equipment by default.' He describes the practice as outdated and discriminatory. 'There are public tenders that outright exclude China by listing only a few 'acceptable' countries, like the U.S., Germany, Japan, or other EU nations. That's unfair. Instead of focusing on country of origin, tenders should ask for EU or IMDA certification. That's what truly guarantees quality.' Dr. Naila offers a sharper critique from the public sector end. She points to the flawed tendering system as a key reason public labs struggle with quality. 'Tenders are always manipulated. The lowest bid gets the tender,' she says. 'So you cannot maintain the quality. The same glucose analysis kit can be purchased for 10,000 rupees, or upto 30,000, and there's no way to ensure what ends up being used in the lab.' She adds that taxation makes it even harder to access reliable tools. 'They have now added duties on duties on duties. Rather than encouraging diagnostic improvements, the government is focused on retrieving as much money as it can through taxes.' She believes the problem goes beyond policy, it's also about enforcement. 'They're not focusing where they should. Whether the kits are coming in acceptable condition, whether temperature is maintained, no one checks that. Instead, they're only counting revenue.' Dr. Alvi agrees that reform must start with cutting down red tape and prioritising reliability over lowest cost. 'There should be a fast-track mechanism for essential diagnostic devices, especially for high-burden diseases like TB, hepatitis, and cancer. Right now, there's no urgency from the system, but the diseases aren't waiting.' Quality control and trust deficit Even when diagnostic services are available, one question continues to haunt the system: can the results be trusted? 'Standardisation is missing. There's no enforced framework for quality control across labs,' says Dr. Alvi. 'Different labs report different results for the same patient, we've seen glucose, cholesterol, or liver function tests vary significantly from one report to another. How do we expect doctors to make decisions based on that?' The lack of consistency is not just frustrating, it's dangerous. When clinicians don't trust results, they either delay treatment, repeat tests, or rely on assumptions. 'This is how misdiagnosis happens. And this is why patient outcomes don't improve even after we spend so much on healthcare,' Dr. Alvi adds. Dr. Naila calls the situation 'deeply flawed at the root.' According to her, the absence of a central regulatory body that enforces strict quality assurance measures has left the sector to function in silos, without checks or balances. 'There is no central body monitoring the quality assurance,' she states firmly. 'Although they have formed all sorts of commissions, Sindh Healthcare Commission, Punjab Healthcare Commission, Khyber Pakhtunkhwa, Balochistan, none are delivering.' She believes the chaos has fueled a culture of profit over precision. 'Smaller labs are working on a commission basis. Even now, the bigger labs are also working on commission basis, they're doing B2B businesses. The result is that obviously, they are not maintaining the required standards.' What's worse is the illusion of regulation. 'This ISO business and accreditation business. it's only sold because of money. I don't believe in this ISO certified or, I don't know, AYZ accredited, because this is now being sold. This is a gimmick,' she says. Dr. Alvi echoes that for diagnostics to be reliable, trust must be backed by transparency and uniformity. 'We need proper licensing and surprise audits,' he says. 'Without enforcement, any lab can call itself certified. But who's checking the calibration? Who's validating the reports?' Despite widespread concerns around standardisation and trust, some large diagnostic players are setting high benchmarks. 'There are labs in Pakistan doing world-class work, they follow strict quality protocols, have internationally certified equipment, and report highly accurate results,' Dr. Alvi points out. 'But unfortunately, their reach is limited. These labs are mostly present in major urban centers, leaving the rest of the country underserved.' At the core of the issue is a public increasingly skeptical of the results they receive, a dangerous position for any healthcare system. Trust in labs, once broken, takes far more than just updated machines to rebuild. Education, reform & the way forward Pakistan's diagnostics crisis doesn't end at infrastructure and regulation, it begins much earlier, in classrooms and hospitals, where the next generation of doctors is being trained. 'We have to rethink how we teach diagnostics,' says Dr. Alvi. 'Most young doctors learn treatment protocols, but they don't fully understand the diagnostic process. They rely on outdated methods or overprescribe tests without knowing what's really needed. That's dangerous.' He believes training must go beyond textbooks. 'If junior doctors and final-year MBBS students don't understand what each test actually indicates, how samples should be collected, or what factors can affect the result, we're creating a cycle of guesswork, not precision medicine.' Dr. Naila agrees, but pushes for structural training reforms during house jobs. 'While doing their house job or rotations, they should be given specific training in the clinical pathology laboratories,' she says. 'They need to know exactly what is the prerequisite for certain samples, how they have to be sent, how much amount of blood should be collected, in which bottle. If they don't know it, how can they expect that the technicians or nurses know how to do it?' Beyond education, both doctors strongly emphasise the need for national-level reform, not just policy documents, but real enforcement on the ground. Dr. Alvi believes this requires coordinated public-private collaboration. 'We don't need another policy report,' he says. 'We need implementation. We need audits. We need better licensing, mandatory quality assurance standards, and incentives for local manufacturing. And we need these reforms to be owned by all stakeholders, industry, government, medical associations, and hospitals.' Dr. Naila's call is more prescriptive. 'There should be quality control evaluation analysis, there should be standard deviation curve analysis, everything should be jotted down. And there should be teams monitoring it, going lab to lab, assessing whether they are delivering or not.' She believes technology can help. 'Everything is on automation now, and everything can be retrieved through the software,' she says. 'So there's no excuse left. These are the things which we can definitely ensure, and definitely our accuracy and specificity would improve.' But systemic change is slow. For now, both experts agree that patient outcomes are compromised daily by a system that fails to recognise the full weight of diagnostics in healthcare. 'There's no point in building cardiac centers or liver institutes,' says Dr. Alvi, 'if we cannot diagnose the disease in the first place.' We live in a country where treatment often begins too late and ends too soon, the quiet work of diagnostics rarely makes headlines. Yet it is this very first step, a timely test, an accurate report, a doctor's trust in a result, that determines whether a patient lives with clarity or confusion. Experts like Dr. Alvi and Dr. Naila remind us that until diagnostics are treated not as a side note but as the backbone of healthcare, even the most well-intentioned reforms will fall short. And as long as labs continue to function without oversight, training remains patchy, and affordability remains elusive, the answers we seek will stay just out of reach, buried not in complexity, but in our failure to simply look closely enough, early enough.
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