"I am thankful to WHO for providing me with a platform from which I can utilize my abilities to work for the welfare of my people.”Jalwa Ali works for the World Health Organization (WHO) in Pakistan, supporting the provision of services to people affected by tuberculosis (TB) at the Women & Children Hospital Rajjar Charsadda in Khyber Pakhtunkhwa Province.  Jalwa works on the frontlines visiting patients, raising awareness, gaining the trust of female patients and communities, addressing misconceptions and reducing the stigma associated with the disease. TB affects over 686 000 people and causes 47 000 deaths annually in Pakistan. The country bears 73% of the TB burden in the Eastern Mediterranean Region and is the 5th most affected in the world.TB can have severe consequences for women, especially during their reproductive years and pregnancy. In partnership with WHO, the Provincial and District TB programme and the Reproductive, Maternal and Newborn (RMNCH) programme are working to implement TB screening for antenatal and postpartum women at the Women & Children Hospital Rajjar Charsadda. WHO also supports the use of GeneXpert testing of stool specimens from young children. The hospital serves a population of 1.6 million and provides outpatient services to over 9800 people each month, including pediatrics (4900), gynaecology (4137), pediatric neonatology (419) and general surgery (394). “I am thankful to the doctors and staff at the hospital who helped me in the diagnosis and treatment of TB,” said Fatima, an antenatal patient who visited the hospital with a 4-day cough. After receiving treatment, she delivered normally and is now fully recovered.  Pakistan has increased TB notifications and treatment coverage, reaching nearly 495 000 people in 2024 (70% of the affected population), compared with 331 800 people in 2015 (57% of the affected population). Over the last decade, in partnership with WHO, Pakistan has provided diagnosis and treatment services to 3.7 million people affected by TB.Despite progress, diagnosing TB in children and pregnant women remains a challenge due to factors such as a lack of information, stigma and hesitation among affected populations. Jalwa works hard informing women about the importance of being tested for TB, a disease that is curable and preventable. Being from the same area as her patients is her biggest asset. Women feel comfortable sharing their health concerns with her. For Jalwa, fighting tuberculosis forms part of her personal commitment to serve her community.“I am passionate about making a difference in the lives of vulnerable populations, and am particularly interested in fighting tuberculosis because of its impact on marginalized communities. I realized that there is a dearth of awareness about tuberculosis among local communities, leading to misconceptions. Ending tuberculosis is now my life’s mission.”  , filtered_html

As one of the largest and longest-serving contributors to UN peacekeeping, Pakistan has recently taken an important step to enhance its contributions to peacekeeping globally.   Pakistan has integrated the United Nations Field Medical Assistants Course (FMAC) into its pre-deployment training for its uniformed peacekeepers. This initiative aims to improve the safety and effectiveness of Pakistani peacekeepers serving in UN missions worldwide.The UN FMAC, launched by the Department of Operational Support in 2023 after a series of  successful pilots, forms part of the United Nations Triangular Partnership Programme’s (TPP) broader efforts to ensure peacekeepers can provide immediate care when needed most.The course equips participants with life-saving skills to stabilise casualties until more advanced medical care is available. This training is crucial in the challenging, and often hostile, environments where peacekeepers operate.A key component of FMAC is the Training of Trainers (ToT), which enables medical personnel from Troop-Contributing Countries to train their own troops for peacekeeping deployments. This approach ensures sustainable knowledge transfer and capacity building in participating countries.Brigadier General Dr Muhammad Muttahhar Asim Niaz, a seasoned Pakistani surgeon, played a central role in bringing this training to Pakistan. After attending the FMAC ToT in July 2023, Brigadier Asim saw an opportunity to elevate Pakistan’s medical training for peacekeepers.  “No soldier should die from an injury when prompt treatment can prevent death”, the Brigadier General Doctor emphasized. Building on the UN’s 7-day FMAC, Pakistan developed its Combat Medics Course (CMC), a 14-day programme that incorporates FMAC elements while adding modules tailored to the unique needs of missions that Pakistani peacekeepers deploy to. This includes modules on Environmental Hazards, Snake, Scorpion and Animal Bites, Poisoning, Management of Specific Injuries, and Blood Pressure Monitoring.To increase accessibility, the curriculum has been translated into Urdu, complementing the UN’s existing translations in English, French, Spanish, and Portuguese.Throughout his time in the Pakistan Army, Brigadier Asim has witnessed many preventable  deaths that can be avoided with prompt and appropriate treatment. This, he says, underscores the importance of preventative measures and immediate response skills to save lives.As of June 2024, Pakistan has successfully conducted three iterations of the CMC ToT. The integration of FMAC standards into Pakistan’s pre-deployment training marks a significant step in improving peacekeepers’ medical readiness. By investing in long-term capacities, Pakistan is contributing to more effective national and mission-level deployments while ensuring better protection for its peacekeepers. Brigadier Asim summarised the empowering nature of this training: "This is something for you, it's not for me. I'm going to tell you how to use [the medical kit but] the person who is going to use it is you yourself". The United Nations, through the TPP, will continue investing in the delivery of FMAC and FMAC ToT courses, with plans for further implementation in 2025. The success and longevity of programmes like FMAC depend on strong partnerships between the United Nations TPP and Member States. Through these collaborative efforts and continued investments in training, peacekeepers are better prepared to face challenges and save lives in their crucial work around the world. The UN TPP is a flagship peacekeeping training and operational support programme of the Department of Operational Support. Learn more about the UN TPP through this link., filtered_html

AS the New Year beckons, and the world begins to count down the final six years of the United Nations’ Agenda 2030, our shared vision of decisive progress towards sustainable development everywhere stands at a precipice. The ambitions of the Sustainable Development Goals (SDGs) — launched in 2015 to end poverty, protect the planet, and ensure prosperity for all — are slipping out of reach.In recognition of this grave danger, UN Secretary General António Guterres has declared a “global emergency”, underscoring the urgent need for bold and transformative actions. The recently adopted UN Pact for the Future provides a renewed framework for re-energising Agenda 2030. Specifically, member states have reaffirmed their commitment to closing the SDG financing gap, through scaling up official development assistance, combating illicit financial flows, and mobilising domestic and private resources.Pakistan exemplifies the struggle of low- and middle-income countries trapped in a web of debt, climate vulnerability, and under-investment in human development. Ranked 137th out of 166 nations in the UN Sustainable Development Report 2024, Pakistan’s SDG performance is off track. While modest improvements are noted in some areas, eight out of the 17 SDGs show stagnation, and three are regressing.Gains that are made in human development terms are literally washed away by the effects of climate change on a regular basis.An estimated 40 per cent of Pakistan’s population — approximately 97 million people — lives in poverty, with women disproportionately bearing the impact. Twenty-six million children do not go to school and half of the women population cannot read or write. Forty per cent of children under five are stunted.These figures represent the enormous challenges Pakistan has to overcome to achieve sustainable development and improve the living standards of its people. While Pakistan has made progress in 2024 towards macroeconomic stabilisation, with inflation dropping to a six-year low, the financing gap for achieving the SDGs in the country remains staggering: a conservative projection puts it at around $60 billion annually, which is 16pc of GDP. The price tag of turning such indicators of deprivation around, and meeting the SDGs, dwarfs the country’s revenue base.Without alternative sources of finance, we fear Agenda 2030 will not be accomplished.As of September 2024, Pakistan’s total debt and liabilities stood at an estimated $308.2bn, representing 81.2pc of GDP. Of this, total external debt and liabilities amounted to $133.4bn. Debt servicing costs the government over half of its annual budget, leaving little room for investments in development priorities. Every dollar allocated to debt repayment is a dollar denied to building schools, improving healthcare, or mitigating the impacts of climate change. These issues are critical not only to human development in Pakistan, but also to the country’s future economic growth and prosperity.Pakistan’s challenges are compounded by the global climate crisis it did not create. Gains that are made in human development terms are literally washed away by the effects of climate change on a regular basis. Contributing less than 1pc to global emissions, Pakistan is among the top 10 nations that are most vulnerable to climate change. The devastating floods of 2022, which submerged more than 10pc of the country, served as a stark reminder of how the Global South bears the brunt of a crisis driven by the industrialised world. Pakistan is obliged to take on more debt to recover from, and attempt to build resilience to, disasters caused by consumption patterns far away, perpetuating a cycle of dependency and vulnerability.In the face of its SDG financing gap, it is time to consider bold options.A six-year standstill on the Pakistan government’s external debt repayments would be one pragmatic and morally compelling solution. It would free up an estimated $108bn, providing the fiscal breathing room needed to invest in re-energising Agenda 2030 in Pakistan. With these resources, Pakistan could widen social safety nets, lifting an estimated 10m out of extreme poverty;reduce maternal and infant mortality; improve schoolenrolment rates; andinvest in climate resilience to protect millions from future shocks.Critics will argue that implementing a debt standstill is fraught with challenges. Multilateral creditors may resist, citing preferred creditor status. Bilateral lenders may be reluctant to create a precedent. Private creditors may fear losses on bonds.These concerns are valid, but not insurmountable. Indeed, the world came together during the Covid-19 crisis to implement not dissimilar debt standstills. Let us recognise that the remaining six-year window to deliver Agenda 2030 represents a crossroads that is equally perilous. And, of course, any debt standstill arrangement would require a robust governance framework be put in place to ensure that funds freed are transparently allocated to SDG priorities, with clear accountability mechanisms to ensure proper use.Short of a full standstill, a break on interest payments can also be considered. Other countries have also experimented with “debt for development swap” arrangements.The UN’s Pact for the Future provides a unique opportunity to align global priorities with the needs of vulnerable nations. Its call to mobilise resources comprehensively to galvanise progress towards achieving Agenda 2030 in this last six years must be heeded.Let Pakistan breathe. Let it invest in its people and its future. And let this moment mark the beginning of a new era of global solidarity, where no nation is left behind in the quest for sustainable development. We are on the final stretch for the SDGs. It is time to be bold.Mohamed Yahya is the United Nations resident and humanitarian coordinator in Pakistan.Bilal Azhar Kayani is a member of the National Assembly and the convener of the National Parliamentary Taskforce on SDGs.Published in Dawn, December 21st, 2024, filtered_html

As the sun rises over the desert of Tharparkar, the small village of Chehlar begins to wake up under a blistering sky. Despite the harsh heat, the people of Chehlar continue their daily routines. Parveen, 39, a mother of two, has already prepared a simple breakfast for her family and sent her daughters to school, which is miles away. Now, she gathers her materials, pamphlets, and tools for her session at the local health house.Today, in her role as a lady health worker, Parveen will meet with a group of women who have walked, some for over an hour along with their children, to address a diarrhea outbreak in the village. Poor sanitation and lack of clean water have made many sick, and there is a risk of acute malnutrition if the situation persists. Sitting in a circle in the stifling heat, the women listen attentively to Parveen.“It is important to wash hands frequently,” she advises. “If you don’t have access to clean water, boil it before drinking, and eat soft foods such as potatoes, boiled rice, and lentils to boost your immune system.” During the session, Parveen records the names of those needing further examination and prepares to refer them to the nearby health center for nutrition assistance. She then checks the children for malnutrition, using a simple tape measure around their upper arms. Today, an eight-month-old boy shows signs of severe undernourishment. His mother watches anxiously as Parveen gently reassures her, offering guidance on nutrition and registering the child for additional care.This is just one part of Parveen’s work. For 24 years, she has walked from home to home, teaching mothers how to prepare nutritious meals and reminding them about vaccinations.“At first, people didn’t trust me,” Parveen says. “But over time, they saw that I was here to help. Now they respect me, and they listen.”Lady health workers like Parveen are lifelines in their communities, bridging the gap between households and healthcare systems. They teach families essential health practices, guiding mothers on hygiene, and nutrition and preparing meals that improve family diets. Parveen’s expertise developed under the Community Management of Acute Malnutrition (CMAM) Surge programme, equips her to assess malnutrition, monitor pregnant women, and coach new mothers.The CMAM Surge approach, launched in Umerkot in 2021 and now expanded to Tharparkar, strengthens health systems in regions with high malnutrition rates. Funded by the European Union and implemented by WFP and Concern Worldwide, the programme provides tools and training to health workers like Parveen, who help detect malnutrition and link communities to critical care. This model, embedded across 12 health centers, enables responsive, effective care during seasonal surges of malnutrition caused by poverty, limited clean water, and high vulnerability to infections and drought. Since Pakistan’s Lady Health Worker (LHW) was launched in 1994, it has empowered community health champions in underserved areas, setting a global standard for grassroots health. LHWs like Parveen are crucial in spotting malnutrition early and establishing reliable referral networks to ensure families get timely help, especially during crises. In the past year, Parveen has referred 180 malnutrition cases to the Basic Health Unit in Chehlar, providing each with dedicated follow-up.Prepared for any emergency, from floods to disease outbreaks, Parveen carries her essential health kit — fetoscope, measuring tape, weight scale — delivering accurate, prompt care wherever needed.“This new way of doing things has really improved the system,” Parveen says.She glances at the women still gathered around her, their faces reflecting the heat but also hope. “Now, when we send someone to the health facility, they know who to go to, and they get the right care. The link between us and the hospital is much stronger.”— — Anam Abbas , filtered_html