Mounting public health challenges blamed on Karachi’s ill-planned growth

Mounting public health challenges blamed on Karachi’s ill-planned growth

KARACHI: Expressing concerns over Karachi’s administrative fragmentation and unplanned expansion, speakers at a discussion on Friday warned that these problems were hindering climate adaptation and leading to worsening health outcomes. The session, titled ‘Climate Change, Urban Issues and Health Management,’ was part of the 8th Biennial Conference (ICON 2026) currently in progress at the Indus Hospital & Health Network (IHHN). The discussion was moderated by senior pulmonologist at IHHN Dr Sohail Akhtar. Speaking on the occasion, leading environmental specialists, medical academics, government officials and media experts called for urgent steps to tackle Karachi’s growing civic challenges, including environmental pollution, chronic water shortages and rapidly growing population. Experts point to urban planning failures, say climate and health challenges require evidence-based solutions They regretted that there had been no concrete progress on the Sindh Health Policy, demanding a comprehensive and uniform health policy for the whole of Sindh. Environment, Climate Change and Coastal Development Secretary Faisal Ahmed Uqaili stated that administrative fragmentation and unplanned expansion were hindering climate adaptation in Karachi. The city’s infrastructure, he pointed out, is mostly unplanned as hundreds of housing schemes have emerged without proper civil utilities. Explaining administrative institutional gaps, he said: “The city is currently run by 26 different administrative agencies, creating excessive disconnects. Until all stakeholders are on the same page, change cannot be expected,” he said, stressing that climate and health challenges required a think tank comprising government, academia and civil society to review data and build evidence-based solutions. In his remarks, Dr Zafar Zaidi, Dean, Indus University of Health Sciences, warned that Karachi’s failure to design urban environments was directly leading to worsening health outcomes, including surges in vector-borne diseases like malaria, cardiovascular complications, and severe sewage contamination. “We have failed in terms of planning, but we must start now by identifying clear accountabilities and responsibilities,” Dr Zaidi said. “Every intervention must be researched with a long-term vision — asking what will benefit the next two generations.” Addressing policy lags, Dr Zafar Fatmi, Professor & Section Head, Environmental, Occupational Health and Injuries, Aga Khan University, shared that Sindh’s health policy was only recently updated after remaining stagnant since 2010. “Academia’s primary output is publication, but policy impact requires academia and government to jointly frame problem statements,” he explained, emphasising the need to bridge the multi-sectoral policy gaps within state institutions. Climate medicine expert Dr Paul Charlton pointed to international frameworks such as the Lancet Countdown toolkit, which equips healthcare professionals to collaborate with policymakers in high-density, climate-vulnerable cities like those in Pakistan. “There are proven, evidence-based solutions globally,” Dr Charlton emphasised. “Healthcare professionals need to analyse health costs, receive formal training to communicate with media and government leadership and actively showcase Pakistan’s climate-health data on global platforms.” Highlighting positive shifts in governance, senior journalist-cum-environment activist Afia Salam said that government departments were beginning to collaborate, as seen in recent pre-monsoon cross-departmental exercises. However, she urged policymakers to pay urgent attention to practical climate impacts on vulnerable groups — such as schoolchildren exposed to heatwaves during peak afternoon hours and lady health workers whose field functionality was severely compromised by extreme heat. She also noted that mainstream media faced institutional barriers when state entities withheld critical data. To counter this, Dr Fatmi advocated for specialised health communication workshops for journalists while Dr Zaidi emphasised translating complex climate findings into local, accessible languages and empowering youth to drive climate awareness. The speakers agreed that a climate-resilient city was ultimately a healthy city, while calling for immediate cross-sectoral accountability, evidence-based policymaking, a centralised co-created think-tank, and active media engagement to tackle the severe breakdown in urban planning across Pakistan. Published in Dawn, October 10th, 2026