The Pandemic Fund

Background

Pakistan was awarded US$18.7 million from the Pandemic Fund to strengthen the country’s One Health coordination and ability to ward off public health threats. The project has catalyzed an additional US$4.1 million in co-financing and US$49.7 million in co-investment.

Pakistan faces a complex public health landscape. Its people know firsthand the repercussions of climate change – notably, the severe flooding of 2022, which triggered outbreaks of malaria and cholera. Pakistan is one of only two countries that never eradicated polio, and it has the fourth highest livestock population in the world. Livestock and their owners often live in close quarters, raising the possibility of zoonotic disease spread. An influx of people fleeing Afghanistan has increased the pressure on Pakistan’s public health system, as have the financial repercussions of COVID-19. With flagging quality, the public health system is used by less than twenty percent of the country’s people. Those who can afford private health care choose it, but more than a quarter of the country’s population lives below the poverty line and cannot do so. The large number of people without any health care leaves both individuals and the country at risk.

Pakistan’s project is a multisectoral collaboration, in the spirit of the Pandemic Fund. It is led by Pakistan’s Ministry of National Health Services, Regulations and Coordination and the National Institute of Health, alongside the Ministry of Climate Change and Environmental Coordination, the Ministry of Economic Affairs, the Ministry of Finance, the Ministry of National Food Security and Research, the National Disaster Management Authority, the National Health Emergency Preparedness and Response Network, and three implementing entities: the Asian Development Bank (ADB), the Food and Agriculture Organization of the United Nations (FAO), and the World Health Organization (WHO). Other partners include the Alkhidmat Foundation, the Centers for Disease Control, the FCDO, the Fleming Fund, JSI, the National Rural Support Program, the Pakistan One Health Alliance, the Rohi Foundation, the UK Health Security Agency (UKHSA), UNICEF, and the Word Bank. 
 

Project objectives

With the Pandemic Fund grant and the support of its partners, Pakistan seeks to strengthen human and animal health capabilities across the country and boost pandemic preparedness and response. 
 

Implementation arrangements and key components

The project embodies the One Health approach, the Pandemic Fund’s priorities – surveillance, laboratory systems, and workforce development – and the Fund’s underlying themes of community engagement and health equity. Activities comprising the project’s main components are detailed below. 

1. Strengthening One Health coordination. This work includes establishing National-Provincial One Health units and secretariats and adopting best practices with the guidance of implementing entities, given their presence in multiple countries, and other project partners.
2. Reinforcing human and animal health surveillance. Activities in this area include expanding the Integrated Disease Surveillance and Response function to all of the country’s 170 districts, incorporating wildlife and fisheries into the Animal Disease Reporting and Surveillance system, and establishing multisectoral provincial- and district-level teams to investigate and respond to outbreaks. This work also involves training health workers on risk assessment, characterization, and profiling, training wildlife staff; and developing national- and provincial-level Control Prevention Plans for zoonotic diseases.
3. Improving laboratory capacity. This component of the project aims to strengthen the laboratory network by setting up one Biosafety Level II laboratory per province, as well as introducing a Laboratory Information Management System, securing external quality assessments for each laboratory at both the provincial and federal levels, establishing a One Health Laboratories Technical Working Group, enhancing sample collection and transport capacities at the district level, and building the capacity of the laboratory workforce. It also focuses on upgrading the National Institute of Health laboratories (in the areas of virology, parasitology, and bacteriology), the National Veterinary Labs (responsible for coordinating veterinary services across the country) and the National Reference Laboratory for Poultry Diseases. This work requires remodeling, procuring equipment and consumables, training staff, and linking with international reference laboratories.
4. Training the multisectoral health workforce, with a focus on surge capacity. Activities in this area include training teams to investigate and respond to disease outbreaks and to conduct risk analysis and communication. It also includes establishing hybrid options for the Basic Field Epidemiology Training Program for Veterinarians and the Field Epidemiology and Training Program (FETP), as well as extending the FETP to wildlife professionals with a focus on wildlife, environment, biodiversity, and ecosystems. In addition, this area features simulation exercises designed to improve detection, management, and response skills and training for laboratory staff on biosafety, biosecurity, diagnostic testing, and quality management.
5. Engaging communities in early detection and response. This component of the project focuses on engaging communities via community focal points, civil society organizations, livestock farmer groups, and school-based programs. 

The ADB supports the Ministry of National Health Services, Regulations and Coordination and the Ministry of National Food Security and Research in their core duties. The FAO and WHO bring their expertise in animal and human health, respectively, and provide technical assistance. 
 

Expected outcomes

Through its Pandemic Fund project, Pakistan aims to:

1. Strengthen One Health coordination across the relevant ministries, provinces, partners, and stakeholders
2. Reinforce existing human and animal health surveillance systems, including for livestock, poultry, wildlife, and fisheries
3. Improve sample referral and transportation, as well as quality enforcement within the national laboratory system
4. Train the multisectoral health workforce, with a focus on surge capacity, and
5. Engage communities in early detection and response.