Pakistan has come under scrutiny after a new audit report revealed significant lapses in the management of international health funding, with more than Rs. 122 billion in Global Fund assistance reportedly lost, missed, or left underutilized due to weak oversight and administrative inefficiencies.
The findings were highlighted by the Auditor General of Pakistan, which reviewed the utilization of foreign assistance provided for major public health programs across the country. The report raises serious concerns about governance and financial management within key health institutions responsible for handling donor-funded initiatives.
According to the audit, the Ministry of National Health Services managed Global Fund assistance totaling approximately Rs. 156.5 billion between 2015 and 2023. The funds were allocated for critical disease control programs targeting HIV, tuberculosis, and malaria.
However, a large portion of the funding was not effectively utilized. The report states that over Rs. 122 billion was either lost, missed, or remained underutilized due to weak monitoring systems, delays in execution, and institutional inefficiencies. In addition, around Rs. 34.5 billion was found to be tied up in stalled procurement processes, delayed infrastructure development, and other operational bottlenecks.
The audit further identified multiple financial irregularities and missed opportunities for additional funding. One of the key issues was the failure to secure an additional $22.9 million in Catalytic Funds due to the non-submission of an Integrated Funding Request by the relevant authorities.
It also highlighted discrepancies amounting to $11.476 million related to in-kind disbursements. Another $2.442 million was reportedly lost due to prohibited practices by a private principal recipient involved in fund handling. In a separate case, $2.197 million worth of donor-funded medicines expired before they could be utilized, reflecting weaknesses in supply chain management and forecasting.
The report underscores systemic challenges in Pakistan’s public sector health financing, particularly in the handling of large-scale donor assistance. Experts suggest that gaps in accountability, procurement delays, and poor coordination between implementing agencies continue to undermine the impact of international aid programs.
The findings are expected to raise concerns among international donors who contribute to Pakistan’s health sector, especially in programs aimed at controlling infectious diseases. Strengthening governance mechanisms and improving transparency will be essential to ensure that future funding is effectively utilized.
The audit serves as a critical reminder of the importance of efficient financial management in the health sector, where delays and inefficiencies can directly impact public health outcomes and the success of life-saving programs across the country.
