Under IMF Oversight
Under IMF Oversight: Many people complain about weak health governance and corruption. I tell them this is only a small part of a bigger problem. Fixing health governance alone cannot solve the issue. One cannot build good governance in health when the rest of the system is corrupt. The IMF’s report, Pakistan: Governance and Corruption Diagnostic Assessment, shows how serious the problem is.
GDP Impact
The report gives shocking numbers on corruption. It also highlights the lack of meaningful reforms. All four IMF programs in the past ten years have warned about this.
The IMF says Pakistan loses 5 to 6.5 percent of GDP to corruption. Weak governance causes this loss. If the government had implemented reforms, Pakistan’s GDP could have grown by the same amount.
Corruption vs Health
Pakistan’s GDP is around $400 billion. Five to 6.5 percent equals $20 to $26 billion, or Rs5,600 to Rs7,280 billion. Pakistan spends only $11 billion (Rs2,000 billion) on health. Corruption alone is 2.5 times larger than the health budget. If the government stopped corruption and used that money on health, health spending could increase almost five times.
Corruption Scale
Five to 6.5 percent of GDP also equals 30 percent of the annual budget, 65 percent of exports, and 60 percent of remittances. The IMF looked only at the federal level. Corruption at the provincial level would make the numbers even higher. Weak institutions, poor checks on bureaucracy, political patronage, and a vulnerable judiciary reduce public trust and scare investors.
Because of corruption, citizens often pay officials to get services. Elites shape policies to enrich themselves at society’s expense. Politics allows them to capture the economy.
IMF Recommendations
The IMF makes 15 recommendations. Some address private sector problems: improve public procurement, make SECP rules transparent, digitize regulations, and resolve economic disputes faster. Others address public sector weaknesses: simplify taxes, strengthen FBR, improve budgeting, and create action plans for vulnerable agencies. The report also calls for accountability: make the auditor general independent, investigate money laundering, publish asset declarations of top officials, and appoint leaders to key oversight bodies based on merit.
Health Sector Corruption
These problems affect the health sector. Governance and corruption affect all sectors. No sector can improve alone. Public procurement in health shows this clearly. Hospitals and professionals often get commissions from suppliers. Private sector practices remain mostly unregulated.
Coordination Gaps
Health governance suffers from unclear federal and provincial roles. Coordination on national health issues is weak. Transparency and accountability remain poor. Civil servants with limited knowledge make major technical decisions. The health and population sectors rarely coordinate, and merging them has been politically stalled.
Citizen Awareness
Citizens, including health professionals, must understand the bigger political system. They must recognize corruption and take action. Without addressing the larger system, health improvements will remain limited. Society and citizen groups should read the IMF report and connect it to their own experiences before it is forgotten.
Published in Dawn,12th December 2025
