As monsoon rains affect parts of Pakistan and contribute to a rising death toll, experts are calling for long-term health preparedness measures to reduce future risk.

With at least 303 deaths reported, humanitarian agencies highlight the need to strengthen existing health infrastructure and improve protections against waterborne diseases.

The World Health Organization (WHO) has already provided hundreds of thousands of life-saving medical supplies in anticipation of monsoon-related health emergencies. 

The move comes as Pakistan’s Monsoon Contingency Plan 2025 – a critical blueprint for effective humanitarian response – prioritises 1.3 million citizens across nearly three dozen high-risk districts. 

According to Amnesty International, increasingly intense floods are contributing to higher mortality, particularly among children and the elderly. Health officials note that extreme weather events place additional strain on existing systems, reinforcing the need to prioritise protections against waterborne diseases.

With heavy flooding projected to become more frequent in Pakistan, the National Disaster Management Authority (NDMA), together with local and international partners, is working to enhance preemptive health logistics to manage potential disease outbreaks.

The priority highlighted by experts for Pakistan is to advance a forward-looking health protection strategy that addresses the monsoon’s risks, both in terms of infrastructure and human life.

Climate experts suggest that, beyond contingency support, targeted investments in district-level disease surveillance, rural health infrastructure, and glacier monitoring are essential to help Pakistan strengthen its defences against future crises.  

Preemptive health logistics

Pakistan’s current approach to disaster resilience during the monsoon season is a marked departure from the past.

The 2022 floods and the subsequent recovery process revealed challenges in disaster response capacity and coordination.

That year, an early warning system was introduced in the southern province of Sindh, providing real-time flood alerts to support rapid responses during flash flooding.

Although it marked progress, experts note that the system could be enhanced through stronger disaster management capacities and better coordination at the district level.

The 2025 Monsoon Contingency Plan incorporates these elements, representing a shift toward more proactive flood management.

The rising death toll this season reinforces calls from experts to improve forecasting systems for better accuracy and accessibility.

This includes delivering swift threat assessments directly to the public, particularly in urban centres prone to flash flooding. 

Where international support remains especially vital is in addressing the rapid melting of glaciers, estimated at around 7,200, in the northern region of Gilgit-Baltistan.

“Glacial melt and intense monsoon rains not only lead to damages and loss of life, but also inundation – serving as a hub for several water and vector-borne diseases,” explains Sumayya Ijaz, co-lead of the Climate, Development and Policy team at Weather and Climate Services (WCS). 

“Research shows that disease outbreaks – including diarrhoea, skin and eye infections, leptospirosis, malaria, leishmaniasis, respiratory infections, hepatitis, and cholera – have occurred as a consequence of floods,” Ijaz adds.

Villages, roads, and extensive agricultural land have already been inundated this season, disrupting livelihoods and complicating access to healthcare. 

Resilience building

The NDMA and its partners are also monitoring the risk of river overflow in the coming months, which could increase the spread of waterborne diseases.

As Aisha Khan, Chief Executive of Pakistan’s Civil Society Coalition for Climate Change, tells TRT World, monsoons are part of a regular weather pattern whose impacts will worsen with rising temperatures. “The combination of heat and humidity will give rise to more outbreaks and perhaps add new diseases to the current list,” she warns.

While Pakistan’s federal cabinet endorsed an integrated National Adaptation Plan (NAP) in 2023, its implementation in high-risk flood districts is still in the early stages of implementation in some high-risk districts, with ongoing work needed to enhance emergency preparedness.

“This year’s monsoon was not historically extreme, but still resulted in over 300 deaths, showing how even moderate rainfall can now be deadly,” notes Fahad Saeed, senior climate scientist at Climate Analytics.

“Every tenth of a degree of global warming intensifies the monsoon further, underscoring the urgent need for resilience-building and a rapid global shift from fossil fuels to renewables.”

Integrating NAP’s early warning systems into ongoing coordination with WHO and local partners may be key to addressing climate-linked health risks, including in Khyber Pakhtunkhwa.

The data highlights the potential risk to approximately 1.8 million people in KPK from severe health issues if preventative interventions are not scaled. Preventive interventions remain central to an effective monsoon contingency response.

Interventions

A “whole-of-system” approach is essential for Pakistan to effectively combat  waterborne disease outbreaks.

Forecasts of continued flooding, coupled with existing challenges in rural housing infrastructure, demand smart disaster management interventions.

During the 2022 floods, health officials reported a significant rise in disease outbreaks, which they attributed to gaps in infrastructure and preparedness.

Recent developments point to progress. “The government plans to prevent waterborne disease outbreaks from reaching crisis levels by combining engineering controls to reduce flood risk, strong early warning systems to enable timely action, and robust health preparedness,” says Dr. Abid Suleri, executive director of the Sustainable Development Policy Institute (SDPI).

Analysts say leveraging the Pakistan Pandemic Fund — a joint initiative involving WHO, ADB, and FAO — could help strengthen early response capabilities.

Integrating the Fund’s technical expertise into health-related early warning systems could improve disease detection and enhance the Monsoon Contingency Plan’s effectiveness.

Ultimately, a whole-of-system approach that addresses waterborne disease prevention, river overflow management, and integrated surveillance could enhance community engagement with Pakistan’s Monsoon Contingency Plan.

Health officials warn that without sustained action, similar levels of casualties may persist in future monsoon seasons.

As Suleri observes, there is cause for cautious optimism: “Pakistan is moving towards a model where early warning (EW) triggers community-led, immediate action, with remote zones benefiting from both technological innovation and grassroots organisation.”