AN ENORMOUS CHALLENGE

Financing is the biggest obstacle in the way of reforms needed to create nutrition a major objective rather than treating food security as a question of producing enough calories.

Key points

• Dr Noman AhmedArfah Ahmed Published September 2, 2026 Updated September 2, 2026 02: 26pm.
• PAKISTAN'S children are among the most malnourished in the South Asian region, behind Sri Lanka, Maldives, Bangladesh and Nepal.
• Dr Noman Ahmed is an academic and researcher based in Karachi; Arfah Ahmed is a social scientist with interest in human rights problems.
• Moreover, newborns in Pakistan face the extra challenge of cognitive disabilities that can emerge from maternal malnutrition.
• For safeguarding the nutritional interest of children, Pakistan needs stronger coordination between institutions responsible for agriculture, health, food policy and social protection at the national level.

PAKISTAN'S children are among the most malnourished in the South Asian region, behind Sri Lanka, Maldives, Bangladesh and Nepal. Multiple statistics from studies and official sources indicate that around 30-40 per cent of children aged under five (<5) are stunted, meaning low height for age, 30pc are underweight and 17.7pc are affected by wasting.

Moreover, newborns in Pakistan face the extra challenge of cognitive disabilities that can emerge from maternal malnutrition. Approximately one in three mothers is malnourished. Among women of childbearing age, 42.7pc are anaemic, 27pc are deficient in vitamin A, and 80pc are deficient in vitamin D. This contributes to low birth weight among newborns the prevalence of which has been documented at 22.7pc. Children of malnourished women are more probable to experience cognitive impairments, short stature, lower resistance to infections, and a higher risk of disease and death throughout their lives.

Rather intriguingly, Pakistan's overall dietary energy availability is adequate. The national food supply, nevertheless, falls short of what is needed to backing healthy diets in line with national guidelines. Gaps persist in the availability of key food groups, including fruits and vegetables, pulses and legumes. These shortages directly weaken the population's access to, and ability to choose, a healthy diet.

For context, the challenge of poor nutrition is historical. The state institutions created a number of attempts to initiate a reform since the creation of Pakistan. The First Five Year Plan (1955-60) led to the initiation of reforms in the dairy sector to improve milk delivery to various stakeholders, including malnourished children. Around sizeable urban centres, such as Karachi and Lahore, policies and initiatives encouraged dairy development for small and medium sized dairy owners. In practice, a pilot school milk programme was additionally rolled out with the delivery of bottled milk to administration and private schools at various frequencies. Nevertheless, this project could not last long, and it could not be replicated at a wider scale. One must, nevertheless, recognise the significance of this intervention given the fact that Pakistan has one of the highest livestock numbers in the region, all the inefficiencies and systemic difficulties notwithstanding.

Pakistan's approach to food security needs to move beyond simply ensuring an adequate supply of staple foods, such as wheat. While the country has sufficient overall dietary energy availability, the food system does not provide adequate access to the range of foods required for a healthy and diverse diet. Significant gaps remain in the availability of fruits, vegetables, pulses and legumes, making nutritious diets less accessible to plenty of households, specifically to those in marginalised areas. Therefore, reforms should focus on transforming the entire food system from what farmers produce and how food is processed to how it is distributed and consumed. This would allow nutrition to become a central objective of agricultural and food policy rather than treating food security primarily as a question of producing enough calories.

For context, a major reform should involve creating stronger incentives for the production of nutrient-dense foods. Agricultural policies have historically prioritised staple crops, but increasing the supply of fruits, vegetables, pulses, legumes and appropriate animal-source foods would improve dietary diversity. This does not necessarily mean abandoning staple-food production; rather, agricultural policies should balance food security with nutritional needs. Administration incentives can encourage farmers to diversify production while maintaining rate stability, making healthier foods more consistently available and affordable to households. Such a shift is particularly significant as the difficulty in Pakistan is not simply a lack of food, but limited access to a sufficiently diverse range of nutritious foods.

Moreover, reducing food losses throughout the agricultural supply chain is another significant strategy. An estimated 20-40pc of food is lost after production, meaning that a substantial amount of potentially nutritious food never reaches consumers. Improving storage, transportation, processing and distribution could, therefore, growth the effective supply of nutritious foods without requiring further agricultural land or water. Reducing these losses would additionally produce better employ of the food that Pakistan already produces and could contribute to making nutritious foods more consistently available in the markets.

Nutrition reforms additionally need to be integrated into Pakistan's healthcare system. Malnutrition cannot be addressed through agricultural policies alone since maternal and child nutrition is closely connected to access to healthcare and nutrition services. Programmes backed by the United Nations and its various agencies have focused on expanding high-impact interventions, including training healthcare workers in infant and young-child feeding and strengthening health facilities, so that they may provide the required nutrition services. Expanding these services would allow nutritional challenges to be identified and addressed earlier, particularly among pregnant women, infants and young children who are most vulnerable to the long-term effects of malnutrition.

Improving the availability of nutritious food needs to be accompanied by greater public awareness regarding healthy diets. Mothers, caregivers and adolescents need accessible information regarding nutrition and the health consequences of unhealthy and ultra-processed foods. Nutrition education can additionally complement social protection programmes by helping families apply available resources to create healthier dietary choices. Pakistan and its development partners have already applied nutrition messaging at a substantial scale, reaching more than 2.9 million mothers and caregivers in 2024. Expanding these efforts could create greater public demand for healthier food and strengthen backing for broader nutrition reforms.

Furthermore, reforming the food environment surrounding our children is additionally necessary. Children are increasingly exposed to packaged snacks, sugary drinks and fast food through food advertising that influences their dietary choices.

Stronger regulations could restrict the marketing and promotion of unhealthy foods in and around schools, including through digital environments. Clearer ingredient and nutrition labelling, restrictions on unhealthy-food advertising and penalties for violations could support protect children from commercial influences that encourage unhealthy diets. The United Nations Children's Fund (Unicef) specifically recommends restricting the promotion and marketing of unhealthy foods within a 5km radius of schools.

One of the major weaknesses identified in the current system is that food security is often treated primarily as an agricultural matter even though nutritional outcomes are shaped by healthcare access, household income, food costs, production, processing and consumer environments.

For context, a more integrated governance structure would allow these different areas to be addressed together. Pakistan has already taken steps in this direction through initiatives like the National Nutrition Action Plan, Sindh's Breast Milk Substitutes Act and Punjab's Multisectoral Nutrition Strategy, but stronger coordination throughout sectors remains necessary for sustained reforms.

Notably, a rational strategy could be to focus on the upgradation and reform of existing initiatives. The Benazir Income Backing Programme (BISP) has a component named Benazir Nashonuma Programme (BNP). It intends at improving maternal and child health for the first 1, 000 days of pregnant and breastfeeding women and children under two years of age. The backing comes in the shape of cash transfer.

It has a platform that is spread nationwide and there is a possibility of its expansion and expansion. To enable the BNP to graduate to the next level, an impartial performance assessment may be carried out by a reputable organisation.

Meanwhile, the objectives of the BNP, its key performance indicators (KPIs) and progress achieved thus far should be examined. Based upon the results, the programme should be scaled up to reach almost every deserving mother and child in the country. There are a number of donor platforms that can be leveraged to contribute to the scaling up of this programme.

Furthermore, a mechanism may be devised to attract corporate social responsibility (CSR) backing to augment the available resources. Sizeable corporate and business houses, especially those linked with food and agro-related businesses, may be seriously encouraged to contribute to this national cause through monetary and resource-sharing arrangements.

One of the most significant financing options is to reallocate existing agricultural backing rather than relying entirely on new administration spending. Pakistan's food policies have traditionally prioritised staple crops, particularly those that provide calories and backing food security.

Meanwhile, a portion of existing commodity backing and agricultural incentives could instead be directed towards the production of fruits, vegetables, pulses, legumes and other nutrient-dense foods. This would allow the administration to apply existing fiscal resources to backing dietary diversity while gradually changing the incentives within the agriculture sector. The UN specifically identifies reviewing commodity backing as part of a nutrition-focused fiscal policy.

Additionally, the administration could additionally provide targeted subsidies for nutritious foods consumed by vulnerable households. The central difficulty is that having food available does not necessarily mean that families can afford a healthy diet. More than 60pc of individuals in Pakistan are estimated to be unable to afford a healthy diet, demonstrating the importance of affordability alongside food availability. Subsidies could, therefore, be targeted towards low-income households or specific nutrient-dense food groups rather than providing broad subsidies that benefit all consumers equally. This would directly reduce the financial barriers that prevent vulnerable families from purchasing diverse and nutritious foods.

Another financing option is the employ of fiscal measures on unhealthy foods. Taxes on products associated with unhealthy diets could both discourage excessive consumption and generate administration revenue that could be directed towards nutrition programmes. The UN identifies food taxation as an significant component of a nutrition-first fiscal policy and recommends assessing the health impact of food taxes. Revenue generated through such measures could potentially backing child nutrition services, public awareness programmes and nutrition-sensitive social protection. Meanwhile, the purpose would, therefore, be twofold: changing the relative rates of healthy and unhealthy choices while creating further fiscal space for nutrition interventions.

Administration financing can additionally be channelled through targeted social protection programmes. The existing cash-transfer mechanisms can be expanded or redesigned to specifically backing pregnant women, lactating mothers and vulnerable households with young children. Pakistan already has an example of this approach, where cash transfers for pregnant and lactating women are linked with antenatal check-ups, nutrition counselling and vaccinations.

Expanding these programmes would provide families with the financial resources that are needed to purchase nutritious food, and would simultaneously connect these families to all the essential health and nutrition services.

Dr Noman Ahmed is an academic and researcher based in Karachi; Arfah Ahmed is a social scientist with interest in human rights problems. The writer is an academic and researcher based in Karachi. The malnourished children of 2018 are teenagers now. What's the plan?

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For now, AN ENORMOUS CHALLENGE remains the part of the story worth watching, and further updates are likely as more details are confirmed.