By Hasan Salahuddin

 As Pakistan struggles with a rising burden of non-communicable diseases and mounting pressure on its overstretched healthcare system, health experts say China’s rapidly evolving community healthcare model offers a practical roadmap for reform.

They believe Pakistan can draw important lessons from China’s push to strengthen grassroots healthcare, improve medicine supply systems and integrate artificial intelligence into primary care services to reduce preventable deaths, ease pressure on major hospitals and improve healthcare access in underserved communities.

China’s National Health Commission (NHC) has launched a major initiative to strengthen its tiered diagnosis and treatment system, aimed at ensuring that common and chronic illnesses are managed at local clinics while more complex cases are referred to higher-level hospitals.

According to the NHC, more than 1.1 million medical and healthcare facilities now serve urban and rural communities across China, with over 90 percent of residents able to access the nearest health centre within 15 minutes.

A central feature of these reforms is the development of specialised chronic disease departments at the grassroots level, alongside improvements in medicine coordination and the introduction of AI-assisted diagnostics and pre-prescription review systems in primary healthcare settings.

Pakistan, by contrast, continues to struggle with an overstretched healthcare system despite its sizeable network of facilities.

The Pakistan Economic Survey 2024-25 reports that the country has 1,696 hospitals and 5,434 Basic Health Units nationwide, while public health expenditure stood at Rs924.9 billion, equivalent to just 0.9 percent of GDP in FY2024.

At the same time, Pakistan is facing a rapidly rising disease burden. WHO-linked research published in the Eastern Mediterranean Health Journal estimates that non-communicable diseases account for nearly 58 percent of all deaths in the country, making stronger community-level healthcare essential for prevention, cost containment and easing pressure on hospitals.

Speaking with Wealth Pakistan, Hassam Khan Durrani, Country Director at Health Systems Insight, described chronic illnesses such as hypertension, diabetes and respiratory diseases as a rapidly escalating public health crisis in Pakistan.

“Chronic diseases such as hypertension, diabetes, chronic respiratory illnesses, etc., constitute a rapidly escalating public health crisis in Pakistan, currently accounting for approximately 58-60 percent of all annual deaths,” he said.

Durrani argued that Pakistan could significantly reduce premature deaths by following China’s example and shifting its focus from curative treatment to preventive and community-level healthcare.

He said strengthening primary healthcare could help prevent more than 600,000 premature deaths annually.

According to him, more than half of Pakistan’s NCD-related deaths are linked to modifiable lifestyle and dietary habits, making preventive strategies critical for both public health and economic sustainability.

Discussing the role of artificial intelligence, Durrani said AI still requires careful technical and ethical oversight before independent deployment in healthcare systems, but it already has immense potential to support frontline healthcare workers.

He noted that recent research suggests the biggest healthcare challenge in many low- and middle-income countries, including Pakistan, is no longer merely access to healthcare but the quality of care being delivered.

In this context, he said AI-assisted systems can help improve diagnostic accuracy, enable timely interventions and support frontline workers operating in resource-constrained environments.

Durrani added that AI deployment is likely to emerge first in support functions such as medical supply chains, where demand forecasting, inventory management and logistics technologies are already relatively advanced.

Dr Muhammad Ayaz Khan, Consultant at the National Institute of Health (NIH), Islamabad, offered a complementary perspective grounded in the operational realities of Pakistan’s healthcare system.

“Reliable medicine supply systems and the responsible integration of technology are increasingly becoming central pillars of effective primary healthcare,” he said.

Dr Ayaz identified the inconsistent availability of essential medicines at frontline healthcare facilities as one of the most persistent weaknesses in Pakistan’s primary healthcare system.

He said frequent stockouts, weak forecasting mechanisms, fragmented procurement systems and supply chain disruptions continue to undermine healthcare delivery and erode patient trust.

To address these issues, Dr Ayaz called for digitising inventory monitoring across Basic Health Units and Rural Health Centres, improving coordination between provincial warehouses and frontline facilities, and strengthening cold-chain and emergency logistics systems.

On AI-assisted diagnostics, he acknowledged their potential to improve early disease detection and clinical decision-making in underserved areas, but stressed that technology should complement healthcare workers rather than replace them.

“Technology must strengthen healthcare workers, not replace them,” he emphasised.

Dr Ayaz also highlighted the need for strong regulatory oversight, healthcare worker training, patient data protection and the validation of AI tools against local disease patterns before their large-scale adoption.

Referring to the WHO Emergency, Critical and Operative Primary Healthcare framework, he underscored the importance of integrating digital health technologies into existing healthcare systems instead of creating fragmented parallel structures.

“For Pakistan, the future of primary healthcare will depend on the country’s ability to combine resilient medicine supply systems with people-centred technological innovation,” he said.

Credit: INP-WealthPk