A nation that cannot protect its own newborns without external assistance has abdicated one of the most fundamental responsibilities of sovereignty
By Farooq Mustafa Chaudhry, Director, Macter International Ltd.
Pakistan stands at a critical crossroads in public health policy. With seven million births annually and a population growth rate of 2.55%, our nation faces an unprecedented challenge in vaccine security that demands immediate and decisive action. The looming withdrawal of GAVI support by 2031 presents not just a crisis, but an opportunity to transform Pakistan into a self-reliant pharmaceutical powerhouse.
Farooq Mustafa Chaudhry
The Stark Reality We Face
The numbers paint a sobering picture of our current vulnerability. Pakistan’s complete dependency on donated and discounted vaccine supplies, supported by GAVI, UNICEF, and WHO to the tune of PKR 26 billion annually, masks a deeper structural weakness. When GAVI’s support ends in 2031, the financial burden will balloon to PKR 100 billion annually as nearly four times our current federal health budget of PKR 27 billion.
This dependency is not merely financial; it represents a fundamental threat to national health security. This isn’t just underdevelopment—it’s a systematic surrender of national health autonomy. Today, Pakistan produces virtually no antigens for the Expanded Program on Immunization (EPI) vaccines domestically. We lack essential seed banks, have minimal university-based vaccine development programs, and operate with regulatory guidelines that are inadequate for sophisticated vaccine manufacturing. Our clinical trial expertise remains severely limited, creating bottlenecks in bringing locally developed vaccines to market.
The contrast with global pharmaceutical leaders is stark. While universities worldwide have been the birthplace of revolutionary vaccines-from the Hepatitis B vaccine developed at UC San Francisco to the Oxford-AstraZeneca COVID-19 vaccine-Pakistan’s academic institutions remain largely disconnected from commercial vaccine production.
Learning from Global Success Stories
International experience offers valuable lessons. India transformed itself into the “pharmacy of the world” through strategic government support for generic manufacturing and robust regulatory frameworks. Singapore built a biomedical hub through integrated research, manufacturing, and regulatory excellence that attracted billions in global pharmaceutical investment. South Korea’s government-industry partnerships created world-class biopharmaceutical capabilities.
These success stories share common elements: sustained government commitment, strategic investment in infrastructure, regulatory excellence, and comprehensive talent development programs. Most importantly, they demonstrate that with the right approach, developing nations can achieve pharmaceutical self-sufficiency and even become global exporters.
The Triple Helix Solution
The path forward requires unprecedented coordination between government, academia, and industry -what experts call the “Triple Helix” approach. Each sector must play a distinct yet interconnected role in building national vaccine capacity.
Government leadership is essential in creating policy frameworks that incentivize domestic production while providing funding for university research. Strategic assignments to national research institutions like the National Institute of Health, Centre of Excellence in Molecular Biology (CEMB), National Institute for Biotechnology and Genetic Engineering (NIBGE), International Centre for Chemical and Biological sciences (ICCBS), Karachi University, Department of Biotechnology, Dow University of Health Sciences (DUHS) etc. can accelerate vaccine development and establish crucial seed banks. Most critically, the government must develop a comprehensive national health security strategy that positions vaccine self-sufficiency as a matter of national defense.
The regulatory transformation cannot be understated. Pakistan’s Drug Regulatory Authority must achieve WHO Level 3 qualification and create “regulatory sandboxes -collaborative environments where university researchers, industry partners, and regulatory experts jointly develop guidelines for the 13 critical EPI vaccine antigens. Fast-track approval pathways and clear regulatory roadmaps will accelerate the journey from laboratory research to commercial production. Formation of sandboxes by bringing together leaders of the University, Regulatory and Industry.
Universities must step up as innovation engines. Institutions with BSL-III laboratories should lead development of live attenuated vaccines, while biotechnology departments focus on recombinant vaccine technologies. Specialized vaccine research centers, industry-relevant curricula, and technology transfer offices will bridge the gap between academic discovery and commercial application. State-of-the-art pilot manufacturing facilities will provide proof-of-concept capabilities essential for scaling innovations.
Industry brings manufacturing excellence and market expertise to the equation. Private sector partners can transform academic research into GMP-compliant commercial production, establish robust supply chains for raw materials, and navigate complex regulatory approvals. Their distribution networks and market access capabilities will ensure that domestically produced vaccines reach every corner of Pakistan. Leading companies in Pakistan already in the field of Biopharmaceutical manufacturing must be involved in the development process.
A Realistic Implementation Roadmap
Success requires a phased approach spanning six years. The foundation phase (Years 1-2) must establish policy frameworks and coordination mechanisms while launching capacity building programs. Infrastructure development (Years 2-4) involves scaling laboratory manufacturing capabilities, establishing vaccine testing facilities, and launching pilot production programs.
The scale-up phase (Years 4-6) transitions to commercial production of EPI vaccines, regulatory approvals, and distribution network establishment. Finally, the optimization phase (Year 6+) expands manufacturing capabilities, develops advanced biologics production, and positions Pakistan as a regional pharmaceutical hub.
Financial innovation will be crucial. Blended financing models combining public funding, private investment, and support from institutions like the Islamic Development Bank can mobilize the substantial capital required for drug substance manufacturing facilities. The initial investment may be significant, but the long-term savings and export potential far outweigh the costs.
The Economic and Strategic Imperative
The benefits extend far beyond health security. A robust domestic vaccine industry could create over 5,000 jobs and reduce import dependency by 50%. More importantly, it would establish Pakistan as a regional pharmaceutical hub with significant export potential to neighboring countries and the broader Islamic world.
The COVID-19 pandemic demonstrated the critical importance of pharmaceutical self-reliance. Nations with domestic production capabilities could respond rapidly to their populations’ needs, while others waited months for external supplies. This lesson cannot be ignored as we face an uncertain global health landscape.
The Time for Action is Now
Pakistan’s demographic dividend- with 64% of the population under 30-represents an unprecedented opportunity to build a knowledge-based pharmaceutical sector. However, this window will not remain open indefinitely. The GAVI deadline of 2031 provides a clear timeline for action, but preparation must begin immediately.
The success of this transformation depends on political will, sustained investment, and most importantly, recognition that vaccine self-sufficiency is not a luxury but a national security imperative. Countries that fail to develop domestic pharmaceutical capabilities will remain perpetually vulnerable to supply disruptions, price volatility, and foreign policy pressures.
A Call to National Action
The establishment of a National and Provincial Coordination Committees bringing together leaders from academia, industry, and regulatory agencies represents the essential first step. This must be followed by a comprehensive assessment of current capabilities, development of a detailed national vaccine strategy, and launch of pilot programs for immediate impact.
Pakistan has the intellectual capital, institutional foundation, and market potential to achieve vaccine independence. What we need now is the collective will to transform this potential into reality. The health and prosperity of future generations depend on the decisions we make today.
The choice is clear: remain dependent on the goodwill of international donors or invest in building a self-reliant pharmaceutical sector that serves not only Pakistan’s needs but positions the nation as a leader in global health innovation. The Triple Helix approach offers a proven pathway to pharmaceutical independence-we must have the courage to take it.
References
- World Health Organization. (2023). “Global Vaccine Market Analysis and Trends.” WHO Press.
- GAVI Alliance. (2024). “Transition Planning Guidelines for Middle-Income Countries.” GAVI Policy Papers.
- Etzkowitz, H. & Zhou, C. (2017). “The Triple Helix: University-Industry-Government Innovation and Entrepreneurship.” 2nd Edition, Routledge.
- Indian Pharmaceutical Alliance. (2023). “India’s Journey to Becoming the Pharmacy of the World.” IPA Annual Report.
- Singapore Economic Development Board. (2022). “Biomedical Sciences Industry Transformation Map 2030.” EDB Strategic Publications.
- Korean Pharmaceutical and Bio-Pharma Manufacturers Association. (2023). “Korea’s Biopharmaceutical Industry Development Strategy.” K-BIO Industry Report.
- Israel Innovation Authority. (2023). “Biotechnology and Life Sciences Innovation Ecosystem Report.” IIA Publications.
- Pakistan Bureau of Statistics. (2024). “Population Growth and Health Demographics.” PBS Statistical Yearbook.
- Drug Regulatory Authority of Pakistan. (2023). “Regulatory Guidelines for Vaccine Manufacturing.” DRAP Technical Documents.
- World Bank. (2023). “Health Systems Strengthening in South Asia: Lessons from Pakistan.” World Bank Group Health Reports.
- UNICEF Pakistan. (2024). “Immunization Programme Evaluation and Future Sustainability.” UNICEF Country Office Reports.
- Islamic Development Bank. (2023). “Healthcare Infrastructure Financing in Member
