Healthcare sector in Pakistan offers a good opportunity for British companies. The sector is under developed and attempts are being made to develop and modernise the sector.
[Healthcare] ? [Pakistan]
Saima Anjarwala, Trade & Investment Officer, Pakistan
Last revised 22 January 10
Whereas every effort has been made to ensure that the information given in this document is accurate, neither UK
Trade & Investment nor its parent Departments (the Department for Business, Innovation and Skills and the Foreign &
Commonwealth Office), accept liability for any errors, omissions or misleading statements, and no warranty is given or
responsibility accepted as to the standing of any individual, firm, company or other organisation mentioned.
Published 2009 by UK Trade & Investment.
Crown Copyright ©
[Healthcare] ? [Pakistan]
Table of Contents
CHARACTERISTICS OF MARKET 6
KEY METHODS OF DOING BUSINESS 7
MORE DETAILED SECTOR REPORTS 8
CONTACT LISTS 9
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[Healthcare] ? [Pakistan]
Healthcare sector in Pakistan offers a good opportunity for British companies. The sector is
under developed and attempts are being made to develop and modernise the sector. Pakistan
does not have local manufacturing expertise in any product apart from surgical goods and
exports all essential products like medical devices, equipment and machinery. Furthermore,
there is a great need for trained and skilled personnel with a top of the line research facilities.
There are many foreign companies that have established their own manufacturing or have
agents selling their products.
Healthcare is an important sector in Pakistan. Pakistan is the 6th most populous country with a
population of 170 million. The population is expected to reach 194 million by the year 2020 with
the current growth rate of 2%. Pakistan?s ranking is 142 in the human development index
According to the latest Ministry of Health Pakistan statistics, there were 13,937 health
institutions in the country including 965 hospitals (with a total of 105,005 hospital beds i.e. ratio
to population per bed is 1,515), 4,916 dispensaries, 4,872 Basic Health Units (mostly in rural
areas), 1,138 Mother and Child Care Centers, 595 rural health centers and 371 TB centers.
The strategy of health sector reform is to achieve accessible quality health care for all. The
policy document identifies ten key areas:
1. Reducing widespread prevalence of communicable diseases;
2. Addressing inadequacies in primary/secondary health care services;
3. Removing professional/managerial deficiencies in the district health system;
4. Promoting greater gender equity;
5. Bridging basic nutrition gaps in the target-population;
6. Correcting urban bias in health sector;
7. Introducing required regulation in private medical sector;
8. Creating Mass Awareness in Public Health;
9. Effecting Improvements in the Drug Sector; and
10. Capacity-building for Health Policy Monitoring.
Prevention is better than the cure. Pakistan is spending 18 percent of its health budget on
Preventive Measures and Health Facilities. Public sector expenditures in Preventive Measures
and Health Facilities sub-sector are progressive at provincial and regional level, except in overall
rural Pakistan. It means the public sector spending on Preventive Measures and Health Facilities
are more evenly distributed as compared to the income distribution.
Expenditure on Preventive Measures and Health Facilities are highly subsidised by the federal
government in Pakistan through its vertical programmes. These federally funded (in
collaboration with the development partners) vertical programmes include:
? Lady Health Worker Programme
? Malaria Control Programme
? Tuberculosis and HIV/AIDS Control Programme
? National Maternal and Child Health Programme
? the Expanded Programme on Immunisation
? Cancer Treatment Programme
? Food and Nutrition Programme, and;
? the Prime Minister Programme for Preventive and Control of Hepatitis A & B.
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[Healthcare] ? [Pakistan]
Government spending in the above sub-sector is more effective and progressive as these
facilities are free for all and there is no household out-of-pocket expenses involved.
The poor can not afford the high costs of private hospitals, that is why they tend to consult
government Hospitals and Clinics where the costs are much lower compared to private health
care centres. On the other hand, the high-income groups prefer to get their medical treatment
from private health care centres where they enjoy better quality of health care facilities.
According to the Economic Survey of Pakistan there were 85 physicians for every 100,000
persons in Pakistan, or in other words, one doctor for 1,475 people. In contrast to most
countries, we a have a dearth of nurses and there are only 65,387 nurses all over the nation
who are supplemented with a strong force of 96,000 Lady Health Workers (primary heath care
All over Pakistan, academic institutions in Healthcare sector are 64 Teaching hospitals with 68
Medical Colleges and only 14 nursing schools. According to the WHO international
standards, the ratio of doctors to nurses should be 1:3; however this is reversed in
the case of Pakistan, i.e. ratio of doctors to nurses is 3:1 in Pakistan.
There is a huge opportunity for Medical colleges and Nursing schools to offer distance learning
programmes and degrees to the Public and Private, as well as establishment or collaboration of
Private Teaching Hospitals.
Government has granted Sindh Provincial government Rs. 200 million and 9000 acres of land to
build Education Park in Sindh near Malir. Four teaching hospitals have already been allocated
land and construction has also started. This presence a unique opportunity for British institutes
in the area to market their expertise such as academics collaboration/investment, medical
equipment and devices, etc.
There is also a growing need for Capacity Building - Planning, Co-ordination,
Promotion and Development of Science and Technology; monitoring and evaluation
of R & D projects; utilisation of manpower for scientific and technological research.
Pakistan meets around 70% of its domestic demand of medicines from local
production and the rest through imports. The pharmaceutical market size is Rs. 111
Billion (US $ 1.35 Billion) approximately. The market for pharmaceuticals in
Pakistan has been expanding at a rate of around 19% over the last few years.
There are 450 Pharmaceutical companies out of which 25 are MNCs that enjoy 47%
of the market share.
Pakistan?s large population, expanding economy including health services,
individual rise in purchasing power, general awareness regarding use of new
molecules of drugs, etc. provides an ideal environment for investment in this field.
The increasing export of Pharmaceuticals from Pakistan is speaking for the quality
that is being maintained for manufacturing of Pharmaceuticals. The export market
is expanding to almost all the continents of the world covering almost 40 major
Presently the Pharmaceutical industry in Pakistan is producing all the major
pharmaceutical dosage forms. Similarly, there are some special products e.g.
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[Healthcare] ? [Pakistan]
immunological, anti-cancer drugs, certain anti-diabetics, antidotes and products
manufactured from biotechnology, which are still being imported, in the finished
form. These specific areas provide excellent opportunities for investment. Only few
bulk pharmaceutical raw materials are being manufactured locally and most of the
Pharmaceutical raw materials are being imported in large quantities from different
counters of the world. Prices of many pharmaceutical products are much higher in
Pakistan as compared to India. The core reason behind this is that most of the basic
pharmaceutical raw materials are imported.
The Pharmaceutical manufacture and trade in Pakistan is regulated through the
Drug Act 1976, and the rules framed there under. This is a fairly comprehensive
law. Pakistan was the first amongst the developing countries in the world to have
introduced Good Manufacturing Practices as a mandatory requirement. The Central
Licensing and Registration Board grant registrations. The professionally competent
drug inspectorates and laboratory services support the Quality Control system at
the federal and provincial level.
The medical device sector is a growing segment in Pakistan. Pakistan's medical
device market was valued at an estimated US$135 million in 2007. Pakistan does
not have any expertise of manufacturing medical devices other than surgical
Pakistan mainly imports from Germany, USA, Japan, China, and Korea or from the
Far East. Demand for high technology devices is met by imports. With the
increasing medical devices market in UK, Pakistan presents a promising market
which is at the moment been taken over by other foreign countries. UK is leading
on supplying Scientific, research and analytical instruments to Pakistan.
Some of the best sales prospects for medical device market include cancer
diagnostic, medical imaging, ultrasonic scanning, and plastic surgery equipment, as
well as polymerise chain reaction technologies. Market sources indicated a
promising sector is the market for cancer diagnostic equipment.
Surgical instruments make up the bulk of a limited domestic manufacturing sector,
located in the Punjab region at Sialkot. Equipment is of a high standard, the
majority destined for export. The industry manufactures about 100 Million
instruments annually including Surgical, Dental, Veterinary, Pedicure and Manicure
Items, Tailoring Scissors, Barber Saloon Scissors and Beauty Saloon instruments.
Limited opportunities exist in this segment, as Pakistan?s surgical instrument
industry is sizeably developed. In addition to extra supply to foreign markets, it
also caters to the local market. The world market for Surgical Instruments is over
US $ 30 billion and Pakistan shares US $ 173 Million in this market. Both Disposable
and Reusable instruments are manufactured and exported.
Sialkot is the hub of the surgical disposable market in Pakistan. Items produced
locally include stainless steel surgical scissors, forceps, cannula, syringes in all
Sizes, I.V set, Blood Transfusion Set, E.T.T tube, urine bag, thermometer, round
strip, stomach tubes, catheter in all sizes and Polythene gloves.
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[Healthcare] ? [Pakistan]
The local manufacturers of Surgical Disposable cater to the local market and export
to the USA, Germany and UK. This is due to improving manufacturing expertise and
lower cost of production.
Local demand for textile based disposable like bandage and gauze?s, etc. has also
been met by the local industry. Local industry experts indicated the imports in the
surgical disposable are confined to items that require high tech manufacturing.
According to the industry opportunity for UK organisation that can support and
provide assistance in getting international certificates for their product and
manufacturing units exist.
Bio medical Instruments and Diagnostic Equipment
In recent years, thousands of new medical centers have been set up all over the
country. Reputable medical professionals run the majority of these private
centers/clinics. Public sector hospitals procure medical equipment through tenders
whereas private hospitals obtain these through distributors and suppliers who can
ensure quality, technical services, and backup supplies. Foreign manufacturers
benefit by appointing agents in Pakistan?s major cities to market their superior
The increasing involvement of the private sector in health facilities is a positive
development for foreign suppliers of used medical equipment to consider marketing
their products in Pakistan. Used/recondition equipment is often preferred, as the
private sector is price-driven. Most of the large hospitals/organisation prefer to buy
new machinery/equipment. Whereas the high value machinery is concerned the
preference is for used items e.g. magnetic resonance imaging system,
computerised tomography scanners.
Pakistan does not have any manufacturing capacity for Bio medical and
sophisticated diagnostic instruments/equipment. This segment thus offers sizeable
opportunities for foreign suppliers. Both private and public healthcare sector,
mainly bank on foreign manufacturers and the market mainly depends on
importable instruments. Government owned hospitals are not price conscious they
would prefer to buy quality instruments from European, Japanese or American
suppliers. Private hospitals opt for less expensive instruments and import from Far
Eastern countries such as Hong Kong, China, Korea, Taiwan etc.
UKTI publishes international business opportunities gathered by our network of British
Embassies, High Commissions and Consulates worldwide. These opportunities appear in the
Opportunities portlet on the relevant sector and country pages on the UKTI website. By setting
up a profile you can be alerted by email when relevant new opportunities are published. New or
updated alert profiles can be set in My Account on the website.
CHARACTERISTICS OF MARKET
Population of Pakistan is spread over four provinces (Punjab, Sindh, North West Frontier
Province and Baluchistan) and four federally administered areas. These are further divided into
126 districts, which have 8575 union councils and 50568 villages.
The main health problems are preventable communicable diseases, severe malnutrition and
high incident of birth resulting in a high proportion of infant and maternal mortality. There are
also clear differentials in health conditions by rural and urban areas and socio-economic groups.
Gastro-enteritis, respiratory infections, congenital abnormalities, typhoid fever,
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[Healthcare] ? [Pakistan]
Malaria, Tuberculosis and wide variety of childhood diseases such as diarrhoea, measles and
tetanus etc. still continue to pose potential threat to the health of millions of people in the
country. Unsanitary condition, polluted water and illiteracy among rural mothers, urban slum
and high fertility, small budgetary allocation and inadequate administrative structures have
been identified as the main hurdles in the progress of health conditions.
Pakistan is disease burden country where 12% of the people in the age groups of 25 years and
above is suffering from diabetes and about 10% from Impaired Glucose Tolerance (IGT).
Diabetes is nearly as common in the affluent urban population as in the less privileged rural
inhabitants. Obesity and particularly central obesity is an important risk factor for diabetes
especially in women. The relative risk of being diabetic for subjects with a positive family history
of diabetes was increased three times in both sexes, but the association between positive family
history of diabetes and presence of IGT was not significant. National Action Plan for the
prevention and control of Diabetes in Pakistan in collaboration with Ministry of Health is
Hypertension is a very common public health problem in Pakistan. Circulatory
Diseases are No.1 cause of death worldwide. Hypertension is a major contributory
factor to this mortality. According to a data published in 1997 revealed that 18% of
the Pakistani Population has raised blood pressure levels. There are an estimated
12 Million hypertensives in Pakistan.
1% of the population of Pakistan suffer from schizophrenia. Depressive disorders
affect the health of seven out of ten persons and attribute to 60% of all suicides.
Epilepsy accounts for 1% of the population in the cities and 2% of the population
living in the villages, most of them untreated. Pakistan also has its due share of
Alzheimer?s disease, substance abuse and mental retardation. With these sort of
figures mental health in Pakistan needs urgent attention.
Pakistan is spending 2 percent of its GDP on health care services. The World Health
Organisation (WHO) in its recent report on macroeconomics has recommended that US$ 34
per-capita is the required package for essential health care services. Pakistan is currently
spending Rs 254 (approximately US$ 4.2) per-capita which is quite low when compared to the
per-capita WHO recommendation; per capita expenditure is almost 12 percent of WHO
recommended level in Pakistan.
Government of Pakistan with international partner organisation is running many
programmes, which have been mentioned above, to improve the healthcare
KEY METHODS OF DOING BUSINESS
The best way to operate in the Pakistan market is through a local agent who could
represent UK Company in the country. However, companies wishing to establish an
office should consider doing so in partnership with a suitable local company.
The most common arrangement is the exclusive agency agreement, under which
the supplier agrees to neither appoint another dealer/distributor, nor to negotiate
sales through any other party. In return, the agent is barred from handling similar
items produced by other companies. Under this arrangement, the agent receives
commissions on all sales of the product regardless of the channels through which
the order is placed.
Other background information on doing business in Pakistan can be found on UKTI?s website.
Simply go to the Pakistan country page where you will find information on:
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[Healthcare] ? [Pakistan]
? Economic background and geography
? Customs & regulations
? Selling & communications
? Contacts & setting up
? Visiting and social hints and tips
MORE DETAILED SECTOR REPORTS
Research is critical when considering new markets. UKTI provides market research services
which can help UK companies doing business overseas including:
? Overseas Market Introduction Service (OMIS). Bespoke research into potential
markets, contacts and support during your visits overseas.
? Export Marketing Research Scheme. Advice on market research and help to
contact subsidised market research administered by the British Chambers of Commerce
on behalf of UKTI.
Contact your local International Trade Advisor if you are interested in accessing these services,
or for general advice in developing your export strategy.
When considering doing business in Pakistan, it is essential to obtain legal, financial and
taxation advice. For further details, please contact:
UK Trade & Investment
British Deputy High Commission
Shahrah-e-Iran, Clifton, Karachi, Pakistan
Telephone: 0092 21 35827000
Fax: 0092 21 35827005
6-10 March 2010
Health Asia and Pharma Asia at Karachi Expo Centre
www.healthasia.com and www.pharmaasia.com
UK Trade & Investment?s Tradeshow Access Programme (TAP) can help eligible UK businesses
take part in overseas exhibitions. Attendance at TAP events offers significant benefits:
? possibilities for business opportunities both at the show and in the future
? a chance to assess new markets and develop useful contacts
? grants are available if you meet the criteria
? UKTI staff overseas will be available to assist delegates
Find out if you are eligible to apply to attend this event, and more about the support UKTI can
offer, on the UKTI Market Entry web page.
Details of TAP events can be found in the Events portlet on the [country] page.
Other Market Visit Support may be available via your local International Trade Advisor.
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[Healthcare] ? [Pakistan]
? Government of Pakistan
? Ministry of Health
? Pakistan Pharmaceutical Manufacturer Association
? Drugs Control Organisation
? Pakistan Anti TB Association
? Pakistan Medical And Dental Council
? Pakistan Dental Association
? National Council for Homeopathy
Ministry of Health Government of Pakistan
UKTI?s International Trade Advisers can provide you with essential and impartial advice on
all aspects of international trade. Every UK region also has dedicated sector specialists who can
provide advice tailored to your industry. You can trace your nearest advisor by entering your
postcode into the Local Office Database on the homepage of our website.
For new and inexperienced exporters, our Passport to Export process will take you through the
mechanics of exporting. An International Trade Adviser will provide professional advice on a
range of services, including financial subsidies, export documentation, contacts in overseas
markets, overseas visits, translating marketing material, e-commerce, subsidised export training
and market research.
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