Persistent heavy rainfall during Pakistan’s monsoon season has caused devastating flooding in the north of the country. Khyber Pakhtunkhwa, Gilgit-Baltistan (GB) and Azad Jammu and Kashmir (AJK) were hit particularly hard with major rivers overflowing into Punjab, Sindh, and Balochistan. Keeping in view of the emerging situation, the National and Provincial Disaster Management Authorities (NDMA) issued alerts for areas identified as high risk.

According to NDMA SitRep data, as of 10 September 2025, over 800 fatalities have been reported nationwide. Damage to property is extensive - 2,019 houses have been fully destroyed and 6,198 partly damaged, with 6,508 livestock perished across the country. Critical infrastructure has suffered heavily, with 671.58 km of roads affected, 239 bridges washed away, and major losses to schools, health centres, irrigation, and power facilities. In Khyber Pakhtunkhwa alone, 25,927 individuals are displaced and sheltered in 308 relief camps. In Gilgit-Baltistan, there are 3,140 displaced persons in relief camps, with a further 2,381 people being sheltered in 67 relief camps in Azad Jammu & Kashmir.

Within 24 hours of the crisis escalating, health authorities activated the Emergency Disease Surveillance System to prevent the secondary disaster of disease outbreaks that often follow floods. The system, developed through a partnership between the UK Health Security Agency (UKHSA) and Pakistan's National Institutes of Health (NIH), builds on successful flood response from 2022 and 2024.

The system pivots the national Integrated Disease Surveillance and Response (IDSR) system using District Health Information System 2 (DHIS-2 to track flood-related injuries, infectious diseases, and deaths in real-time, while monitoring maternal and child health concerns that emerge during such emergencies. Data flows from local health facilities through district and provincial levels to create a national picture of emerging health threats.

A key component of this rapid pivot is a new live dashboard developed by the UKHSA International Health Regulations Strengthening (IHR-SP) team. This dashboard provides crucial and immediate access to disease patterns and geographical distribution enabling swift responses to potential outbreaks before they spread.

Government Coordinates National Response

On 19 August 2025, the NIH convened the first National Command and Operation Center (NCOC) meeting to review the situation and coordinate the national response. The meeting was attended by key stakeholders, including health authorities from the most affected regions (KP, AJK, and GB), and UKHSA representatives. The Federal Minister for National Health Services Regulations and Coordination (MNHSR&C), Syed Mustafa Kamal along with Federal Secretary and Director General MoNHSR&C attended to review the progress made in flood emergency preparedness and response efforts. The Minister of Health commended the NIH for its swift activation of the emergency disease surveillance system.

Following this meeting, all three provinces began daily situation reporting to track the evolving crisis. The coordinated response highlights how established partnerships between international health experts and national and local authorities can rapidly mobilise to protect communities when climate disasters strike.

Image: the first National Command and Operation Center (NCOC) meeting takes place

This surveillance system not only represents a critical tool in Pakistan's growing arsenal against climate-related health threats, but as a futureproofing in the response to other emergencies in the future, whether floods, other climate disasters or disease outbreaks.

Dr Mirza Zeeshan Iqbal Baig, Epidemiology and Surveillance Lead for UKHSA IHR-SP in Pakistan explains, “The recurring floods in Pakistan demonstrates the power of building surveillance systems that can adapt to different public health emergencies. The Integrated Disease Surveillance and Response (IDSR) system we developed together with the National Institute for Health was designed for routine disease surveillance but has been brilliantly adapted by Pakistan’s health authorities for real-time flood response within 24 hours. When we build locally-owned, flexible systems, they create lasting health security benefits that extend far beyond any single project - protecting communities from future emergencies and adapting to meet each new challenge."

UKHSA teams remain on standby to provide ongoing technical support throughout the emergency.