Pakistan's Border Health Services (BHS), supported by the UK Health Security Agency’s (UKHSA) IHR Strengthening Project (IHR-SP), has taken a significant step towards strengthening the country's readiness to detect and respond to serious disease threats at its airports, seaports and land borders. 

A response to a global challenge 

Recurring outbreaks of Ebola and other high consequence pathogens have underlined the need for strong border health systems worldwide. In response, a first-of-its-kind meeting in Karachi brought together 25 representatives from BHS, the Sindh Department of Health, the Federal Investigation Agency and the Civil Aviation Authority to review, test and plan how Pakistan can better prepare and protect its borders against infectious diseases. 

The centrepiece of the day was a live functional simulation exercise, testing how agencies would respond to a passenger showing symptoms of Ebola Virus Disease. Teams practised each step of the response, from the initial in-flight alert through to the passenger's arrival, clinical assessment, isolation and referral for care. The exercise allowed participants to see, in practice, how well multiple agencies could work together, and where the process could be strengthened in line with international standards, including IHR (2005) capacities, WHO benchmarks and Joint External Evaluation technical areas for points of entry. 

Putting readiness to the test 

The exercise was developed and delivered with technical guidance of UKHSA’s IHR-SP Pakistan teamworking alongside Pakistan's National Institute of Health to co-design realistic case scenarios and facilitate the simulation. Throughout the exercise, UKHSA technical advisersacted as observers, helping to identify systemic gaps.

Alongside technical presentations, facilitated discussions and a joint interactive exercise, the workshop gave participants a clear, practical view of existing capacities in Pakistan’s border health system, as well as where it can be strengthened. Identified areas for strengthening included screening procedures, referral pathways, infection control, surge capacity, and how information is shared across airports, seaports and border crossings. 

Turning lessons into action 

These insights will directly shape a new year-long plan of joint work between multi-agency partners, turning the lessons into actions. The workshop also established a new coordination mechanism, linking BHS with immigration, aviation and health authorities, providing a foundation for closer collaboration and ensuring this work continues to strengthen Pakistan's border health capacity for the future. 

Looking ahead 

This marks the start of a longer-term partnership. Over the coming year, BHS and UKHSA will work together to carry out detailed assessments, develop preparedness plans and standard operating procedures, and run further training and simulation exercises, building steadily towards a more resilient and prepared Pakistan.