Public vs private: two cancer realities in Pakistan

By Mushfiq Ahmad

KARACHI, Pakistan (MNTV) — In Pakistan, people’s chances of surviving cancer are shaped less by medical science and more by timing, poverty, and access. While cancer outcomes in wealthier nations reach as high as 80 to 90%, survival rates in Pakistan hover around 50 to 60% — and drop even further for those diagnosed late, doctors say.

As the world marks World Cancer Day, oncologists are calling attention to a stark divide in Pakistan’s healthcare system: two parallel cancer realities, one public and one private, producing vastly different outcomes for those battling the disease.

Across Pakistan, cancers are usually diagnosed at advanced stages, when treatment becomes more complex, expensive, and less effective. According to Dr. Saqib Ansari, the problem begins long before one reaches a hospital.

“There is a lack of testing, very few laboratories, and improper diagnosis,” he says. “Human resource training is the most important factor. You can buy machines, but without trained doctors and technicians, the system fails.”

Limited diagnostic facilities, particularly outside major cities, mean that early warning signs are often missed. By the time patients are referred to specialized centers, cancers that were once curable have progressed.

Public and charitable hospitals such as Indus Hospital, SIUT, JPMC, and NICH provide free or heavily subsidized cancer care — the only option for the vast majority of Pakistani families.

But free care comes at a cost.

Dr. Ahmar Hamid, pediatric oncologist at Indus Hospital, says government and charitable institutions are struggling under an immense patient load. “Public hospitals are overwhelmed,” he explains. 

“Long waiting times, limited beds, fragmented services — surgery in one place, imaging in another, chemotherapy somewhere else — all these delays turn treatable cancers into advanced disease.”

Beds are scarce, and coordination between departments is often slow. For those with aggressive cancers, even small delays can be life-threatening.

Despite these challenges, public hospitals manage to save thousands of lives every year.

“If you treat 100 children with blood cancer in a public hospital like NICH, about 40 to 45 survive,” Dr. Ansari says. “That number alone shows the dedication of doctors working with limited resources.”

Private hospitals: faster care, higher survival — at a price

In contrast, private hospitals offer streamlined care under one roof — rapid diagnostics, immediate surgery, chemotherapy, imaging, and supportive treatment.

“At private centers, decisions are made quickly and treatment starts without delay,” Dr. Hamid says. “That continuity naturally improves outcomes.”

Survival rates reflect this advantage. In private hospitals, doctors report saving 50 to 55 out of 100 children, a 10–15% improvement over public institutions.

But for most families, this option is financially impossible.

Dr. Rashid ul Amin of Sindh Institute of Urology and Transplant (SIUT) explains that even early-stage cancer treatment in the private sector can cost over one million rupees, with advanced imaging such as PET scans costing up to 170,000 Pakistani rupees ($603) at some hospitals.

“Private treatment can consume a family’s lifetime savings,” he said. “Two to three million rupees ($7,100 to $10,500) is common, and most families simply cannot afford it.”

Doctors emphasize that better outcomes in private hospitals are not due to superior medical knowledge, but to socioeconomic conditions. “Cancer does not discriminate (between the wealthy and the poor),” Dr. Hamid says.

Patients treated in private hospitals are more likely to be well-nourished, live in hygienic conditions, afford supportive medicines, and complete treatment without interruption — all factors that significantly affect survival.

With 70 to 80% of Pakistan’s population living below or near the poverty line, these advantages remain out of reach for most families.

Charitable institutions offering hope

Institutions like SIUT stand out for their commitment to equality in care. “We do not ask about financial status,” Dr. Rashid said. “Treatment is completely free, funded by donations. All patients are treated equally.”

However, even charitable hospitals face difficult choices. Many prioritize younger patients and early-stage cancers to maximize survival, while advanced cases often receive limited palliative support due to resource constraints.

On World Cancer Day, Pakistan’s doctors are sending a clear message: awareness alone is not enough.

Until early diagnosis becomes accessible, laboratories expand beyond major cities, and public hospitals are strengthened to match demand, thousands will continue to be diagnosed too late — and survival will remain tied to wealth.

For many families, the fight against cancer is not just against disease, but against time, poverty, and an unequal healthcare system.