A SILENT crisis is unfolding on our plates: diets built on grains and sugar leave many undernourished while diabetes continues to rise. Pakistan does not lack food, but many still struggle to access a balanced diet. A policy shift from a ‘food security’ approach to a ‘food systems transformation’ one could be a gamechanger.

Walk through any Pakistani bazaar or sit for a cup of tea and one thing is hard to miss: sugar. It is cheap, plentiful and woven into daily life. The human cost is less visible. Pakistan’s children are among the most malnourished in the region. Thirty-four per cent of under-fives are stunted, and diet-related diseases are rising. According to the International Diabetes Federation, Pakistan has the highest prevalence of adult diabetes in the world, with approximately 34.5 million people living with the condition — a prevalence rate of between 26.7pc and 30.8pc.

What looks like a dietary habit is really a macroeconomic outcome: a system that prioritises calories above nutrition. For decades, Pakistan’s food policy has been shaped by an understandable preoccupation: ensuring sufficient staples for a fast-growing population size. The central questions were logistical and political — wheat procurement, strategic reserves, administered prices. Those instruments mattered in a world where famine was a real fear. But the national challenge has evolved. Today, the test is not simply whether Pakistan can feed its people, but whether families can afford and access sufficiently diverse foodstuffs to nourish themselves.

The latest global food security report estimates that 60.3pc of Pakistanis cannot afford a healthy diet. Some 16.5pc are undernourished, even as obesity has risen to 23pc.

Can families afford and access enough good food?

New evidence from a Food Systems Transformation initiative led by the Food and Agriculture Organisation of the United Nations — clarifies the access problem: while Pakistan’s overall dietary energy availability is adequate, the national food supply falls short of what is needed to support healthy diets in line with national guidelines. Significant gaps persist in the availability of key food groups, including fruits and vegetables, pulses and legumes. These shortages directly weaken the population’s access to — and therefore ability to choose — a healthy diet.

Pakistan needs a policy shift. Staple-focused food security is not food systems transformation. The first manages commodities; the second manages the entire system — how resources are allocated, what is grown and processed, and how those choices shape diets, health and sustainability.

Three things currently hamper this transformation. First, policy remains narrowly focussed on the availability of staple foods, technically limiting the definition of food security. Second, the institutional architecture treats food security almost exclusively as an agricultural problem, designing and implementing policies through that lens. And third, there is a complete absence of modern food systems governance capable of integrating the diverse actors, factors and processes that ultimately shape food security outcomes.

Immediate action on four tracks could transform Pakistan’s approach. First, create incentives for dietary diversity. Rather than privileging a narrow set of staple crops, policy should support the production and affordability of nutrient-dense foods such as fruits, vegetables, pulses and, where appropriate, animal-source foods, without undermi­ning price stability. Second, redu­­ce food loss and wa­­­­ste. Cutting post-harvest los­ses in the agri-food sector, estimated at 20 to 40pc, may be the fastest way to expand the effective supply of nutritious foods without requiring more land or water. Third, build awareness and a strong political and social constituency for healthy diets. Until citizens demand better nutrition and leaders see electoral value in delivering it, progress will be slow. Fourth, use fiscal policy to make healthy choices easier. A nutrition-first agenda cannot rely on messaging alone; it requires coherent taxation, subsidies and public procurement that shift relative prices and incentives, including reviewing commodity support, assessing the health impact of food taxes, and using targeted social protection to improve access to diverse diets.

Pakistan has spent decades asking: do we have enough wheat? The more urgent question today is: can families afford and access enough good food? A food system that reliably delivers healthy diets is not a luxury agenda. It is economic policy, resilience policy and ultimately, nation-building.

The writer is UN Resident and Humanitarian Coordinator in Pakistan.

Published in Dawn, February 28th, 2026

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