The COVID-19 pandemic underscored a fundamental truth—epidemics cannot be contained unilaterally. The rapid spread of the virus highlighted the global interdependence of health systems, where technology, medicine, expertise, and vaccine production relied on the complementary strengths of each state. Multilateral efforts—such as the COVAX initiative, ASEAN’s collective pandemic response, or the Quad and interested partner countries’ coordination calls—demonstrated the necessity and potential of cooperation. In South Asia, India and Pakistan’s geographic proximity and shared health and climate vulnerabilities make them a compelling case study for regional health collaboration, an area often overshadowed by their historical mistrust and their military and political conflicts.

The South Asian Association for Regional Cooperation (SAARC), despite its dormancy since the cancellation of the 2016 summit, remains the only institutional framework for structured regional collaboration. The SAARC Health Ministers’ Conference in April 2020 provided a rare moment of unity, facilitating discussion on regional pandemic response strategies and proposing mechanisms for documenting national experiences, sharing best practices, and ensuring continued high-level exchanges. There is an urgent need to resuscitate SAARC to serve as a vehicle for more structured and sustained health cooperation going forward and provide an opening for cross-border goodwill and stability. 

The SAARC Health Ministers’ Conference in April 2020 provided a rare moment of unity, facilitating discussion on regional pandemic response strategies and proposing mechanisms for documenting national experiences, sharing best practices, and ensuring continued high-level exchanges.

The Case for Health Diplomacy in South Asia

Despite ongoing tensions between the two neighbors, Pakistani NGOs offered assistance to India during its oxygen shortage during the 2021 Delta wave of the COVID-19 pandemic. Discussions that took place at the highest Indo-Pak levels to cooperate over polio eradication in 2012 suggests that health diplomacy can create space for dialogue and working together on common challenges even during periods of strain.

Sharing a long border, India and Pakistan face common vector-borne diseases, exacerbated by similar climatic conditions, weak surveillance, uncoordinated vector control, and cross-border wildlife and livestock movement. Despite limited human movement across the border, confidence building measures (CBMs) built on shared health challenges offer cooperation potential. As the World Health Organization has stated, cross-border collaboration is essential to prevent, detect, and respond to infectious diseases, as no country can fully protect itself in isolation.    

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