Helpdesk Report: K4D - Areas and population groups in Pakistan most exposed to combined effects of climate change, food insecurity and COVID-19

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Iffat Idris
GSDRC, University of Birmingham

1. Summary

There are strong interlinkages between the effects of climate change and natural disasters in Pakistan, food insecurity, and exposure to COVID-19.1 Areas/groups at risk of one will often be at risk of the others as well, demonstrating the complexities and multifaceted nature of vulnerability, risk and exposure. In areas exposed to natural disasters, for example, there are likely to be higher levels of food insecurity. Key geographic areas at risk of the combined effects of climate change-natural disasters and food insecurity in Pakistan are Balochistan, Sindh, southern Punjab and parts of Khyber Pakhtunkhwa (KP). With the exception of Balochistan due to its very low population density, these are all also regions at high risk of COVID-19. Key population groups especially at risk are the poor and landless, and women. The poor, in particular, lack the capacity to adapt or recover from climate change impacts and natural disasters, face difficulties in accessing adequate food, and often live/work in conditions which promote transmission of COVID-19.

This rapid review looks at areas and population groups in Pakistan most exposed to the combined effects of climate change and natural disasters, food insecurity and malnutrition, and COVID-19. The review draws on a mixture of academic and grey literature, including reports by development organisations. While considerable information was found about the diverse effects of climate change and natural disasters on different parts of the country (including down to district level), data on food insecurity was largely only at provincial level. There are also significant gaps in the evidence base on specific population groups, notably religious minorities.

Key findings are as follows:

Climate change and natural disasters

▪ Pakistan is among the countries in the world most affected by climate change. Impacts already being seen include more frequent and intense extreme weather events, rising temperatures, water scarcity, reduced forest cover, and rising sea levels.
▪ Climate change effects are predicted to intensify in coming years. Pakistan is forecast to reach absolute water scarcity (per capita annual water availability of 1,000 cubic metres) by 2025 (Baloch, 2018).
▪ Natural disasters which are most common in Pakistan are floods, drought, cyclones, earthquakes, landslides and avalanches. The country has seen repeated such disasters in recent years, which have displaced civilian populations and caused massive damage to property, crops and infrastructure, setting back development and growth. Virtually all areas of the country are at risk of natural disasters, though which natural disasters vary from one area to the next, reflecting Pakistan’s diverse topography and climate.

o Floods – Floods are the most frequent recurring natural disaster in Pakistan. The country is at risk of glacial lake outburst floods (GLOF) and flash floods (hill torrents) in the north, riverine flooding along the Indus River basin in Punjab and Sindh, and coastal flooding in the south.

o Droughts – Most of Balochistan is at risk of drought, as well as Sindh and southern Punjab. Droughts build up over long periods, and their effects can last for many years.

o Cyclones – Vulnerable districts are all found along the coast in Sindh and Balochistan.

o Earthquakes – Pakistan lies in a seismic belt where two tectonic plates meet, so suffers frequent small and medium intensity earthquakes. Most at risk are districts in KP, as well as Pakistan Administered Kashmir (PAK) and Gilgit-Baltistan.

o Landslides and avalanches – These also largely affect northern areas of the country: parts of KP, Gilgit-Baltistan and PAK. Vulnerability to landslides is exacerbated by high deforestation rates, cultivation and unplanned construction.

▪ Karachi merits particular attention because it is Pakistan’s economic hub and is highly vulnerable to climate change effects, notably rising sea levels and increased salinity. Large numbers of people displaced by climate change effects in surrounding areas have migrated to the city, adding to the load on already over-burdened services and resources. Water scarcity is especially acute in Karachi.

Food insecurity and malnutrition

▪ Pakistan is a food surplus country in terms of production (including wheat, rice, fruits, vegetables, milk and meat) but despite this, is largely a food insecure country. Key indicators of food insecurity are Prevalence of Undernourishment (PoU) and Prevalence of Moderate and Severe Food Insecurity. The former assesses how many people lack dietary energy, while the latter also looks at access to nutritious and sufficient food.

▪ PoU in Pakistan has remained at around 20% since 2007-9, but has increased in absolute terms (to 40 million in 2016-18) because of population growth as well as droughts (FAO et al, 2020: 8). PoU is highest in Balochistan, followed by Sindh and Punjab, and lowest in KP. PoU is consistently lower in rural areas than urban areas.

▪ In 2018, 23.5% of households in Pakistan were estimated to be either moderately or severely food insecure, while 10.1% were severely food insecure. The prevalence of both moderate or severe food insecurity, and severe food insecurity was highest in Balochistan (38.4% and 21.4% respectively) followed by Sindh (33.3% and 14.7% respectively). Both are also higher in rural than urban areas (FAO et al, 2020: 17-18).

▪ Key indicators of malnutrition are stunting, wasting and underweight among children under five years of age. Pakistan is estimated to have 12 million stunted children, at a national rate of 40.2%. Stunting prevalence is slightly lower among boys than girls, but significantly higher in rural areas than urban areas. Among the four provinces, it was highest in Balochistan (46.6%), followed by Sindh (45.5%), KP (40.0%) and Punjab (36.4%) (FAO et al, 2020: 23).

▪ Childhood wasting nationally was 17.7% in 2018, with prevalence higher among boys than girls, and in rural areas than urban areas. Among the provinces, it was highest in Sindh (23.3%) – reflecting the recurring dry spell in southern parts of the province - followed by Balochistan (18.9%) (FAO et al, 2020: 24).

▪ Underweight prevalence was 28.9% nationally in 2018, but much higher in Sindh (41.3%) followed by Balochistan (33.7%) (FAO et al, 2020: 26-27).

▪ Climate change effects and natural disasters strongly impact food insecurity, leading to both reduced agricultural productivity and reduced purchasing power. In the past year torrential monsoon rains in Sindh, Balochistan and northern Pakistan, and a massive desert locust infestation in Sindh, Balochistan and Punjab, have caused extensive damage to crops, with negative effects on food availability and accessibility.


▪ The COVID-19 pandemic has been relatively limited in Pakistan, in terms of cases and deaths. As of 4 March 2021, the country had a total of 585,435 cases and 13,076 deaths.

▪ Calculation of exposure risk to COVID-19 in different parts of Pakistan - based on population density, proximity to others in the household, and access to water, sanitation and hygiene (factors that contribute to/prevent the spread of COVID-19) - identifies Sindh, southern Punjab and KP as the areas at highest risk.

Population groups

Poor and landless

▪ Climate change and natural disasters hit the poor hardest because they have the least capacity to respond (to adapt and to recover). Exposure and vulnerability are also unequal in a community, reflecting powerlessness and poverty. For example, the poor tend to have homes in low-lying areas made of less durable materials (e.g. mud), while the affluent are usually on higher ground beyond inundation zones, in solid (e.g. brick) houses.

▪ Food insecurity is a function of four dimensions, including accessibility of food. Poverty directly impacts this. While overall multidimensional poverty in Pakistan has fallen in recent years, there are significant regional differences: it is high in Balochistan and Sindh, as well as parts of KP and southern Punjab, and higher in rural areas than urban areas.

▪ The poor are most at risk of COVID-19 infection because of the conditions in which they live and work (e.g. crowded neighbourhoods) and are also most vulnerable to the wider socioeconomic effects of the pandemic. Rise in multidimensional vulnerability (including effects on jobs, education, etc.) due to the pandemic is forecast to be highest in Punjab and Sindh; Balochistan and KP already have high rates of multidimensional poverty and food insecurity. The latter is forecast to rise in the pandemic, due to higher prices and reduced purchasing power.

▪ There is also correlation between multidimensional vulnerability and natural disasters: most districts in which the former is high have experienced recent natural shocks, which mean poverty and food insecurity levels are already high, and community resilience low. The highest correlation is seen in Balochistan, Sindh, southern Punjab and parts of KP.


▪ As in other developing countries, patriarchal norms and lack of gender equality mean that women in Pakistan are disproportionately affected by climate change and natural disasters: they are at more risk of dying, have to spend more time on chores such as collecting water, face loss of livelihoods, can end up carrying the household burden as men migrate in seek of work, or face difficulties following displacement.

▪ The effects of food insecurity are particularly dire on poor women and children: in Pakistan 50.4% of women are anaemic, up to 46% experience Vitamin A deficiency, and an average of 40% have iron deficiency (compared to a global average of 17%) (FAO & WFP, 2020: 1).

▪ Women in Pakistan are highly vulnerable to the wider negative effects of the pandemic, such as loss of livelihoods, discontinuation of reproductive and other healthcare, increased unpaid work responsibilities, increased food shortages, and domestic violence.