The presence of multinational corporations (MNCs) in Pakistan presents a profound paradox. On one hand, global food and beverage giants drive a “sweetened” lifestyle that fuels a mounting crisis of non-communicable diseases (NCDs).On the other hand, healthcare MNCs provide toothpaste, brushes, floss, mouthwashes, restorative materials, and pharmaceuticals and are therefore required to manage the fallout of that sweetened lifestyle. This dual role creates a cyclical economic burden, where the “disease-creating” and “disease-managing” arms of the global corporate machinery both profit from the same demographic, ultimately straining health expenditure of the country and household finances.
Architect of the Crisis: Processed and Sugary Edibles
Over the last two decades, multinational food and beverage companies have aggressively expanded their business in Pakistan. High-sugar carbonated drinks, ultra-processed snacks, and industrial juices are no longer luxury items but staples in both urban and rural diets. The results are visible in the data. Pakistan now has one of the highest diabetic populations globally, with approximately 33 million adults living with the disease.
From an oral health perspective, the impact is equally devastating. The “sugar overload”, with the average Pakistani consuming roughly 26 kg of sugar annually, has led to tooth decay prevalence of nearly 50% in permanent teeth and significant gum disease across all age groups. These companies utilize sophisticated marketing and vast distribution networks to make cavity-causing products more accessible than fresh produce. This environmental shift effectively “fires the gun,” while the public health system is left to “treat the bullet wound.”
Oral Healthcare & Pharmaceuticals
Parallel to the rise of sugary consumables is the growth of the multinational oral healthcare sector. Companies selling fluoridated toothpaste, antibacterial mouthwashes, and advanced restorative materials market themselves as the guardians of the Pakistani smile. Their products are essential for prevention and treatment, but there is a general irony: the demand for these products is largely sustained by the dietary habits encouraged by their corporate counterparts in the food industry.
In Pakistani dental clinics, the leadership generally falls to the “mechanical trade”, the manufacturers of equipment and materials. While these MNCs bring innovation and quality standards to the country, the cost of their technology remains high. For a nation where the dental workforce is relatively small (roughly 1.2 dentists per 10,000 people), the reliance on expensive imported materials further drives up the cost of care, making “preventive” products a significant portion of out-of-pocket spending for an average citizen.
Collective Impact on National Health Expenditure
The synergy between these two corporate roles creates a massive drain on the Pakistani economy. The financial toll can be analyzed through two lenses:
Public Sector Strain: Pakistani public health expenditure remains low, hovering around 1% of GDP. However, the rising tide of non-communicable diseases (NCDs), including diabetes and oral cancers, forces the government to divert limited funds toward chronic care rather than primary prevention. For instance, the annual cost of managing diabetes in Pakistan was estimated at over $ 2.6 billion in 2021. When billions are spent on the complications of sugar consumption, there is little left for oral and dental healthcare.
Private and Out-of-Pocket (OOP) Burden: In Pakistan, over 50% of health financing is out-of-pocket. Families are caught in a financial pincer movement. They spend a portion of their income on cheap, processed foods – the risk factor, and then a significantly larger portion on medicines and dental procedures – the treatment. For a factory worker or a labourer, the cost of managing a chronic condition like diabetes or hypertension can consume a bulk of his/her monthly income; undergoing a dental procedure, other than tooth extraction, becomes impossible.
Fiscal Policy and Corporate Responsibility
The government has begun to push back through fiscal measures, such as the 2023 increase in Federal Excise Duty (FED) on sugary drinks to 20%. While these taxes generate revenue and theoretically lower consumption, they face intense lobbying from the beverage industry. The revenue from these “sin taxes” is rarely earmarked directly for oral health or NCDs prevention, leaving the cycle of disease and expensive treatment unbroken.
To break this cycle, the government must move beyond reactive healthcare. This requires a two-pronged approach: stricter regulation and higher taxation on the “disease-creating” sector, paired with the domestic empowerment of the dental and medical industries to reduce reliance on expensive foreign imports. Only by decoupling corporate profit from the prevalence of disease can Pakistan hope to stabilize its health expenditure and protect the well-being of its future generations.
The Author is a Dean, Bhitai Dental & Medical College, Mirpurkhas