2018 finally ended but it did not farewell to theimprovement ofhealthcare system of Pakistan. It has remained unhealthy throughout the year. Like any other third world state, Pakistan’s healthcare system demonstrated a sorry picture of negligence and dilapidation. The rampant cases of infectious diseases like Dengue Fever, Congo Virus, HIV/AIDS, Hepatitis, Poliomyelitis and TB were glaring illustration of the predicament. It has also been a bad year for children. A recent WHO survey depicts that, in every three hours, a child dies helplessly in Pakistan due to lack of basic healthcare and first aid services. Also, malnutrition was the grave issue for children under 5; the most recent estimates by the United Nations Food and Agriculture Organization (FAO) state that 37.5 million people in Pakistan are not receiving proper nourishment. According to UNICEF, “If malnutrition in children is above 15%, it must be declared as an emergency and the necessary action must be taken. But the level of child malnutrition in Pakistan has crossed threshold level and has reached up to 17.5 %. Here, malnutrition largely contributes to high mortality rate, a catalyst for infectious diseases among children and is like that of in Ethiopia, Darfur, and other African countries. Moreover, according to UNICEF health survey statistics, under 5 mortality rate is 75/1000 live births, over 25% of all newborns in Pakistan have low birth weight, 33.03% of children under the age of 5 are underweight, 53.38% of the children are stunted and wasting has been reported in 11.52% of the children, which clearly shows that the nutritional status in this country is poor. Malnutrition in Pakistan is usually associated with poverty and the main causative factors include low consumption of food and foods with low nutritional value. The policymakers should know that their inaction in eradicating malnutrition has alasting legacy on the future development of children and has been linked to low birth weight and birth defects, mental and physical health problems, and educational outcomes. 2018 has also remained highly infectious year and HIV/AIDS has become a terrible health challenge with 150000 cases positive for HIV including 40000 women, who have the tendency to vertically transmit the virus to their babies during pregnancy; hence doubling the disease burden And, this agony does not end here, but 2018 has also remained highly infectious year and HIV/AIDS has become a terrible health challenge with 150000cases positive for HIV including 40000 women, who have the tendency to vertically transmit the virus to their babies during pregnancy; hence doubling the disease burden. Similarly, Tuberculosis and Viral Hepatitis have wreaked havoc on the massive population. Pakistan ranks fifth amongst TB high-burden countries worldwide. Approximately 420 000 new TB cases emerge every year and half of these are sputum smear positive. It accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. Likewise, Hepatitis has a population pool of about 13 million chronic hepatitis B and C carriers. Furthermore, even though it has been eliminated from the world, Poliovirus is still prevalent in Pakistan and its re-emergence is a major public health threat to the world; yet there still exist taboos regarding the polio vaccination in northwestern Pakistan under the garb of religion. In 2017 we have 8 positive cases of Poliomyelitis and even with the spending of huge budget, the number of cases remained same in 2018. It is ironic that in Afghanistan, importations of wild poliovirus from Pakistan occurred. Moreover, the lack of prior preparedness and disaster management tactics at the local and governmental level have contributed to the emergence of many infectious diseases, malnutrition in children and the deterioration of health conditions of many children, woman and elderly population. Apart from it, the number of cases of non-communicable diseases has also increased. The three entirely preventable diseases Diabetes Mellitus, Cancer and Hypertension have been the major killers in Pakistan. According to International Diabetes Federation, Pakistan will be among top five countries within next few years with 11.5 million people living with Diabetes Mellitus. Similarly, Hypertension League reports that 50 percent of adults suffer from hypertension and it has been a major killer because hypertensive people are at high risk of developing Cardiovascular Diseases. Lastly, the mortality rate due to Cancerespecially Breast & Lung Cancer has remained high in 2018 with total increase of 0.2 million cases. It is very pathetic to say that all mentioned diseases are totally preventable. I believe that these all problems have instigated at the first placebecause we systematically neglect primary care, prevention and the principles of Public health.And, apart from blame game, the policy makers stand first culprit of all these predicaments since they haven’t had enough capacity to cope with such quagmires. There are certainly many organizations working for health issues in Pakistan; however, they also bear nothing but the baggage of failures except very few. Time and again, the cause of such utter failures resides in underlying policy making and there exists no condign implementation and accountability system. The writer is Chevening Scholar MSc Global Health in London School of Hygiene & Tropical Medicine Published in Daily Times, January 6th 2019