Pakistan has roughly 40 percent of its children living this reality today. Yet walk into any ministry briefing on nutrition or primary healthcare and the language is oddly upbeat: officials speak of a “health dividend” — the idea that money spent on health today will generate economic growth tomorrow. It is also, judging by the evidence of our own budgets, largely a slogan that dresses up policy failure as policy choice. A health dividend is the economic return a country gains from investing in its population’s health: better health leads to a more productive workforce, higher earnings, lower treatment costs and stronger GDP growth. Pakistan spent roughly 0.8 percent of its GDP on public health in FY2025–26, a figure that has barely changed in years and remains far below the 5 percent that many health economists consider necessary for achieving universal health coverage.