Institutional inertia in a model capital: environmental health indicators and fragmented urban governance in Islamabad

Source abstract

The rapid pace of urban growth in low- and middle-income countries is pushing environmental boundaries and escalating health risks, from unsafe water and deteriorating air quality to the intensification of urban heat islands. Environmental Health Indicators (EHIs) are intended to guide cities toward achieving the Sustainable Development Goals (SDGs), but in many parts of the Global South, including Pakistan, these tools remain largely aspirational rather than actionable. This study analyzes why EHIs have not been embedded in Islamabad’s urban governance, despite its original vision as a sustainable garden city. Using grounded theory and systems thinking, underpinned by the Institutional Analysis and Development (IAD) framework, we interviewed 14 stakeholders, including policymakers, planners, and regulators from core federal agencies. Our research identifies fragmented governance as the primary barrier. Development projects are consistently prioritized over health and environment, with infrastructure taking 40-60% of urban budgets, while environmental health receives only 5-15%. This leads to a reactionary approach, data gaps, and the exclusion of vulnerable populations living in peripheral areas most affected. Innovative actions are isolated and rarely scaled. We advocate for a dedicated Urban Environmental Health Authority and enforceable EHI targets within Islamabad’s Master Plan to advance health-focused, climate-resilient urban development.