Quackery in Pakistan: a narrative literature review of a persistent public health threat.

INTRODUCTION AND BACKGROUND: Quackery remains a significant yet under-recognized public health threat in Pakistan. The term "quack" varies in definition across regions but commonly refers to individuals lacking formal training, legal registration, and authorization to provide healthcare services. As per Section 2(XXIX) of the Sindh Health Care Commission (SHCC) Act, 2013, a quack is defined as a pretender delivering healthcare services without registration with the Pakistan Medical Commission (PMC), National Council for Tibb (NCT), National Council for Homeopathy (NCH), or Pakistan Nursing Council (PNC). OBJECTIVES: This narrative review aims to explore the historical background, current prevalence, and contributing factors sustaining the practice of quackery in Pakistan, as well as to propose potential strategies for its control and eradication. MATERIALS AND METHODS: A narrative literature search was conducted across various databases, including PubMed, Science Direct, Embase, Google Scholar, and Scopus, along with official government documents from the Pakistan Medical and Dental Commission (PMDC), Provincial Health Commissions of Pakistan, the World Health Organization (WHO), and news outlets. FINDINGS: Quackery continues to flourish in both rural and urban areas, largely due to systemic challenges such as poverty, illiteracy, lack of access to qualified medical services, and public mistrust of formal healthcare systems. While some quacks may provide short-term symptom relief, the long-term consequences often result in severe health complications or fatalities. CONCLUSION: Addressing the widespread menace of quackery in Pakistan requires a multifaceted and coordinated strategy. This includes stricter policy enforcement, expanded health education programs, strengthened primary healthcare infrastructure, and strategic media engagement for public awareness.