Contech International has been supporting Public Health England on IHR compliance and IDSR in Pakistan since 2015, initially for Punjab and federal level, but later extended to Federal, Khyber Pakhtunkhwa (KP) and Sindh provinces. The key activities at federal level include the finalization of workplan for implementation of Phase, selection of DHIS2 as the surveillance tool for IDSR, preparation of guidelines and Case Definitions for Infection Disease Surveillance, and collection of information from provinces for setting up IDSR hubs. Contech worked with ODI in 2015 to conduct Political and Institutional Economy Analysis (PIEA). This was a cross-sectional study that involved desk review and qualitative research. Data was obtained from academic databases, published academic and grey literature, and 45 key informants were interviewed. The results of the PIEA were intended to inform the implementation of technical strategies for improved IDSR and IHR compliance and the Health Security Roadmap.