Pakistan has taken positive strides in recent years to alleviate core development challenges. Nevertheless, the stresses of an economy under pressure, poverty, gender inequality, inequities and the demands of sustainable development remain, and have been exacerbated by both natural disasters and crises. The recurring large-scale floods, earthquakes, droughts, and landslides are all external shocks which have impacted on the people, their livelihoods as well as on national infrastructure. The floods of 2010 affected more than 18 million people and caused an estimated $10 billion in damages. They were followed by heavy monsoon rains in September 2011, which affected some 9.7 million people in Sindh and Balochistan. Natural disasters have disproportionately affected the excluded and the vulnerable.