IGH provides technical support to CDC’s Division of Foodborne, Waterborne, and Environmental Diseases Branch for stakeholder engagement and program implementation for extreme drug-resistant (XDR) typhoid in Pakistan’s Sindh province. IGH’s Typhoid Fever Implementation Specialist is based in Karachi, Sindh, and coordinates routinely with the Integrated Disease Surveillance & Response Unit (IDSRU). Additionally, IGH personnel participated in key stakeholder engagement and prioritization workshops for XDR activities in Sindh in October and November 2024 and are providing technical assistance to the IDSRU and stakeholders to implement key recommendations, draft policies, and standardization of surveillance and reporting measures.