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United Nations aid agencies have provided assistance to hundreds of thousands of victims of floods but relief operations have yet to reach an estimated six million people, a UN report said.
The lives of 16 million people have been disrupted by one of the worst catastrophes in Pakistan's history. Six million still need food, shelter and water, the UN said in a statement.
Highlighting the scale of the disaster, Prime Minister Yousuf Raza Gilani said in an Independence Day speech that the country faces challenges similar to those during the 1947 partition of the subcontinent, Reuters reported.
A third of Pakistan is now under water, and fresh rainfall threatens two more waves of flooding in the southern Sindh province.
Pakistan flooding has left 20 million people homeless, Gilani said Saturday, as authorities confirmed a cholera case and expect more.
Gilani, whose estimate on the number of homeless far exceeds the United Nations estimate of 16 million, spoke to the nation in an address marking Pakistan's independence from Britain 63 years ago, the BBC reported.
Pakistan's worst flooding in 80 years canceled official celebrations as health workers prepared for a possible epidemic of water-borne illness in the nation of 180 million people.
Maurizio Giuliano, of the United Nations Office for Humanitarian Affairs, said one case of cholera has been confirmed in the town of Mingora, in the Swat valley and 36,000 people were suffering from watery diarrhea, a symptom of the disease.
"Given that there are concerns about cholera, which is a very deadly disease, what we've started to do instead of testing them for cholera is to treat everyone for cholera," Giuliano said.
"We're not suggesting that everyone who has acute watery diarrhea has cholera, but cholera is certainly a concern and that's why we're stepping up our efforts to treat cholera."
UN Secretary General Ban Ki-moon is expected to visit Pakistan this weekend. Zamir Akram told the BBC that the extent of the flooding's toll is just being realized worldwide and expressed hope relief would come faster.
"I don't think that Pakistan has been abandoned. As the gravity of the situation and the extent of the damage that has been caused by these unprecedented floods spreads around the world, the response is growing," he said.
The Guardian editorialized on Saturday, "In these crude terms, the floods in Pakistan have what it takes to turn a disaster into a fundraising opportunity. They were sudden and catastrophic, affecting rich, poor and poverty-stricken alike. Most importantly, the world's media are there. The urgency of the need is on our screens and in our newspapers day and night."
The United Nations is now calling for nearly half a billion dollars in international aid for Pakistan, in the face of a weird resistance on the part of the world community to step up and help. When Pakistan faced a relatively minor security threat from a small guerrilla movement of Pakistani Taliban in the northwest, the world community ponied up billions in aid. This much more devastating flood is not generating the same enthusiasm for helping the country.
Earlier, President Asif Ali Zardari said there should be no official celebrations.
In his Independence Day message, he said: "The enthusiasm of Independence Day this year ... has been dampened because of the unprecedented floods that have devastated the lives of thousands of people and left scars on the lives of several hundred thousands more in all parts of the country.
"I salute the courage and heroism of flood victims and assure them that the government will do everything possible to alleviate their sufferings."
Thousands of families were torn apart after the bloody partition into Hindu-dominated India and Muslim-majority Pakistan that led to the flight of at least 10 million refugees in the greatest migration in recorded human history.
Pakistan's government, overwhelmed by the disaster, has been accused of being too slow to respond to the crisis with victims relying mostly on the military and foreign aid agencies for help.
Anger is spreading, raising the possibility of social unrest. In Sindh province, flood victims complain of looting and there are signs of increasing lawlessness, Reuters reported.
"The government has given us half a carpet. We have received rice and medicine from the government but no tent," said 22-year-old laborer Zarsheed.
The economic costs of the flooding are staggering, making it tougher for the government to carry out strategic spending in former Taliban bastions to win public support.
Wheat, cotton and sugar crops have all suffered damage in a country where agriculture is a mainstay of the economy.
World Bank President Robert Zoellick said the floods may have destroyed about $1 billion worth of crops and that the Bank was considering reprogramming about $900 million in aid.
The International Monetary Fund has warned of major economic harm and the Finance Ministry said it would miss this year's 4.5 percent gross domestic product growth target.
In his speech Gilani called on Pakistanis to rise to the occasion and face challenges posed by the floods.
"The nation faced the situation successfully at that time (of the partition) and InshaAllah (God willing) we will emerge successful in this test," he said
"World Bank President Robert Zoellick said the floods may have destroyed about $1 billion worth of crops and that the Bank was considering reprogramming about $900 million in aid."
With how many strings attached???