Sindh has emerged as a national and global model in emergency cardiac care, where the National Institute of Cardiovascular Diseases (NICVD) Karachi and its expanding network of 11 cardiac centres across the province are offering round-the-clock, completely free emergency angioplasty (Primary PCI)—having already performed over 138,000 procedures since the programme’s launch in 2017.
In stark contrast, no public hospital in the federal capital or many other parts of the country currently offers Primary
PCI after dark, leaving countless lives at risk during heart attack emergencies.
Sindh’s public health initiative, on the other hand, has delivered an estimated Rs34 billion worth of advanced cardiac procedures entirely free of charge—making it the largest publicly funded Primary PCI programme in the world.
Launched in 2017 with an initial grant of Rs380 million from the Sindh government under the vision of Pakistan Peoples Party (PPP) Chairman Bilawal Bhutto Zardari, the programme began at NICVD Karachi and has since expanded to Larkana, Tando Muhammad Khan, Hyderabad, Sehwan, Sukkur, Nawabshah, Mithi, Khairpur, Karachi’s Lyari, and most recently Baldia Town.
The roll-out was gradual, with new centres opening almost every year as part of a long-term expansion strategy.
The newest facility in Baldia, inaugurated this year, now also serves parts of Balochistan, including Hub and Lasbela, bringing free heart attack treatment to previously neglected segments of population.
“All 11 centres operate 24/7, and not a single rupee is taken from any heart attack patient,” said Prof Dr Tahir Saghir, Executive Director of NICVD.
“Primary PCI is a race against time—it must be done immediately. In Pakistan, most heart attacks occur at night or early morning, so our centres are built to save lives when others are closed.”
NICVD Karachi alone has performed 71,558 Primary PCIs to date.
Other centres have also made significant contributions: Hyderabad (13,728), Sukkur (13,580), Tando Muhammad Khan (9,839), Larkana (7,335), Nawabshah (5,445), Sehwan (5,039), Mithi (3,730), Khairpur (4,014), Lyari (3,983), and Baldia (111).
Each centre is fully equipped with a catheterisation lab, trained interventional cardiologists, nurses, and cath lab technicians.
More importantly, they are structured to provide intervention within the “golden hour”—the first 60 minutes after a heart attack when emergency treatment can prevent irreversible damage or death.
The programme’s success is particularly visible in rural and underserved regions.
In Mithi, NICVD teams have even treated Chinese engineers working on the Thar coal project who suffered heart attacks.
“They were amazed to find such high-level cardiac care, entirely free, in the middle of the desert,” Prof Saghir recalled.
To ensure early diagnosis and transfer, NICVD has also deployed a growing number of Chest Pain Units (CPUs) in Karachi and throughout Sindh.
These units are equipped to conduct ECGs, stabilise patients, and transport them to the nearest cardiac centre via ambulance.
“Our integrated approach allows us to get patients to the cath lab within an hour of symptom onset,” Prof Saghir added.
“This has significantly reduced mortality from heart attacks across Sindh.”
The NICVD model has also disrupted the private healthcare market in Karachi.
Many private hospitals that previously charged between Rs250,000 to Rs500,000 for a single angioplasty are now seeing reduced patient numbers. “People now know they can receive the same—or better—treatment for free,” a public sector cardiologist said.
On the other hand, public hospitals in the federal capital, including PIMS, remain unable to offer Primary PCI after sunset, despite having the equipment and trained cardiologists. A lack of support staff and operational planning continues to leave patients vulnerable at critical hours.
Prof Saghir urged other provinces to learn from Sindh’s experience. “We’ve shown it’s not only possible—it’s sustainable. With the right leadership and commitment, this model can save lives nationwide.”
As cardiovascular disease remains one of the leading causes of death in Pakistan, Sindh’s NICVD-led cardiac network offers hope—and a roadmap—for a more responsive, equitable public health system.
Published in News Daily on 02-July-2025.