By Dr. Quaid Saeed Akhunzada
On August 26, 2026, a fire tore through the nursery of the Mother and Child Health Centre at the Pakistan Institute of Medical Sciences (PIMS) in Islamabad, killing at least 14 newborn infants in what should have been the most protected ward in the country’s most prestigious public hospital. Parents watched a locked door separate them from their children as smoke filled the room; only one baby was pulled out alive. In the weeks that followed, as investigators picked through the wreckage of burnt incubators and melted wiring, a second story began to surface, not about faulty air conditioners or overloaded plugs, but about the regulator that was supposed to have caught all of this years before a single flame was lit.
The Islamabad Healthcare Regulatory Authority (IHRA) was established under the Islamabad Health Regulation Act, 2018, with a clear mandate: to license healthcare establishments in the capital, enforce minimum safety standards, and suspend or revoke the registration of any facility that repeatedly failed to comply. Dr Muhammad Riaz Shahbaz Janjua was appointed a member of the IHRA Board in October 2024, and was soon after unanimously elected its chairman. It was a position of real consequence, the very authority meant to stand between a hospital’s negligence and a family’s tragedy.
Yet even before the PIMS fire, questions had already been raised about the Board Janjua chaired. In 2025, Dawn and other outlets reported allegations that IHRA Board members were using their regulatory positions for personal benefit. One board member’s own clinic had received a deficiency notice in May 2024 for failing to meet regulatory requirements, yet went on, after that member’s October 2024 appointment to the Board, to receive a “lifetime registration certificate”, a category that does not exist under Pakistan’s healthcare regulations, which mandate annual renewal. Janjua himself faced a parallel allegation: that his position atop the very body meant to regulate Islamabad’s hospitals sat uneasily beside his ownership of HBS Dental Hospital, one of the facilities under IHRA’s jurisdiction. When the matter reached the National Assembly’s health committee, Janjua maintained that the conflict had been disclosed in his CV before appointment and that fee revisions had been Board-approved. The committee took the matter up formally. And then, as so often happens in our institutional life, the file and the issue went quiet. No removal followed. No structural fix was made. The chairman continued in office, and the authority continued operating exactly as before, until 14 children paid for that inertia with their lives.
In the aftermath, IHRA’s own Board came under fire from parliament for something just as damning as any conflict of interest: it had reportedly not conducted a comprehensive inspection of PIMS in years, despite the CDA’s own fire department having flagged fire-safety non-compliance at the hospital. On August 31, the government accepted Janjua’s resignation as chairman and board member, with Janjua himself citing circumstances that had compromised the authority’s autonomy. Within days, five more board members followed him out the door, bringing the total resignations to nine, reportedly in protest at the ministry’s tightening grip and the public backlash the Board faced once the fire made its failures impossible to ignore.
Reading through this timeline, I could not help but recall a couplet of Mirza Ghalib that seems to have been written for exactly this moment:
Kī mire qatl ke baa’d us ne jafā se tauba
Hā.e us zūd-pashīmāñ kā pashīmān honā
(After she had slain me, then from torture she forswore
Alas! the one now quickly shamed was not so before)
How precisely this fits our present condition. The remorse arrives only after the killing is done. The conflict-of-interest questions were raised in 2025; the parliamentary committee took the matter up; a resolution for accountability was tabled, and none of it moved an inch until fourteen infants had already burned. The resignations we are now witnessing are not proof of a system that corrects itself. They are proof of a system that only ever reacts to bodies, never to warnings.
This is the question that ought to trouble us long after the headlines fade: why must the red flag be soaked in blood before anyone salutes it? A regulator flagged for compromised independence in 2025 should not have still been sitting atop its Board, unchanged and unaccountable, in August 2026. A hospital cited for fire-safety non-compliance should not have been allowed to operate its most vulnerable ward for eight more years without consequence. Somewhere between the notice and the negligence, between the allegation and the ash, someone was supposed to act, and did not.
Chairmen and boards can resign. Files can be closed. But until we build a system that responds to the first warning rather than the fourteenth coffin, the next fire is not a possibility we must guard against; it is a certainty we are already writing.
Ends