Islamabad: At a time when public hospitals in the federal capital are unable to offer life-saving heart attack treatment at night, a groundbreaking initiative by the National Institute of Cardiovascular Diseases (NICVD) Karachi is transforming emergency cardiac care in Sindh where a network of 11 state-of-the-art cardiac centers is providing round-the-clock, free emergency angioplasty (Primary PCI) services.
The NICVD and its allied centers have already conducted over 138,000 procedures since 2017, saving thousands of lives across the province.
Had these Primary PCIs been done in private facilities, they would have cost patients more than Rs. 34 billion, making NICVD’s program the largest publicly funded free heart attack treatment initiative in the world.
Launched in 2017 with an initial Rs. 380 million grant from the Sindh government, the program was envisioned by PPP Chairman Bilawal Bhutto Zardari to ensure equitable access to emergency cardiac care.
Starting from NICVD Karachi, it now operates in Larkana, Tando Muhammad Khan, Hyderabad, Sehwan, Sukkur, Nawabshah, Mithi, Khairpur, Lyari, and most recently, Baldia Town.
The program expanded gradually, with each new center added over the years, as evident from official data. The latest center in Baldia now also caters to patients from neighboring Balochistan, including Hub and Lasbela, offering much-needed access to life-saving cardiac care in the region.
“All 11 centers work 24/7, 365 days a year, and we don’t charge even a single rupee from any heart attack patient,” said Prof. Dr. Tahir Saghir, Executive Director of NICVD. “Primary PCI is only effective if it’s immediate. Most heart attacks happen late at night or early in the morning, which is why our centers never close.”
NICVD Karachi has performed the highest number of Primary PCIs—71,558—followed by Hyderabad (13,728), Sukkur (13,580), and Tando Muhammad Khan (9,839). Other centers include Larkana (7,335), Nawabshah (5,445), Sehwan (5,039), Mithi (3,730), Khairpur (4,014), Lyari (3,983), and Baldia (111) since its launch in early 2025.
Every center has a fully functional cath lab, interventional cardiologists, nurses, and technicians trained to perform angioplasty within the “golden hour”—the crucial first hour after a heart attack, where timely treatment prevents permanent heart damage.
In remote areas like Mithi, even Chinese engineers working on the Thar coal project have benefited from the free service. “Chinese engineers were amazed to receive world-class cardiac care without paying a single rupee, in such a remote desert region,” Prof. Saghir shared.
Backing these centers is a vast network of Chest Pain Units (CPUs), placed in busy areas of Karachi and key locations in interior Sindh. These units quickly assess, stabilize, and transfer patients to the nearest NICVD center, often within minutes.
“This integrated system allows us to bring patients to the cath lab table within an hour,” Prof. Saghir added. “It’s one of the key reasons we’ve managed to significantly reduce mortality from heart attacks in Sindh.”
The success of the NICVD program has caused a major shift away from private hospitals, many of which charge Rs. 250,000 to Rs. 500,000 for emergency angioplasty. “Why would people pay when they can get the same or even better care for free?” a senior cardiologist commented.
In sharp contrast, public hospitals in Islamabad, including the Pakistan Institute of Medical Sciences (PIMS), still do not offer Primary PCI services after dark, despite receiving patients from across Punjab, KP, Azad Kashmir, and the capital region.
Prof. Saghir called on other provinces to replicate Sindh’s model. “We’ve shown that with political will and professional leadership, such services can be made available even in remote districts. It’s time others followed suit.”
As cardiovascular diseases continue to claim thousands of lives annually in Pakistan, NICVD’s model stands as a national example of how public healthcare can deliver free, quality treatment—at scale and on time.
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