IBA KARACHI

18th amendment and

impact on the
healthcare sector
Muhammad Khizer Alam ERP 11805
Business Government and Society

18th amendment and impact on the healthcare sector

The 18th Amendment was passed by Pakistans Parliament on April 8,
2010 and brought about several major changes in Pakistans
constitution. It reversed several changes that had been made over the
past three decades by Pakistans military dictators that were against
the spirit of parliamentary democracy. One of the biggest examples
was the scrapping of Article 58 2(B) which was hailed as one of the
biggest milestones in the democratic history of Pakistan. It also gave
much needed and talked about provincial autonomy to Pakistan
Provinces.
Having said all this, its impact was deeply felt by different sectors in
the Pakistan economy that includes but is not limited to the healthcare
sector, energy sector and the educational sector. This write up here will
aim to analyze the impact of the 18th amendment on the health sector
of Pakistan.
After the 18th Amendment, Pakistan is left without a federal regulator of
the health sector. The 18th amendment effectively devolved the power
of the federal health ministry to the provinces, thereby making health
a purely provincial subject. Although, the devolution of power is a
welcome step in purely theoretical terms but in the case of a
developing nation like Pakistan, the on ground realities differ greatly
which makes this decision a tricky one ; the reason being that
provincial government in many cases lack the institutional capacity to
deliver on the effective performance level that is required on the
subjects being devolved. Industry players said the PPMA(Pakistan
pharmaceutical manufacturers association) took 40 years to develop drug
testing and registration mechanism, but it was not possible to create a
similar system in the provinces within a year.

Moreover, the drug act of 1976 that governs the pharmaceutical sector
of Pakistan and the regulatory structures formed under it for
registration, manufacturing , quality assurance has ceased to exist
after the 18th Amendment . There is no provincial legislation presently
to fill this void which has raised concerns over the scope and matter of
drug regulation in the country and especially at a time when nations

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18th amendment and impact on the healthcare sector

are moving towards centralization with regards to law making
governing drug regulations.
A ray of hope is in the eminent formation of a national drug regulatory
authority, approved by the federal cabinet in 2002, and since
languishing for lack of follow-up, under the auspices of the
Implementation Commission formed under the 18th Amendment.

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