Help offered, help hindered

EDITORIAL: That a group of Pakistani-origin physicians based in the United States must request facilitation just to invest in their own country says more about Islamabad’s governance failures than it does about their goodwill.

The prime minister’s latest directive to the Economic Affairs Division to “address and resolve all issues hindering investment” in the health sector is the kind of instruction that has been issued countless times before.

The problem is not the absence of statements; it is the absence of results. Everyone already knows what the bottlenecks are. It’s just that nobody in the state machinery seems prepared to remove them.

The meeting itself was unremarkable in its structure. A delegation of respected physicians and professionals expressed a strong interest in strengthening Pakistan’s healthcare infrastructure. The prime minister welcomed the sentiment. He asked the EAD to work with them and design a practical roadmap.

The usual reassurances were exchanged. And yet, buried beneath this familiar choreography is the same old truth: even Pakistanis who want to invest face the same barriers that deter foreign investors. The expertise, capital and intent exist; the system continues to reject them.

What makes this pattern so corrosive is the complete predictability of the failure. The obstacles these physicians are encountering are not mysteries. They are the well-known by-products of a regulatory environment that is outdated, opaque and vulnerable to discretionary interference.

Sectors as critical as healthcare require clarity, consistency and credible governance. Instead, investors find themselves dealing with overlapping jurisdictions, slow decision-making and ministries that promise coordination but deliver inertia. The diaspora is often described as an asset. But it cannot perform that role if the state refuses to create a framework in which its contribution is viable.

The broader implication is impossible to ignore. If highly qualified Pakistani doctors — motivated not just by opportunity but by a desire to give back — cannot navigate the system, what hope is there of attracting global capital? Foreign investment is not simply about incentives; it is about confidence. It requires the assurance that rules will not shift arbitrarily, that approvals will not be trapped in administrative loops, and that the state will facilitate rather than obstruct.

Pakistan’s recent economic performance leaves little doubt that this confidence is in short supply, and this episode only reinforces that perception.

Even the IMF, in its recent governance and corruption assessment requested by the government itself, highlighted weaknesses that sit at the heart of this problem. The Fund talked about persistent challenges in internal controls, audit frameworks and the implementation of reforms. These are not peripheral issues. They define the investment climate.

When integrity mechanisms are weak and administrative processes slow, the cost is measured not only in capital outflows but also in missed opportunities from those who still believe in the country and want to contribute.

Yet official responses to these concerns continue to follow a familiar pattern. The government acknowledges the problem. It welcomes proposals. It forms committees. It promises action. What it does not do is restructure the architecture that drives investor behaviour.

There is no political will behind reform, and without that will, even the most sincere commitments fade into the background noise of policy announcements. That is the environment these physicians are entering. It is not surprising that many who try eventually give up.

The tragedy is that investment in healthcare should be the easiest kind to endorse. It strengthens human capital, creates skilled employment and improves national wellbeing. But good intentions cannot overcome systemic dysfunction. Until the government proves that it is capable of more than issuing directives, episodes like this will continue to recur: earnest offers of help colliding with a state apparatus unable to accept them.

If Pakistan is serious about revitalising its economy, it must start by clearing the path for those who are already willing to invest. The diaspora cannot substitute for structural reform, but it can be a powerful partner — provided the government stops treating goodwill as an infinite resource.

Copyright Business Recorder, 2025