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PRIME TIME: A TWIST IN THE TALE
The Sixth Sense. Fight Club. Every Christopher Nolan movie. The twist is the lifeblood of Hollywood.
Even major big-budget releases ensure that audiences are left reeling at least a couple of times. Think the Snap in Infinity War, or “I’m your father” in The Empire Strikes Back, or that infamous revealer in James Bond: Spectre, which turned four films of the franchise into a… Craigverse, for lack of a better term?
Pakistani dramas have traditionally trod lightly on twists, focusing on being comfort viewing rather than puzzles. Twists, surprises and shocking moments have been reserved for genre dramas rather than the mainstream ones.
Most have done without twists, and the few that have had them were made blindingly obvious to the audience beforehand and the entire suspense was when and how the protagonists would discover them. Think of the villainous Saad Salman in Tanhaiyaan or the convoluted property dispute tying the lead couple in Dhoop Kinaaray.
Cast an eye over some of the memorable recent twists, surprises and reveals that caught us all off-guard in recent Pakistani dramas
However, in recent years, that has shown signs of changing. Let’s take a look at some of the memorable recent drama twists, surprises and reveals that caught us all off guard. Please note that not all twists are in the story itself. You will see what I mean!
GENTLEMAN
What better place to start than the famously twisted Khalil-ur-Rehman Qamar (KRQ) and his wannabe magnum opus — launched with much fanfare but fizzling out into a vapid imitation of ’80s Indian cinema, mixed with KUQ’s idea of what a Western would look like in a Pakistani setting.
This drama launched with a bombastic claim: showcasing the inner workings of Karachi’s gangs in the Korangi area. All the ingredients were present and correct. KRQ’s self-insert in the form of a protagonist, played by Humayun Saeed, ie a gangster with a — sigh! — heart of gold. His cabal of sidekicks who constantly tell themselves, the audience and their boss what a saint he is. A mentor that morphs into a rival — a very interesting character study by Adnan Siddiqui, which had real potential before being swept away in a sea of generic story beats. And a female lead played by Yumna Zaidi, a journalist who becomes the love interest of both rivals.
The gang warfare? Just a backdrop to the awkward love story, with ladies left, right and centre falling head over heels for Khalil… Humayun’s character, the latter making cosmic pronouncements about society and love. Meanwhile, the heroine’s father is perfectly okay with his daughter hanging out with a killer and, in later episodes, egging him on to avenge murders…
The first twist was that the promising set-up devolved into a pathetic, sloppy soap opera, with gang warfare, politics and social commentary used to lend it street cred. The second twist, which is by no means a twist by now knowing KRQ, is Humayun Saeed apparently dying in the end — before we learn in a flash-forward that he lives on.
Sadly, this “twist” is now being repeated to the point of being a trope. Looking at you, Behroopia.
DUNYA PUR
Brilliant from start to finish, Dunya Pur was an epic production, in every sense of the word. The story showcased rivalry between two tribes, with the overlords and their family members stopping at nothing to assert their dominance.
Filmed on location in rural Punjab, the story’s grandeur and scope are perfectly captured by its fast pace, diverse and rich cast, and expert action photography.
So, what was the twist? Oh, where to begin, with at least one major character getting killed in every episode, and the loyalties of hapless and oppressed tribals being traded like currency.
The two protagonists, played to perfection by Khushhal Khan and Ramsha Khan, hailing from opposing tribes in perfect Romeo-and-Juliet fashion, were shown to be ruthless, cruel characters with their own definition of the “greater good.” Let’s just say that they think nothing of taking lives, as long as they deem it right.
There is a helpless police officer caught in the middle, who finally decides that it takes a monster to undermine monsters, and whose final ploy to rid the land of the bloodthirsty tribespeople from both sides results in a bloodbath for the ages, with apparently everyone riddled with bullets.
The final scene, though, reveals that the police vehicles carrying the bodies of the supposedly murdered hero and heroine have “disappeared” with the camera zooming in on the poker face of the police officer, who breaks the fourth wall with his eyes — in resignation, or triumph?
It really needs to be seen to be believed.
DIL WALI GALI MEIN
Let’s leave blood-soaked streets behind for something a bit more familiar: the Ramazan romcom.
The genre has been, for years, a hotbed of bubble-headed romance, flowery dialogue, predictable humour and familiar ‘twists’, consisting of misunderstandings that completely ignore the existence of cell phones, or the fact that, 90 percent of the time, the romantic leads live only a few feet from each other.
Amidst all this, Dil Wali Gali Mein arrived like a completely inexplicable surprise. Kicking off with the romantic leads sitting in court, attempting to get married, the story unfolds within the twisty streets of Lahore’s Walled City, perfectly encapsulating the multi-layered complexity of its geographical backdrop.
The story shows a couple’s search for privacy amid the tightly knit, overbearing presence of Pakistani joint families, their ancient disputes, wars of ego and prying eyes, with the added ‘fun’ of the house actually hosting a full-fledged school. The story explores everything from marital discontent and rising joblessness to gang warfare and house-ownership fraud, and everything in between.
The biggest twist in the story, however, comes when both the bride and the groom decide to leave their households behind to preserve their marriage (and sanity). Further twists: every scene is on location, the hero and heroine retain their squarely middle-class dialects, the dialogue is stunningly realistic and, above all, the quality and the surprises never let up till the very last scene. A must-watch!
TANN MANN NEELO NEEL
This drama has one of the biggest, most heart-wrenching twists of all. What makes it even more depressing is that the abrupt ending of the serial is completely different in tone from the earlier, lighter countenance of the serial.
The story revolves around a couple who are planning their future together as event managers/caterers. There is a villain who, of course, has romantic feelings for the heroine. The story moves along, imparting subtle social messages, but it is the final nine minutes that actually turn the whole thing on its head.
While the couple are managing an event, the villain plays a video of the protagonist dancing in a temple, claiming the dance was filmed in a mosque. The whole crowd turns into a mob and starts chasing the couple. Within minutes, most of the leading cast is dead; their mutilation is conveyed by glimpsed blood, a stray chappal, the heroine’s sash suspended from a power line.
This has to be one of the more harrowing endings ever in Pakistani dramas, none of it foreshadowed in the slightest. A masterstroke, and one of the most effective depictions of religious mob violence that inflicts our society.
PARWARISH
One would think that an ensemble cast spearheaded by Naumaan Ijaz would get centre stage in a drama serial about generational divides. That there would be long lectures about how Gen Z is taking everything too easy. That there would be penance for past sins, swift Divine rebuttal of defiance towards elders, and very public repentances by youth admitting the error of their ways.
Furthermore, that there would be submissive, hysterical wives clutching their daughters to their chests and waiting for lightning to strike their abusers. And that when that lightning would strike, the evil father/husband would be lying on a bed, paralysed, begging forgiveness.
None of that happened. And somehow, that is the biggest twist of all in Parwarish.
Quickly becoming a sensation, with a reputation so powerful that, after decades, Gen X, Y and Z gathered before the television to watch something together, Parwarish managed to subvert expectations at every turn.
A family returns from the USA to the patriarch’s brother’s household, trying to blend in. Between them, they have several kids of school- and college-age. The kids from the US are not abrasive or lacking in manners, the kids who grew up in Pakistan are not models of decency. The parents are complicated characters with their own demons. Mental health is highlighted as an important issue for today’s youth.
The story is quite multi-layered to fully cover here; suffice it to say that, by the time the story draws to its somewhat cookie-cutter conclusion, it has given its multi-generational audience plenty of surprises, delights and shocks along the way.
JAMA TAQSEEM
An educated girl, progeny of liberal-minded parents, marries into a hyper-conservative joint family. Since this is a love marriage, both sets of parents are united in their scepticism about the union, though for different reasons.
The boy’s family is none too pleased about the girl’s outgoing (for them) nature, her willingness to work at an office, and their son’s affection for her. The girl’s family, in turn, fears for their daughter’s sanity and life aspirations, since they know that her in-laws’ mindset would never allow her to fulfil her professional dreams.
Within this mix, the extensive susraal [in-laws’ household] features two elder brothers, their wives and children. The patriarch runs the family business while his wife rules like a benevolent queen — polite, cultured yet firm. The two elder bahus [daughters-in-law] hail from differing social backgrounds, with the eldest one victimising the younger one, based on financial status.
This dynamic, compounded by the elder bahu’s husband’s dominance over his father’s business, enables their son’s perverse tendencies, as he spends much of his adolescence secretly harassing the daughter of his younger uncle.
The first twist comes when, after the son is caught red-handed harassing his cousin, he is expelled from the household by his grandfather and father, despite his mom’s platitudes. This decisive and unanimous action is a breath of fresh air — with no talk of redemption or forgiveness.
Sent to a hostel, the boy is subjected to sexual abuse by fellow residents that, while subtly but unmistakably conveyed, gives him a taste of his own medicine. His ultimate return to the household is also fraught with mental health issues and lingering discomfort; nobody rushes to forgive him.
MERI ZINDAGI HAI TU
Bilal Abbas does the privileged, insufferable antihero perfectly. An ostensibly middle-class girl, nevertheless living in a house that suffers only slightly in comparison to the mansion inhabited by Abbas, becomes the object of his affections.
The “hero” is an alcoholic, a misogynist, a child of a broken home, the heart of the “party scene”, and indulges in every social ill imaginable.
He first encounters the girl and her brother in his Cybertruck, where a roadside spat ensues. The sparring continues at various venues because, of course, they keep running into each other. This culminates in the girl scratching the Cybertruck and the boy burning her “humble” Suzuki Alto to the ground. Yet, when he falls for the girl with “middle-class” values, he vows to change himself and does too, to the utter shock of everyone around him. They are engaged, and the wedding date is announced.
Like in every drama like this, there is an “upper-class” girl who will stop at nothing to make the hero love her instead. A few days before his wedding, she invites him to a party, drugs him and then films him with another girl in some inappropriate situations. The upper-class girl then dumps him at the doorstep of his father-in-law to be, who then proceeds to drop the hero to his home, staring in horror as he rants and raves under the influence.
Twist number one: the father-in-law-to-be keeps mum. Twist two: the very second of the wedding, the graphic video is received on everyone’s cell phones. The wedding is called off. Twist three: In a few episodes’ time, it is proven that everything that happened was a trap for the hero. But now, the hero is not interested in the wedding.
So, what does our brave heroine do? Throw herself at his feet, insisting that she can only redeem herself by marrying him, against the wishes of everyone involved!
The writer of the drama has recently revealed that this stunning story is meant solely to entertain, not to impart any moral lessons. Oh, we didn’t see that coming, did we!
HONOURABLE MENTIONS
Jinn Ki Shadi Unn Ki Shadi provided a neat twist by being a well-paced, well-filmed horror-comedy broadcast in prime time, offering a refreshing change of pace. Biryani, meanwhile, provided a deep social study of the culture of the Urdu-speaking Karachiite populace, in comparison with that of interior Sindh, with the love of the titular dish being one of the common threads. While the drama was unique, it ultimately lost steam and fell prey to the usual love triangle/quadrangle tropes, thus providing an anti-twist.
After decades of predictability and wholesomeness as its hallmarks, the Pakistani drama industry is finally beginning to reflect the variety and diversity of storytelling elsewhere on the planet. The palette is beginning to expand, and there is a drive to capture the younger audience as well.
It is great to see that, as the world and audience expectations evolve, our dramas remain the hallmark of our industry, going from strength to strength and gaining even more popularity outside the country.
The writer is an accountant by profession, a reader, writer, public speaker, poet, trainer and geek by passion.
He can be reached at talhamid@gmail.com
Published in Dawn, ICON, February 15th, 2026
Camouflage and mimicry are among the oldest concepts in biology — taught in classrooms as elegant outcomes of natural selection. Animals that blend in avoid getting eaten. Over many generations, tiny random changes accumulate. Simple, neat, intuitive.
But the deeper scientists look, the more the real world looks less like a simple narrative and more like a puzzle with missing pieces.
Across the animal and plant kingdoms, there are creatures whose mimicry is so precise — down to texture, colour gradients, behavioural nuance and even spectral reflections invisible to the human eye — that the standard explanation strains at the seams. What mechanisms allow an insect or a plant with no brain, no eyes and no cognitive awareness of its surroundings to develop such astonishing resemblance?
Take, for example, walking stick and leaf insects. Some species do more than mimic the general outline of foliage; they reproduce irregular edges, asymmetries and colour variations indistinguishable from real leaves — even under close inspection. Predators that rely on pattern recognition walk right past them. The perception of texture and shading that these insects embody is typically associated with sensory and neural processing — yet they lack anything resembling a central nervous system capable of that.
From mantises matching UV patterns they cannot see to vines copying plastic leaves, nature’s most precise disguises challenge simple evolutionary explanations
Or consider moss-mimicking stick insects filmed in South American rainforests. These insects display not just green surfaces but irregular lichen-like roughness and mottling. Their bodies look like small patches of moss clinging to branches. The patterns of light and dark, the uneven ridges and indentations, and the behavioural postures enhance the illusion. All produced without eyes capable of seeing the moss they so closely resemble.
Then there are the orchid mantises, a case that explicitly challenges assumptions about sensory requirements for mimicry. These insects mimic flowers not only in shape and colour but in ultraviolet reflectance — a visual band invisible to humans. Many of the insects they deceive (bees, flies) see this ultraviolet spectrum. But the mantises themselves cannot see ultraviolet patterns. Despite this, their bodies evolve ultraviolet reflectance that matches real flowers so closely that pollinators land on them routinely, mistaking insect for nectar source.
A plant example intensifies the puzzle. In South America, the vine Boquila trifoliolata can grow leaves that mimic the shape, size, colour and venation of nearby host leaves — even when those hosts are artificial plastic cutouts. This suggests that the vine responds to local cues in its immediate environment with astonishing specificity. Whether the cues are chemical, light-based or something else entirely, the mechanism remains unclear. What doesn’t appear to be required is any form of vision or cognition — yet the results are near-perfect mimicry.
Finally, some caterpillars display mimicry so dynamic that it becomes behavioural rather than purely morphological. Certain tropical caterpillars, when threatened, inflate their bodies and rear up in a way that makes them appear strikingly like a small snake. The patterning, the posture, the timing of the display all combine to trigger hesitation in predators that hunt visually. This behaviour — which requires striking precision of posture and display — occurs in organisms with only rudimentary nervous systems.
What unites these examples is not just mimicry but extreme mimicry: cases where resemblance is fine-grained, context-sensitive and effective against the perceptual systems of other organisms. These are not simple cases of “same colour = hidden”; these are examples where texture, shape irregularity, spectral signatures and behavioural display all converge to create illusions that fool highly tuned biological sensors.
Standard evolutionary theory explains the existence of mimicry — that similar forms can be favoured by selection when they confer survival advantage. But in many of these cases, the path from “random change” to “highly specific resemblance” is not clearly documented. Intermediate stages would not function, or would function poorly. Many of these mimetic features appear as if they encode information about the environment that the organism itself cannot perceive.
The accumulating evidence prompts more questions than answers:
• How do organisms without visual systems produce mimicry tailored to visual systems they do not possess?
• What sensory or molecular mechanisms allow plants to adjust leaf morphology to match local neighbours — including artificial proxies?
• Are our explanations too focused on selection after the fact and not enough on how complex phenotypes originate in the first place?
These questions are not a repudiation of evolutionary biology — they are an invitation to expand it. The natural world continues to defy simple explanations, revealing depths of complexity that resist tidy summary.
By confronting these puzzles with honesty, scientists expand both theory and wonder.
The writer is a banker based in Lahore. X: @suhaibayaz
Published in Dawn, EOS, February 15th, 2026
It was never going to be easy for the International Cricket Council (ICC) to sideline Pakistan from the T20 World Cup, let alone exclude them from the marquee clash against India. That is precisely why, today on February 15, Pakistan will take on India for the ninth time in T20 World Cup history.
It is a rivalry in which Pakistan has managed only one victory so far. Yet win numbers barely matter when these two teams meet, because this contest has grown far beyond cricket and has become arguably the most anticipated fixture in global sport.
In the build-up to this match, uncertainty loomed large. Until just days before the game, there was no official confirmation that Pakistan would play. This followed a dramatic political intervention when the Government of Pakistan announced that it would not permit the Pakistan team to participate in the World Cup group-stage match against India. Despite the tournament featuring 20 teams, this single lucrative fixture dominated headlines across the cricketing world.
The tension had been sparked when Bangladesh approached the ICC, requesting that their World Cup matches be shifted out of India due to political and security concerns. The ICC rejected this request, citing operational challenges, and eventually removed Bangladesh from the tournament, replacing them with Scotland. This decision sent shockwaves through the cricket community and raised serious questions about fairness and consistency in governance.
The most anticipated match in the ongoing T20 World Cup, Pakistan versus India today, almost didn’t happen. But the issue was always about more than a single match. It was about respect, equity and the balance of power in international cricket
At that moment, Pakistan emerged as the only major cricketing nation willing to stand publicly in solidarity with Bangladesh. Pakistan’s position was rooted in recent precedent.
In the 2025 Champions Trophy, India refused to travel to Pakistan and the ICC allowed their matches to be played at a neutral venue in the UAE. Similarly, in the 2026 T20 World Cup, Pakistan was already playing all its matches in Sri Lanka rather than India. Given this background, many believed that Bangladesh deserved the same consideration rather than outright exclusion.
The Pakistan government took a firm stance and instructed the national team not to play India unless the issue was addressed. This moment marked a rare instance of a powerful cricket board openly challenging both the ICC and the Board of Control for Cricket in India (BCCI).
On Sky Sports, former England captain and respected commentator Nasser Hussain weighed in on the controversy. He remarked that it was difficult to imagine the ICC treating India the same way if they had refused to play in a host country at short notice. He further stated that Pakistan was speaking to the ICC and BCCI in the only language that truly moves world cricket, financial leverage and commercial reality.
Hussain also expressed admiration for both Bangladesh and Pakistan, praising Bangladesh for taking a principled stand and Pakistan for defending another full member of the ICC.
The situation reached a turning point on Sunday, February 8, when the Bangladesh Cricket Board (BCB) president and the ICC deputy chairman travelled to Pakistan for high-level talks with Pakistan Cricket Board (PCB) chairman Mohsin Naqvi. These discussions proved crucial and, by Monday evening, a resolution began to take shape.
Following the meeting, the BCB formally requested Pakistan to proceed with the match against India on February 15. Shortly after, the ICC issued a detailed press release outlining key assurances, including recognition of Bangladesh as a valued full member with a proud cricketing heritage, confirmation that their absence from the 2026 World Cup would not harm their long-term cricketing future and a commitment to continue supporting cricket development in Bangladesh, a nation of over 200 million passionate fans.
Most importantly, the ICC confirmed that no financial, sporting or administrative penalties would be imposed on Bangladesh. The BCB also retained the right to approach the ICC Dispute Resolution Committee if it chose to do so. Additionally, Bangladesh was guaranteed hosting rights for an ICC event between 2028 and 2031, ahead of the 2031 Men’s Cricket World Cup, subject to standard procedures.
Following this resolution, the Government of Pakistan officially announced on social media platform X that Pakistan would indeed play India today. This marked a historic moment in cricket diplomacy, where one board stood up for another in the name of fairness and equality among ICC members.
Despite this positive outcome, a misleading narrative began circulating in the Indian media. Several outlets portrayed Pakistan as backing down or surrendering under pressure. This interpretation was far from the truth.
The reality is that India versus Pakistan matches in ICC tournaments generate immense global viewership and revenue. Broadcasters, sponsors, the ICC, BCCI and PCB all benefit significantly from this rivalry. Even during periods of intense public hostility, such as the 2025 Asia Cup, India ultimately played Pakistan despite political tensions at home. At that time, Indian players refused to shake hands as a symbolic gesture, yet they still participated because a full boycott was simply not commercially viable.
What made this situation different was that Pakistan became the first team to openly risk financial losses and potential ICC sanctions by threatening to withdraw from the biggest match in world cricket. This was not a retreat but a calculated stand based on principles.
At the same time, the ICC was never in a position to simply remove or punish Pakistan the way it did with Bangladesh, even though this was exactly what many in India, particularly sections of Indian media and officials close to the BCCI, were hoping for.
Kicking Pakistan out of a global event was never going to be straightforward, because Pakistan is one half of the biggest rivalry in world cricket, a rivalry that generates enormous revenue, viewership, sponsorship and broadcast value for every ICC tournament.
The India versus Pakistan contest is not just another match, it is one of the most commercially powerful fixtures in international sport and the entire financial model of ICC events benefits heavily from its existence. Broadcasters pay premium rights fees largely because of this match-up. Sponsors invest more when these two teams meet. And host countries rely on this game to maximise ticket sales and global engagement.
Because of this, the ICC had to handle Pakistan’s stance with far greater caution and diplomacy than it did with Bangladesh, as any harsh action against Pakistan would have directly damaged the tournament’s commercial appeal and credibility. Unlike Bangladesh, Pakistan sits at the centre of the most profitable rivalry in cricket.
In truth, all three parties, Pakistan, India and the ICC, ultimately wanted this match to go ahead. However, Pakistan ensured that the ICC and BCCI acknowledged the need for fair treatment of all member nations rather than selective enforcement based on power or politics.
In the end, this episode became a win-win situation. Bangladesh secured a future ICC hosting opportunity without any penalties, while Pakistan demonstrated leadership, solidarity and moral courage. More importantly, Pakistan proved that it is not merely a participant in world cricket but a nation willing to challenge the system when fairness is at stake.
This was not just about a single match. It was about respect, equity and the balance of power in international cricket. And on that front, Pakistan emerged with its reputation not only intact but strengthened.
The writer is a cricket correspondent and
digital content creator. X: @abubakartarar
Published in Dawn, EOS, February 15th, 2026
Ten-year-old Ashfaq lives in a bustling household of ten siblings in Sindh’s Ghotki district, some 540 kilometres north of Karachi. Two and a half years ago, when he was just eight, Ashfaq’s world had narrowed to the confines of a bed, his body ravaged by a mysterious, relentless illness.
A second-grade student at that time, Ashfaq arrived at the National Institute of Child Health (NICH) in Karachi in June 2023, cradled by his father and his 25-year-old sister. He was febrile and gasping for air, his skin ghost-white from severe anaemia. Most heartbreaking for the family was Ashfaq’s inability to walk; the very bones that should have carried him through childhood were now sources of agonising pain.
Ashfaq was brought to the paediatric oncology department, run by the medical charity Child Aid Association under the public-private partnership model. As the head of paediatric oncology, I examined Ashfaq and the grim reality became clear: he had been suffering in silence for 10 long weeks and the signs were pointing towards a childhood cancer illness.
Every year, 8,000 Pakistani children are diagnosed with cancer. Less than half receive proper treatment. While childhood cancer survival rates exceed 80 percent in wealthy nations, they plummet below 30 percent in Pakistan. On International Childhood Cancer Day, a doctor reveals how a historic pledge could lead to hope for families across the nation…
ONE CHILD AMONG THOUSANDS
Ashfaq’s story, though tragic, is not unique. It is the hauntingly familiar narrative of countless children who arrive at our centre, their young lives pushed to the brink by delayed diagnosis and systemic hardship.
Childhood cancer, a devastating health concern, affects approximately 400,000 children each year globally, according to World Health Organisation (WHO) estimates issued in February 2025. While survival rates in high-income countries exceed 80 percent, they plummet to under 30 percent in low- and middle-income regions, the WHO notes.
According to non-profit Pakistan Society of Paediatric Oncology (PSPO), around 10,000 children are diagnosed with cancer annually in Pakistan. But less than half receive proper diagnosis and treatment, because of the limited number of paediatric oncology centres and cancer registries. Currently, there are eight paediatric oncology departments across Pakistan. Two cancer registries exist — one in Karachi and the other in Lahore — but both track adult and child patients together.
In October 2025, PSPO launched a national paediatric cancer registration programme, involving multiple hospitals across Pakistan. It aims to maintain accurate and comprehensive records, in order to improve diagnosis, treatment and survival rates for children battling cancer.
Among the most common types of childhood cancers, leukaemia leads with nearly 30 percent of cases. Acute lymphoblastic leukaemia (ALL), a specific, aggressive type of blood cancer, has a high cure rate with contemporary treatments — as high as 80 percent among children, according to the US National Library of Health — yet access remains a challenge.
THE JOURNEY TO SURVIVAL
Following Ashfaq’s arrival at the NICH in 2023, my team quickly worked to diagnose and stabilise him, running blood tests and imaging studies, providing blood transfusions and medications over the next few hours. The results, confirmed the next day by a bone marrow test, revealed a diagnosis of ALL. The family was completely shocked, as they had never imagined a child could have cancer.
Following many hours of counselling, my oncology social workers and I worked to convince the family to arrange accommodation in Karachi. This was crucial because the child needed a long course of chemotherapy and, being immunocompromised, would not have been able to travel back and forth from home.
Ashfaq’s family initially refused, having already depleted their savings on the journey to Karachi. After two or three more sessions, we managed to convince the father — a farmhand — to give the child a fighting chance. I also emphasised that the disease has a good chance of a cure, provided the child receives the complete, necessary sessions of chemotherapy. The family ultimately agreed to stay and begin treatment for their child, full of hope for recovery.
FROM BEDRIDDEN TO THE PLAYGROUND
Today, on International Childhood Cancer Day, Ashfaq’s story represents both tragedy and triumph. After completing his rigorous chemotherapy regimen, he is now in remission — a joyous outcome for his family and our medical team. He returned home to Ghotki, joyfully reuniting with his family
Life began to resume its normal rhythm as he eagerly went back to his studies, embracing the future with renewed vigour. The family was grateful to the medical team for their care and the hospital for providing the child’s complete treatment free of cost, transforming a time of hardship into one of celebration and relief.
Without financial support, the same treatment would have cost at least Rs1 million over the course of treatment — a sum beyond what the family could afford. Given this financial barrier, his recovery demonstrates the power of comprehensive care and community support.
But Ashfaq’s access to such care is the exception, not the rule.
CLOSING THE GAP
Unfortunately, paediatric cancer treatment outcomes in low- and middle-income countries (LMICs) significantly lag behind those in high-income countries. One reason for this disparity is accessibility to cancer care services for children with cancer.
Another major reason is high treatment abandonment rates — failure to start or complete curative-intent therapy after a cancer diagnosis. Broadly, lack of financial resources, medical facilities, and social support services contribute to the poor outcome rates we see in LMICs. Each of these barriers to treatment intersects and exacerbates the others.
In July 2025, Pakistan became the second country in the WHO-designated Eastern Mediterranean Region to join the Global Platform for Access to Childhood Cancer Medicines, co-founded by WHO and St Jude’s Children Research Hospital in Tennessee, USA. The platform aims to address the lack of treatment affecting at least 50 percent of paediatric patients and to increase their survival rate from 30 percent to 60 percent by 2030.
This is made possible thanks to the pledge of the government of Pakistan, the professional commitment of the Pakistan Society of Paediatric Oncology and the dedication of national stakeholders to standardise childhood cancer care and establish training and build research infrastructure in the country, thereby tackling low survival rates due to access issues.
Today, Ashfaq runs and plays with his siblings in Ghotki — a simple joy that seemed impossible when he arrived at our doors unable to walk. But for every child like him who makes it home, there are countless others who never reach us at all.
The question isn’t whether we can save these children. We know we can. The question is whether we will reach them in time.
The writer is head of the paediatric oncology department at NICH, Karachi, and chief oncologist of the medical charity Child Aid Association
Published in Dawn, EOS, February 15th, 2026
لاہور میں خدمت کا رمضان مہم کا آغاز، شہر بھر میں سحری دسترخوان سج گئے
غزہ میں اس سال بھی رمضان ٹوٹے گھروں، بکھرے خاندان اور شہدا کی یاد کیساتھ شروع
افطاری کیلیے اداکارہ صبا فیصل کس وقت فروٹ چاٹ بناتی ہیں؛ مداح حیران رہ گئے
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