LAHORE: Punjab Chief Minister Maryam Nawaz Sharif has approved an allocation of Rs1.2 billion for a comprehensive stroke care programme that health officials say will transform the lives of thousands of patients across the province. The initiative, described as one of the most ambitious public-sector stroke programmes in Pakistan, focuses on early diagnosis and timely treatment, the two most critical factors in reducing death and lifelong disability caused by stroke.
Stroke is emerging as a major health crisis in Punjab. Estimates show that the incidence of stroke in the province ranges between 153 and 250 per 100,000 population, resulting in nearly 250,000 new cases every year. Public-sector data reveals that 47,560 stroke patients admitted to different hospitals during 2025, out of which 12-15,000 were treated, underlining the growing pressure on the healthcare system. Medical studies indicate that around 70 to 75 per cent of strokes are ischemic, caused by blockage of blood vessels, while 25 to 30 per cent are hemorrhagic, caused by vessel rupture.
Doctors stress that stroke is a race against time. For ischemic stroke, clot-busting drugs such as TPA or TNK are effective if employed within four and a half hours of symptom onset, while mechanical thrombectomy can benefit selected patients up to 24 hours. International data shows that only a small fraction of patients reach hospitals within this critical window, mainly due to lack of awareness and limited services. A CT scan is essential at the earliest stage to determine the type of stroke and begin appropriate treatment.
At present, Punjab has one comprehensive stroke centre at the Punjab Institute of Neurosciences in Lahore and only 15 primary stroke centres capable of providing IV thrombolysis. Advanced procedures such as mechanical thrombectomy are available at just two centres, one in Lahore and the other in Rawalpindi. In 2025, public hospitals managed 575 patients with clot-busting drugs and 166 patients with mechanical thrombectomy, with most advanced cases concentrated in major cities. The hospitals included in the current programme are Punjab Institute of Neurosciences, Lahore; Bahawalpur Victoria Hospital, Bahawalpur; Allama Iqbal Teaching Hospital, Dera Ghazi Khan; Allied Hospital, Faisalabad; DHQ Teaching Hospital, Gujranwala; Mayo Hospital, Lahore; Services Hospital, Lahore; Sir Ganga Ram Hospital, Lahore; Nishtar Hospital, Multan; DHQ Teaching Hospital, Narowal; Sheikh Zayed Hospital, Rahim Yar Khan; Holy Family Hospital, Rawalpindi; Allama Iqbal Memorial Hospital, Sialkot; DHQ Hospital, Bhakkar; and DHQ Hospital, Layyah. These hospitals provide a combination of IV thrombolysis and, where available, mechanical thrombectomy, with referral systems in place for complex cases.
Under the new plan, the government will use existing cardiology infrastructure while gradually expanding neurology capacity. IV thrombolysis services will be rolled out in phases, increasing the number of primary stroke centres from 15 to 54 hospitals across Punjab. During the first phase in 2025-26, 30 tertiary hospitals with functional CT scanners will be enabled to provide clot-busting treatment. In 2026-27, 24 district headquarters hospitals with CT facilities will be added. Tele-neurology support will be introduced for hospitals without in-house neurologists, and emergency physicians will be trained under international guidelines.
Mechanical thrombectomy services will also be expanded. While PINS Lahore and Rawalpindi Institute of Cardiology currently provide this treatment, selected cardiac institutes will temporarily serve as thrombectomy-capable centres after proper training. The Cardiology Institute in Multan will become the first such centre in South Punjab, with others to follow after further capacity building. Each centre will have neurologists posted to ensure safe and effective care.
For the first year, the programme targets 2,000 patients for IV thrombolysis at an average public-sector cost of Rs350,000 per case, and 500 patients for mechanical thrombectomy at an average cost of Rs800,000 per case. The total annual expenditure, including medicines, imaging, consumables and taxes, has been estimated at Rs1.2 billion.
