he controversy over Imran Khan’s treatment following the Supreme Court orders regarding his medical check-up has bought the Pakistan Tehreek-i-Insaf a new lease of relevance. The party is now revisiting its policy regarding its efforts to secure the release of its founding chairman. The Pakistan Muslim League-Nawaz led government, meanwhile, is still struggling to find a secure antidote to Khan’s ever-increasing popularity.

In the aftermath of the recent episode, the PTI has come up with a multi-pronged strategy to rekindle its movement for Khan’s release. From continued legal battles and raising the issue at international levels to ensuring a strong show in the parliament and initiating a long march, everything is now on the table.

Almost three years into Khan’s incarceration, the political equation surrounding him remains remarkably unchanged. Government’s manoeuvres to contain his influence has failed to dent his popularity.

The situation has now reached a dangerous phase. Khan’s reported health problems are now being turned into a trigger for political confrontation that can push the government down a difficult road. If his health deteriorates significantly while in jail, public reaction can be far harder to manage than the protests that followed his arrest in 2023.

For now, large-scale mobilisation remains limited.

The authorities have succeeded in suppressing violent unrest that accompanied Khan’s detention. The opposition has struggled to recreate that momentum. But the absence of mass protests should not necessarily be interpreted as the disappearance of public sympathy for Khan.

Political pressure can remain dormant for long periods before being triggered by an event that changes the public mood.

That possibility has become more evident following a virtual press briefing by Khan’s sons—Kasim and Sulaiman Isa Khan—international counsel Jared Genser and Sayed Z Bukhari. The family presented an alarming account of Khan’s condition and his treatment in prison.

Kasim described his father as having spent nearly three years, mostly in solitary confinement, in a cell lacking natural light and alleged that delayed medical treatment had resulted in the loss of most of the vision in one eye. Sulaiman said the family had not spoken to their father for around six months and had been unable to visit him for years.

“The entire world is asking Pakistan to do one thing: obey its own courts,” he said.

Genser went further, describing Khan’s treatment as “slow-motion murder” and arguing that the actions against Khan and his wife, Bushra Bibi, were incompatible with a functioning democracy.

These are serious allegations.

These are being made against the backdrop of an increasingly contentious dispute over medical access and judicial orders. The government, for its part, has rejected claims of prolonged isolation or inadequate medical treatment, pointing to records of meetings and medical examinations.

The next battle will be fought in the courts. The immediate controversy centres on an August 18 Supreme Court order directing that Khan be transferred within 48 hours to the Shifa International Hospital. An independent medical panel, including his personal physician, was to examine him. Instead, authorities moved him overnight under heavy security to the state-run Pakistan Institute of Medical Sciences. He was examined, declared ‘fit’ and returned to Adiala Jail the same morning.

It does not serve the government’s broader interests to allow Khan to consume political space at a time when Islamabad is seeking to consolidate the gains of its recent diplomatic initiatives. Domestic instability inevitably limits the room available for economic and foreign-policy manoeuvring.

The challenge, then, is not simply how to keep Imran Khan in prison. It is how to prevent his imprisonment from continuing to increase his political worth.

Khan’s refusal to compromise, as portrayed by his supporters, has helped preserve his image as a leader who would rather remain in prison than accept terms that dilute his political position. His health concerns now add another layer of urgency. If the state is seen as disregarding either his medical needs or court orders, the controversy could move beyond the familiar boundaries of Pakistan’s polarised politics.

Containment may still be possible, but the margin for error is shrinking. Khan’s popularity, his physical condition, the credibility of the judicial process and the growing international scrutiny over his treatment have converged into a problem that cannot be managed indefinitely through detention and denial alone.

Khan’s lawyers say the use of a decoy and disregard of court instructions justify contempt of court proceedings. A contempt petition has been filed. The government, too, has appealed the court order. What once was merely a question about Khan’s custody is now also about whether the custodians of the state are operating within legal parameters.

His sister, Uzma Khan, who has filed a contempt petition against the government, will be seen in mid-September; she has filed another request to be heard earlier.

In custody since last August, after a string of convictions that the former premier and his supporters deem politically motivated, Khan has been the subject of UN concern regarding his confinement and treatment. The government firmly contests any claims of mistreatment, insisting it has provided due medical attention.

The main challenge facing the authorities is political. To remain politically potent, Khan does not need to be released. Continued imprisonment, particularly with reports of his worsening health, only fuels the narrative of victimisation he is so adept at cultivating.

As such, the government has a limited range of options. Further restrictions could reinforce the perception that they are powerless in handling Khan politically. Concessions will be seen by his supporters as victory. They will then claim that their sustained pressure has finally delivered.

Then there are other political developments. The JUI-F chief Maulana Fazlur Rehman has made the opposition’s Tehreek-i-Tahaffuz-i-Ayeen-i-Pakistan bloc stronger by committing his support. This could amplify their show of power in and outside the parliament.

The PTI’s long march is set for September 27. It has the potential to rekindle the party’s street influence at a time when the hearing of the contempt petitions will be in progress.

Perhaps the wisest course of action for the government is to lower the temperature, without appearing to cede control. Greater transparency regarding Khan’s health, access to independent physicians and a demonstration of compliance with judicial orders could prevent the controversy from spiralling.

Prudence is essential on account of Pakistan’s political and economic instability. The nation faces numerous sources of public frustration. The global civil unrest index by Verisk Maplecroft ranks the country as one with relatively high risk of civil disorder.

Thus far, the authorities have succeeded in curbing street demonstrations. However, sentiments relating to underlying deep-seated grievances persist.

The writer is a journalist, teacher of journalism, writer and analyst. His X handle: @BukhariMubasher.