Pakistan’s Airport Offloading Rules: What the New IHC Judgment Means for Travellers

A September 2026 Islamabad High Court judgment has placed new limits on the use of Pakistan’s Passport Control List. Here is what the ruling means, what it does not change, and what Pakistani travellers should do if they are stopped at immigration.

I know the small anxiety that begins before an international flight from Pakistan.

You have the passport. The visa is valid. The ticket sits on your phone. Yet somewhere between the airline counter and immigration, another question remains: Can I still be stopped?

For Pakistani travellers, that fear is not imaginary. Reports of passengers being offloaded have circulated for months, particularly among people travelling on visit visas. Families heading abroad to see their children worry about it. First-time travellers worry even more.

A recent Islamabad High Court judgment has now placed an important legal limit on one part of that system. It has not abolished immigration checks. Nor has it given every passenger with a visa an automatic right to board.

What the court actually decided is more interesting.

The case behind the judgment

The case involved a Pakistani citizen named Moinuddin, who arrived at Islamabad International Airport on December 18, 2025, intending to travel to Saudi Arabia for Umrah. He had a valid Pakistani passport, a Saudi visa and a confirmed ticket. Immigration authorities nevertheless prevented him from travelling because his name had been placed on Pakistan’s Passport Control List, commonly known as the PCL.

There was another side to his story, and it matters.

Moinuddin had previously been deported from the United Kingdom after serving a sentence following a conviction for causing death by dangerous driving while under the influence of alcohol. According to reporting on the Islamabad High Court judgment, however, there was no pending criminal case or inquiry against him in Pakistan. Nor was there an extradition request or proclaimed-offender status that independently explained the restriction on his travel.

That made the legal question uncomfortable, but useful. The court did not have to decide whether Moinuddin was a sympathetic traveller. It had to decide whether the government possessed lawful authority to stop him.

Justice Raja Inaam Ameen Minhas examined Rule 22(2)(b) of the Passport Rules, 2021. The provision allowed names to be placed on the PCL following recommendations from government agencies or departments. The court found a deeper problem: the rule did not adequately identify the competent authority exercising this power or provide sufficient procedural safeguards. It declared the disputed provision beyond the scope of the Passports Act, 1974, and inconsistent with constitutional protections.

For an ordinary passenger standing at an immigration counter, all of that legal language reduces to a surprisingly simple question: Who has the legal authority to stop me from travelling?

Having a passport and being stopped from travelling are different things

One part of the judgment caught my attention. The court distinguished between the government’s authority to refuse or regulate the issuance of a passport and the power to prevent someone who already holds a valid passport from travelling. Those powers cannot simply be treated as interchangeable.

The distinction sounds technical until you imagine discovering a restriction at the airport. Your suitcase may already be checked in. Your family has said goodbye. A hotel or onward journey may be booked. Perhaps your daughter abroad has purchased the ticket.

Suddenly an administrative decision becomes very personal.

The September judgment was not the first time the IHC had scrutinised the PCL. In May 2026, the court ordered the removal of YouTuber Rajab Butt’s name from the list, provided no other legal impediment or competent court restraint existed. The court stressed that such restrictions required lawful justification and due process.

The issue running through these cases is not whether Pakistan may control its borders. Of course it can. The harder question is whether the official exercising a coercive power can identify where that power comes from.

Has the court ended airport offloading?

No.

A dramatic social-media headline can easily turn the judgment into something it is not. The Islamabad High Court dealt with a particular legal route used to place people on the Passport Control List. The ruling does not erase every other lawful restriction on overseas travel.

A valid court order, for example, raises a different legal issue. So can another restriction imposed under separate legislation. The PCL should not automatically be confused with Pakistan’s Exit Control List, either. They operate through different legal frameworks.

There is also a practical difference between a passenger being stopped because his name appears on a control list and an immigration officer questioning the passenger’s documents or stated purpose of travel. Pakistan has legitimate reasons to examine suspicious journeys. Human trafficking and migrant smuggling remain serious problems, while forged documents and false travel purposes can form part of those networks.

Your documents and travel purpose therefore still matter. My recent article on Pakistan’s new E-Immigration app and airport offloading looks at that wider screening problem.

A genuine traveller gains little by walking towards immigration believing that the new judgment means, “I have a visa, so nobody can question me.” That is not what the court said.

What I would carry to the airport

I would prepare for my next international journey much as I prepared before this judgment. My passport and visa would be immediately accessible. So would my return booking. If I were staying with family, I would keep their address and contact details with me rather than trying to retrieve everything from WhatsApp while standing at immigration.

The documents should fit the journey. A tourist staying in hotels may need accommodation evidence. Someone visiting relatives has a different story and should carry documents appropriate to that visit.

People travelling abroad for employment face additional requirements under Pakistan’s formal emigration system. They should check the requirements of the Bureau of Emigration and Overseas Employment before reaching the airport.

Family-sponsored travel deserves particular attention. Many Pakistani parents travel abroad to stay with their adult children. They may not have hotel reservations because they will sleep in a daughter’s spare room. Their child may have bought the airline ticket. They may carry relatively little cash because most expenses are being paid abroad.

None of that makes the journey suspicious by itself. But it means the traveller should be able to explain the arrangement clearly.

I recently wrote about my own situation in My Daughter Sponsors My Visits to Germany: What Should Family-Sponsored Travellers Show FIA at Pakistan Airports? The principle is simple: the documents should tell the same story as the traveller.

If my daughter were sponsoring my visit, I would keep the relevant invitation or sponsorship documents available. I would know her address and telephone number. My return booking would also be easy to show.

The aim is not to arrive at immigration carrying a suitcase full of photocopies. It is to make a genuine journey easy to understand.

If FIA stops you at immigration

This is where the new judgment becomes practically useful.

  • Stay calm and ask why you are being prevented from travelling.
  • If an officer says your name appears on a control list, ask which list.
  • If the answer is the PCL, ask what authority ordered the restriction and, where possible, request the reason in writing.
  • Keep your boarding pass, ticket and travel documents, and note the time and counter details while you still remember them.

You may need those records if you later seek administrative review or legal advice. The Moinuddin judgment shows why the exact answer matters. An agency recommendation cannot create a legal power that the governing law has not actually granted.

Why this reminds me of banking

I spent much of my working life around banking systems, SWIFT messages and cross-border payments.

Banks operate under heavy regulation, and sometimes transactions have to be stopped. Yet a compliance officer cannot simply say, “Something about this payment bothers me,” and expect that sentence to replace the rules. There has to be a basis for the intervention.

Border control involves different laws and much greater state power, so I would not push the banking comparison too far. Still, the institutional problem feels familiar to me. A system becomes unpredictable when the citizen cannot identify the rule being applied.

Pakistan certainly has reasons to take irregular migration seriously. Young Pakistanis have died on dangerous migration routes towards Europe, and criminal networks make money from that desperation. Those tragedies demand enforcement.

They do not answer the separate question of what should happen to a genuine passenger with lawful documents.

The airport should not be where you discover a restriction

For me, this remains the most important part of the judgment.

If the state has lawful grounds to restrict someone’s movement, there should be an identifiable authority behind the decision. The affected person should also have some meaningful way to understand and challenge it.

Discovering a travel restriction after reaching the airport is especially damaging. By then the passenger may have spent hundreds of thousands of rupees. The aircraft will not wait while someone searches for the legal basis of an administrative decision.

Moinuddin’s own background makes the judgment more significant, not less. The court was not asked to decide whether it approved of his past conduct. It examined whether the state had exercised a particular power lawfully.

That is an important institutional distinction.

What changes for Pakistani travellers now?

Less changes at the airport than some headlines may suggest. Immigration checks remain. Genuine passengers should still carry appropriate documents and be ready to explain the purpose of their journey.

What has changed is the legal position surrounding one route by which a citizen could be placed on the Passport Control List.

Before my next international flight, I would still check my passport twice. I would keep my visa, return booking and family details accessible. I would arrive early.

But if someone told me at immigration that my name appeared on a government control list, I would know what to ask next.

Not, “Please let me travel.”

A more useful question comes first: Under what legal authority am I being stopped?

At a Pakistani airport counter, that is no longer a minor technical question. It may be the central one.

Related reading

My Daughter Sponsors My Visits to Germany: What Should Family-Sponsored Travellers Show FIA at Pakistan Airports?

My daughter sponsors my visits from Karachi to Munich, so I stay in her home rather than a hotel. What should family-sponsored Pakistani travellers show FIA at the airport? Here is what FIA, Germany and Schengen rules actually say.

When my wife and I travel from Karachi to Munich, we do not book a hotel.

There is a simple reason. Our daughter lives in Munich, sponsors our visits and accommodates us in her home. This is an ordinary family journey for us, not a package holiday.

Yet a Pakistani traveller reading the Federal Investigation Agency’s public guidance could reasonably become confused. FIA’s FAQ says a person travelling abroad on a visit visa should have a valid passport and return ticket. It also lists sufficient funds, a “sound profile” and a confirmed hotel booking with advance payment among the conditions.

That last requirement catches my attention because it does not describe my journey at all. I have somewhere to stay in Munich. It just happens to be my daughter’s home.

This distinction matters to Pakistani parents who visit children settled overseas. It also reveals a weakness in generic immigration checklists. A tourist and a father visiting his daughter may both hold visit visas, but the documents explaining their accommodation will naturally be different.

Germany Recognises Accommodation With a Family Host

Germany’s official guidance is much clearer about family visits. The German missions in Pakistan maintain specific guidance for people visiting friends or relatives. A host in Germany can provide a formal Verpflichtungserklärung, commonly translated as a declaration or letter of obligation.

The document is issued through the competent German authority. The host’s financial position is assessed, and the declaration establishes responsibility for certain costs associated with the visitor’s stay.

German guidance also recognises other supporting arrangements in relevant cases. A host may provide an informal signed invitation accompanied by supporting identity and residence documents. Most importantly here, the guidance distinguishes between someone staying with the person who invited them and someone who needs separate accommodation.

That describes my situation far better than a hotel reservation would. When I visit Munich, my daughter is my host. Her home is where I intend to stay. The wider Schengen framework also recognises invitations and private accommodation as evidence relevant to a private visit.

FIA and Germany Are Asking Different Questions

FIA has a different responsibility from German immigration authorities. Germany decides whether an applicant qualifies for a German visa and, at the external Schengen border, whether the traveller meets the conditions for entry. FIA controls departure from Pakistan.

Keeping those roles separate matters because travellers sometimes assume that obtaining a visa settles every immigration question. It does not. Likewise, an FIA departure check does not replace the destination country’s border controls.

FIA’s public FAQ provides the hotel-booking language as general guidance for visit-visa passengers. What it does not clearly explain is the case of a parent staying in a son or daughter’s home. Germany’s guidance does.

I would therefore be uncomfortable advising a genuine family visitor to arrange a hotel reservation simply to make a checklist look complete when that hotel is not actually where the traveller intends to stay. The more sensible approach is to carry evidence that explains the real journey.

What My Documents Need to Explain

When I travel to Munich, an immigration officer should be able to understand the basic purpose of my journey without reconstructing it from unrelated papers. I am travelling to visit my daughter in Germany and will stay at her home. My documents should support that account.

The passport and valid German or Schengen visa obviously come first. I also keep the return itinerary readily available. Germany’s family-visit guidance asks visa applicants for evidence covering the intended journey, while FIA’s visit-visa FAQ refers to a return ticket.

Then comes evidence explaining sponsorship and accommodation. Where a formal Verpflichtungserklärung has been issued, it is an important document to retain with the travel papers. Where the applicable process relies on an invitation, the supporting papers may include information identifying the host and establishing the host’s residence in Germany.

For me, the practical question is simple. If somebody at Karachi airport asks where I will stay after arriving in Munich, I want the documents in my hand to support the answer I give. That does not mean every FIA officer will ask for every paper.

Establishing the Family Relationship

If someone in Germany is sponsoring or accommodating me, an immigration officer may reasonably want to understand my relationship with that person. Germany’s current family-visit documentation for applicants in Pakistan includes a NADRA Family Registration Certificate among the supporting documents.

A parent who already obtained an FRC during the visa process may therefore find it useful to retain an accessible copy while travelling. I would not turn this into another enormous airport checklist. The useful documents are those that make the journey coherent: who I am visiting, where I am staying and why that person is supporting my visit.

Sponsorship Does Not Make Personal Money Irrelevant

My daughter sponsoring my visit does not mean I want to arrive at an international airport without access to my own money. FIA’s FAQ refers to sufficient funds for visit-visa passengers and says credit-card funds can be considered. One example on the FIA website relates specifically to Dubai, so I would not turn that example into a universal cash requirement for every country.

Schengen rules approach the question more broadly. Authorities can consider the length and purpose of a visit when examining means of subsistence. Sponsorship and accommodation provided by a host can be relevant, while credit cards may also contribute to evidence of available resources.

I still prefer access to my own funds while travelling. An unexpected delay during a connection or some other disruption can create expenses long before I reach my daughter’s home in Munich. For me, sponsorship explains who bears the main cost of the visit. Personal access to money gives me some independence while I am in transit.

A German Visa Is Not the Last Check

A valid Schengen visa is essential, but possession of the visa does not create an unconditional right of entry. At the Schengen external border, a non-EU traveller may still be asked to explain the purpose and conditions of the visit. Border authorities can also examine available means of support and conduct the required database checks.

If I leave Karachi saying that I am visiting my daughter in Munich, I should be able to give the same straightforward explanation when entering the Schengen area. My accommodation documents, return journey and other supporting papers should not tell a different story. A thick folder does not automatically make a journey more credible. Papers that contradict one another can do the opposite. Frequent family visitors should also understand how Europe’s Entry/Exit System records short-stay arrivals, departures and the 90-days-in-180 rule.

What FIA Says About Stopping Passengers

Family sponsorship does not exempt anyone from Pakistan’s departure controls. FIA still performs immigration checks.

Its published Travelers’ Guide describes examination of travel documents and checks against applicable stop lists. The guide also says that when a passenger is offloaded, the shift in-charge should personally inform the passenger of the reason.

FIA’s guidance says immigration personnel are not authorised to stop further travel when a passport and visa are genuine and valid and there is prima facie no misdeclaration, unless there is valid justification. That should not be read as a promise that anyone holding a valid visa can never be stopped. A lawful travel restriction, fraudulent document or another valid ground can change the situation.

The E-Immigration App Could Expose This Problem

Pakistan’s proposed e-immigration system makes the family-accommodation issue even more interesting. I recently examined the planned e-immigration system and the question of airport offloading because reports indicate that it could allow some travel information and documents to be checked before passengers arrive at the airport.

For a family-sponsored traveller, that could be genuinely useful. Suppose I could submit the documents showing that my daughter is hosting me in Munich before leaving for Karachi airport. Any obvious problem could potentially be identified while I still had time to address it.

But imagine an electronic form that simply refused to proceed until every visit-visa passenger uploaded a hotel reservation. My perfectly ordinary family visit would suddenly appear incomplete because the software had been designed around a tourist rather than a parent visiting a child.

Nothing would have been solved. The ambiguity would simply have moved from the immigration counter to the telephone screen.

What I Will Carry on My Next Munich Journey

I do not intend to turn my hand luggage into a travelling filing cabinet. I will keep the documents that explain the journey accessible: passport and visa, return itinerary and the relevant sponsorship or invitation documentation. Evidence identifying where I will stay and, where useful, the family relationship can remain with those papers.

I also want access to personal funds during the journey. Travel health insurance remains important as well. Germany’s current Schengen visa guidance requires qualifying travel medical insurance for visa applicants, with coverage of at least €30,000 throughout the Schengen states.

The exact file will not look identical for every family. Someone visiting a German citizen may have different supporting evidence from a traveller visiting a relative who holds a German residence permit. This is precisely why a universal airport checklist can become misleading. The documents should fit the journey.

The Question at Karachi Airport

When I next stand at Karachi airport and an FIA officer asks where I am staying in Germany, my answer will not be complicated. I am staying with my daughter in Munich.

A hotel booking would not accurately describe my accommodation because I am not staying in a hotel. German guidance itself recognises private accommodation with a host, while Schengen rules allow supporting evidence appropriate to private visits.

What I should be prepared to do is support the account I have given. My visa and return journey establish part of it. The appropriate sponsorship or invitation documentation explains another part, including where I will be staying.

Pakistan’s public immigration guidance would be more useful if it explained this distinction clearly. A tourist with a hotel reservation and a father staying with his daughter are both legitimate visitors, but their accommodation evidence cannot reasonably look identical.

When I next stand at Karachi airport and say that I am staying with my daughter in Munich, that is not a workaround for a missing hotel reservation. It is simply where I am going to stay.

The paperwork should be able to explain that without making an ordinary family visit look unusual.

Pakistan’s New E-Immigration App: Can It Stop Passengers From Being Offloaded at the Airport?

Pakistan is preparing an FIA e-immigration app that could check travel documents before passengers reach the airport and issue QR-code clearance. Here is what Pakistani travellers need to know about the proposed system and airport offloading.

Last verified: 30 September 2026.

A Pakistani traveller can have a valid passport, a visa and an airline ticket and still approach the immigration counter with an uncomfortable question: Will FIA allow me to board?

I have travelled abroad from Karachi several times, and I know the immigration counter is quite different from an airline check-in desk. The airline checks whether you meet its document requirements and those of the destination. Pakistan’s Federal Investigation Agency has another responsibility. Its officers examine travel documents, check restrictions and look for signs of illegal migration or document fraud.

Pakistan now appears ready to move part of that process away from the airport. Reports published on September 28 and 29 say the FIA is preparing an e-immigration mobile application that would allow passengers to submit travel information before arrival. Documents could be reviewed in advance, with cleared passengers receiving a QR code.

For thousands of Pakistanis travelling abroad, the real value may not be a shorter queue. It could be the chance to discover a problem while sitting at home rather than standing at immigration with a boarding pass in hand.

What Pakistan’s E-Immigration App Is Supposed to Do

The proposed system has been developing for some time. In its Annual Administration Report 2025, FIA listed the development and rollout of an “eIMMI mobile application” among its immigration reforms. The agency said the application would support passenger facilitation, rule-based targeting and early identification of high-risk travel behaviour. At that stage, FIA described it as under development.

Recent reports say development has reached its final stages. Travellers would submit information before reaching the airport. FIA could scrutinise their documents, notify a passenger when clarification is needed and issue a QR code after clearance.

At the airport, immigration officials could retrieve that information through the code. Moving part of the check backwards in time could turn a last-minute airport crisis into a problem a traveller can correct earlier.

One limitation needs to remain clear: a QR code should not yet be treated as an unconditional guarantee that a passenger will board. The details reported so far describe digital scrutiny and pre-travel clearance. They do not establish that an immigration officer loses the authority to perform lawful checks at the airport.

Why FIA Checks Passengers Leaving Pakistan

Airport immigration has to balance passenger facilitation with border enforcement. FIA says its Immigration Wing handles more than 22 million passenger movements annually through notified checkpoints. Its responsibilities include examining documents, detecting forgeries and implementing government travel restrictions. FIA describes those functions here.

Pakistan also faces migrant smuggling and fraudulent travel documents. The government has pushed FIA towards stronger screening while demanding faster airport processing. Those objectives can collide at an immigration counter, where an officer may have little time to understand an unusual but legitimate journey.

Digital pre-screening could give officials more time to examine such cases. It could also create a record showing what a passenger submitted and what the system decided. For travellers, that record may eventually matter more than saving several minutes in a queue.

What Documents Can Cause Problems?

FIA’s published FAQ provides a useful starting point. It says a person travelling on a work visa should have a valid passport and visa, along with required protector documentation. A work permit is also required for certain destinations.

Visit travel is less straightforward. FIA lists a valid passport, return ticket and confirmed hotel booking among the requirements for visit-visa travel. It also refers to sufficient funds and what it calls a “sound profile.”

Not every legitimate traveller fits neatly into a hotel-booking model. Many Pakistanis stay with relatives. Parents visit children settled in Germany, Britain, Canada or elsewhere. A daughter may buy her parents’ tickets and accommodate them at home, leaving no reason for a hotel reservation.

A family-sponsored traveller should therefore carry documents that explain the real journey. Depending on the destination and visa, these may include the host’s invitation or sponsorship documents, address and contact details, evidence of the relationship, a return ticket and relevant financial evidence. Destination-country rules still apply. FIA clearance cannot replace the conditions attached to a foreign visa.

Related: If you are staying with family rather than in a hotel, I have also examined what family-sponsored travellers visiting Germany should be prepared to show FIA at a Pakistani airport.

Not Every Offloading Case Is the Same

The word offloading often makes very different cases sound identical. FIA’s published immigration material distinguishes passengers stopped over forged documents from passengers stopped because their documentation is incomplete.

Examples of incomplete-document cases include an expired passport or visa, inconsistencies between passport and visa details, and visit travel without a return ticket. FIA material also identifies inadequate evidence concerning accommodation or funds as potential problems.

A correctable paperwork problem is not the same thing as an attempt to travel on a counterfeit visa. A useful e-immigration system should expose the first type of problem before departure. Discovering at home that a passport number does not match a visa is irritating. Discovering it shortly before an international flight can end the journey.

Can FIA Offload Someone Who Has Valid Documents?

FIA’s published traveller guidance says that when a passenger’s passport and visa are genuine and valid and there is prima facie no misdeclaration of facts, immigration personnel are not authorised to stop that passenger from travelling without valid justification. It also says that when a passenger is offloaded, the shift in-charge should personally inform the passenger of the reason.

A passport and visa do not override every lawful restriction. FIA also administers immigration controls and checks relevant government restrictions and databases. Still, the agency’s wording establishes an important principle often lost in social-media arguments about offloading: immigration discretion is not supposed to mean unexplained discretion.

The proposed app could strengthen that principle if it records both queries and decisions.

Why Offloading Became Such a Sensitive Issue

Pakistan has already faced controversy over passengers being prevented from travelling. In November 2025, the Ministry of Overseas Pakistanis took notice of reports that workers had been offloaded despite possessing work visas and protector certificates. FIA’s director general told a government meeting that incidents had been reported at Lahore and Karachi airports and were being investigated. The government also said a digital system was being prepared through which workers could complete immigration procedures online before departure. The official press release is available here.

The issue has not disappeared. In September 2026, litigation before the Lahore High Court again raised questions about the legal basis for stopping passengers from leaving Pakistan. The litigation involves contested legal arguments, so it should not be read as a final ruling that all offloading is lawful or unlawful.

Karachi recently supplied another reminder of the practical problem. On August 29, Interior Minister Mohsin Naqvi visited Jinnah International Airport and reviewed immigration processing. During the visit, the immigration system went down. He ordered alternative arrangements so processing would not stop during technical failures. He also directed action against fake documents and said passengers with incomplete or unverified documents should not be permitted to travel. The Interior Ministry’s account records the visit.

The episode exposes both sides of digitisation. Technology can remove uncertainty, but a failed system can create a new bottleneck.

What Should the QR Code Actually Mean?

Before the application goes live, FIA needs to explain exactly what its QR code certifies. A code confirming that FIA has merely received documents is very different from one confirming that officials examined them and found no current objection to the journey.

Passengers will also need to know whether pre-clearance expires, whether changing a flight requires another application and under what circumstances an airport officer can reopen a cleared case.

A useful system should also explain correctable objections in plain language whenever law and security permit it. “Return ticket missing” or “passport details do not match visa” gives a traveller something concrete to fix. A mysterious rejection merely moves the airport counter onto a smartphone.

Risk Profiling Needs Transparency

Reports about the system say FIA intends to use passenger information for risk profiling. Border agencies cannot examine every traveller with equal intensity, but automated profiling creates its own questions. Travellers need to know how errors can be corrected, how long uploaded documents remain in the system and whether incorrect information can be challenged.

FIA’s annual report says its wider immigration modernisation includes stronger integration between the Integrated Border Management System and national databases, along with controlled information sharing between agencies. Digitisation therefore does more than shorten an airport queue. It changes how the state evaluates a traveller.

What Travellers Should Do Right Now

The e-immigration application has not yet been publicly launched according to the latest information I could verify on September 30, 2026. Reports say development is in its final stages, but I found no official launch date.

Until FIA announces otherwise, travellers should prepare for the existing immigration procedure. Check the passport and visa carefully. Make sure names, passport numbers and dates match. Carry the return or onward ticket when travelling on a visit visa, and keep evidence explaining accommodation, sponsorship and finances when those matters apply. Workers should pay particular attention to protector and employment documentation.

FIA says One Window Facilitation Desks operate at major international airports, including Karachi, Lahore, Islamabad, Peshawar and Quetta, to help passengers with grievances and related issues. Travellers should check FIA or the relevant government authority rather than relying on a screenshot circulating on WhatsApp.

The Real Test Will Come at the Airport

From Karachi, I see the proposed system as more than another government app. Pakistanis do not mainly fear spending ten extra minutes at immigration. The greater anxiety comes from uncertainty.

A family may spend heavily on international tickets. A worker may have waited months for a foreign job, while parents travelling to see children overseas can organise an entire family visit around one departure date. Finding an avoidable documentation problem at the immigration counter is far too late.

E-immigration could move that moment several days earlier. But the technology will matter only if the QR code has a clear meaning, passengers receive understandable reasons when problems arise and airport officers work from the same information that produced the digital clearance.

Otherwise Pakistan will have digitised the paperwork without removing the uncertainty. The traveller will still reach the immigration counter with the old question in mind: Am I actually cleared to fly?

Pakistan’s First Astronaut Will Fly to China’s Tiangong. Why Beijing’s Invitation Matters

Pakistan is preparing to send an astronaut to China’s Tiangong space station. Behind the national milestone lies a larger question about China’s effort to turn its orbital infrastructure into international influence.

From Karachi, China’s space station feels very far away.

Pakistan has more immediate problems on the ground. Power bills bite into household budgets. Water remains a daily worry in parts of this city. Every monsoon reminds us how vulnerable our infrastructure still is. Yet somewhere in China, two Pakistani pilots are learning Mandarin and training for weightlessness.

One of them may eventually float through Tiangong carrying a Pakistani flag.

I am less interested in the flag than in the invitation.

China is preparing to put its first foreign astronaut aboard its own space station, and Pakistan has been given that place. For Pakistan, the mission will be a national milestone. For China, it could mark the beginning of something larger: turning a Chinese space station into an institution that other countries want to enter.

The question is whether Pakistan is an exception because of its unusually close relationship with Beijing, or the first test of a wider model.

Pakistan did not suddenly arrive at Tiangong

The road to Tiangong began years before the two pilots entered training.

Pakistan and China signed a framework agreement on human spaceflight cooperation in 2019. The relationship moved considerably further in February 2025, when Pakistan’s Space and Upper Atmosphere Research Commission and the China Manned Space Agency signed an agreement covering the selection and training of Pakistani astronauts and their participation in a future Chinese space-station mission.

China described it as the first time its government would select and train astronauts from another country.

In April 2026, Chinese authorities announced the selection of Muhammad Zeeshan Ali and Khurram Daud as Pakistan’s two astronaut candidates. They travelled to China for training. One is expected to fly as a payload specialist after completing the programme and passing the required assessments.

Reuters reported on September 28 that both men are now undergoing intensive preparation.

There is more here than a Pakistani buying a ticket into orbit.

The astronaut selected for the mission is expected to take part in crew activities and conduct Pakistani scientific experiments. Pakistani researchers therefore gain access, however limited at first, to a field in which the country has no independent human-spaceflight capability.

That matters more than the ceremony.

The relationship already extends beyond astronauts. China has played an important role in Pakistan’s satellite programme, including launches of Pakistani Earth-observation spacecraft.

In April 2026, Pakistan’s PRSC-EO3 electro-optical satellite was launched from China’s Taiyuan Satellite Launch Centre aboard a Long March 6 rocket. SUPARCO says the spacecraft can support agriculture, urban planning and environmental monitoring. It can also help with disaster response.

Those functions receive much less attention than human spaceflight. Pakistan may ultimately need them more.

Why did the first invitation go to Pakistan?

China could have opened its first foreign astronaut position to another partner. Pakistan got it.

We should resist the temptation to turn that fact into a secret Chinese master plan. Beijing has not publicly explained the selection in those terms.

The existing relationship gives us enough to work with.

China and Pakistan already cooperate closely in infrastructure and defence. Their governments regularly describe the relationship as an “all-weather” strategic partnership. Space has gradually become another part of it.

Human spaceflight raises its visibility.

The China-Pakistan joint statement issued in May 2026 welcomed the training of the two candidates and said both governments looked forward to a Pakistani becoming the first foreign astronaut to enter the Chinese space station.

Beijing and Islamabad are therefore not treating the mission as an isolated scientific experiment. They have placed it inside their wider bilateral relationship.

Pakistan is also a relatively safe partner with which China can attempt something it has never done before.

A foreign astronaut aboard a national space station creates complications that do not arise when another country simply places an experiment there. Training standards have to match. Procedures must work across languages. Scientists and engineers need sustained institutional contact.

China will now acquire experience managing those questions with a country it has worked with for decades.

Whether Beijing intends Pakistan to become a prototype for others remains an open question. Its public language, though, points beyond Pakistan.

When the China Manned Space Agency announced the Pakistani candidates, it described the cooperation as a model for greater participation by developing countries in international human-spaceflight programmes.

That is the sentence I would watch.

Tiangong is acquiring a diplomatic life

China does not need Pakistan to prove that Tiangong works. Chinese crews have already done that.

Bringing a Pakistani aboard serves a different purpose. A national space station starts acquiring international weight when scientists and governments outside the country seek access to it.

China began opening that door before the Pakistani astronaut programme.

It has worked with the United Nations Office for Outer Space Affairs to invite scientific experiments from other countries. In 2019, UNOOSA reported that nine projects had been selected through the initiative, involving researchers from institutions across several regions.

An experiment sitting inside a space station rarely becomes front-page news.

An astronaut does.

There will be photographs, interviews and television coverage when a Pakistani reaches Tiangong. Schools will talk about it. Pakistani officials will celebrate it, quite reasonably, as a national achievement.

Human spaceflight gives scientific cooperation a public face.

There is a historical precedent worth remembering here, although the circumstances differ.

The International Space Station became much more than a laboratory after the Cold War. American and Russian astronauts lived and worked together in orbit even when relations between Washington and Moscow deteriorated badly on Earth.

The ISS also tied Europe, Japan and Canada into a long-running institutional network centred heavily on American space capabilities.

China developed outside that arrangement.

Tiangong gave Beijing something it had never possessed before: its own permanently crewed orbital infrastructure, under Chinese control, with China deciding how foreign participation works.

Pakistan is now entering that system.

The timing is worth noticing because the old architecture of low-Earth orbit is approaching a major change.

NASA plans to end International Space Station operations around 2030 and move towards commercially operated destinations. Under the American approach, NASA expects eventually to become one customer using privately operated stations rather than owning and operating another ISS-like platform indefinitely.

NASA was still working through that transition in July 2026, when it sought industry input on the next phase of its commercial-space-station programme.

China is following another route. It operates a state-built station and can decide how quickly to internationalise it.

I would not assume one model will defeat the other. American commercial stations could eventually provide extensive access to foreign governments and researchers. Tiangong could remain selective.

But countries without the money to build their own human-spaceflight programmes may eventually have choices that did not exist before.

China clearly wants to be one of them.

Pakistan should ask what remains after the astronaut comes home

I can imagine the excitement in Pakistan when the mission finally happens.

There will probably be a live broadcast. The Pakistani flag will appear inside Tiangong. The astronaut will become a national celebrity almost overnight.

None of that is trivial. Pakistan has never sent one of its citizens into orbit through its national space programme.

Yet the harder question begins after the photographs.

What does Pakistan bring home?

A single astronaut cannot turn the country into a major space power. Pakistan still has large gaps in scientific funding and advanced technical capacity. Its universities do not suddenly acquire laboratories because one Pakistani has experienced microgravity.

Training can still create useful institutional knowledge.

Pakistani personnel will gain direct exposure to human-spaceflight operations. Researchers involved in the mission can learn how experiments must be designed for microgravity and integrated into a crewed station.

The value depends on whether those relationships continue.

Pakistan would gain much more from sustained scientific collaboration and technical training than from treating the flight as a spectacular national event and then moving on. That question echoes a broader problem I have written about before: Pakistan often gains strategic importance without converting it into durable national capacity.

There is a mundane side of space technology that rarely makes television.

Pakistan already uses Earth observation to study crops and water resources. Satellite data can assist planners during floods. In a country repeatedly exposed to extreme weather, those capabilities touch ordinary lives in ways human spaceflight may never do.

I keep coming back to that contrast.

A Pakistani floating above Earth will produce the photograph everyone remembers. A satellite quietly watching the Indus during a flood may produce information somebody actually needs.

A serious Pakistani space programme has room for both.

China is testing something too

China’s achievement is no longer simply that it can put people into orbit.

It has done that repeatedly.

The next measure of Tiangong’s international importance will be whether other countries want to participate in the system China has built.

Every foreign experiment creates institutional contact. Astronaut training goes considerably deeper. Engineers must work together for months or years before anyone reaches the launch pad.

Influence can grow out of such ordinary contact without anybody signing a political declaration. It fits a wider pattern in which Chinese power can become embedded in infrastructure and institutions, a theme I explored in America Built an Empire of Money and Weapons. China Is Building an Empire of Things.

That does not mean every country using Tiangong will become a Chinese ally. Space cooperation did not erase disagreements among the countries involved in the ISS. There is no reason to expect China’s programme to work differently.

Access still has political value.

Pakistan is a useful first case precisely because so much of the political relationship already exists. If the programme succeeds, Beijing will know much more about integrating a foreign astronaut into Chinese training and station operations.

Then we will learn whether the experiment stops with Pakistan.

At some point, assuming the programme proceeds as planned, a Pakistani astronaut may float through Tiangong while cameras record the moment.

Here in Pakistan, we will probably look at the flag.

I will be looking behind him.

There will be a Chinese space station built outside the Western-led human-spaceflight architecture that shaped much of the previous half-century. Inside it will be a Pakistani trained through Chinese institutions, carrying experiments from home.

One astronaut will tell us very little.

The interesting part comes afterwards.

Who gets the second invitation?

Taking Metformin for Years? What to Discuss With Your Doctor

Taking metformin for years? Long-term users should discuss vitamin B12, kidney function, gastrointestinal problems and sick-day medication rules with their doctor.

I recently looked back at my diabetes medicines and noticed something I had almost stopped thinking about. Metformin had been part of my treatment for years.

The brand name and dose had changed. Doctors had adjusted the treatment as my needs changed. Yet metformin remained somewhere in the prescription.

That made me ask a simple question: when someone has taken metformin for several years, what should they actually discuss with their doctor?

The answer involves more than blood sugar. Long-term treatment deserves a periodic review of kidney function and vitamin B12. Persistent stomach or bowel problems also deserve attention. If another diabetes medicine such as empagliflozin has been added, the conversation becomes broader still.

This is not a reason to stop metformin. It is a reason to have a better conversation with the doctor who prescribes it.

My Own Experience Raised the Question

I started taking a metformin-containing diabetes medicine in 2019. Over time, doctors changed my treatment.

At one stage, I was prescribed metformin 1000 mg. Bowel problems later became an issue, and another physician switched me to sustained-release metformin 750 mg.

The change made me think about something many patients probably experience. We tend to remember our latest prescription. We do not always think about the total number of years we have been exposed to a medicine.

For metformin, that history matters.

The American Diabetes Association’s 2026 Standards of Care say that metformin remains a useful glucose-lowering treatment for older adults because it has a low risk of causing hypoglycaemia when used by itself. But the ADA also stresses that its use needs regular reassessment.

For people taking metformin for more than four years, the ADA recommends annual monitoring of vitamin B12 levels. That is a small detail with potentially important consequences.

Ask About Vitamin B12

Metformin can interfere with vitamin B12 status during long-term treatment. The problem may develop quietly. A person may take metformin for years without connecting a new symptom with B12 deficiency.

Possible B12 deficiency symptoms can include unusual tiredness, weakness, numbness or tingling. Anemia may also occur.

For somebody with diabetes, numbness and tingling present an additional problem. It is easy to assume that every strange sensation in the feet comes from diabetic neuropathy. Sometimes another explanation needs investigation.

The 2026 ADA guidance recommends considering periodic B12 assessment in people receiving long-term metformin, particularly when anemia or peripheral neuropathy is present. For older adults who have taken metformin for more than four years, the ADA guidance recommends annual B12 monitoring.

A practical question for the next appointment is: “I have been taking metformin for several years. When was my vitamin B12 last checked?”

Do not automatically start high-dose supplements because you use metformin. Discuss testing and treatment with your doctor.

Kidney Function Matters Too

Metformin leaves the body largely through the kidneys. Kidney function therefore affects how safely the medicine can be used.

The number patients should learn to recognize on their laboratory report is eGFR, or estimated glomerular filtration rate.

The U.S. Food and Drug Administration recommends obtaining an eGFR before starting metformin and at least annually while taking it. Kidney function may need more frequent monitoring in older people and others at greater risk of renal impairment.

An eGFR below 30 mL/min/1.73 m² is an important threshold. Metformin is contraindicated below that level. If the eGFR falls below 45 while a person is already taking metformin, the FDA advises clinicians to reassess the benefits and risks of continuing treatment.

Patients do not need to calculate any of this themselves. Ask: “What is my eGFR, and is my present metformin dose appropriate for my kidney function?”

When Metformin Upsets the Stomach

Metformin has another familiar problem. The gut sometimes objects.

Diarrhoea, abdominal discomfort and reduced appetite can occur. For some people these effects become troublesome enough to interfere with daily life.

I experienced bowel problems myself after changes in treatment. My physician eventually moved me to a sustained-release formulation.

The 2026 ADA Standards note that extended-release metformin can be used as an alternative for older adults experiencing gastrointestinal problems with treatment. But persistent diarrhoea should not simply be labelled “the metformin problem” forever.

Tell your doctor when the symptoms started. Explain whether they followed a dose increase and whether they improved after switching formulations. The timing gives the doctor useful information.

Illness Changes the Equation

A tablet that is appropriate on an ordinary Tuesday may require a different plan when you are vomiting, unable to drink or losing substantial fluid through diarrhoea. Dehydration can affect kidney function.

The 2026 ADA Standards say clinicians should consider temporarily holding metformin and SGLT2 inhibitors when a person cannot maintain oral intake or when there is concern about acute kidney injury.

The sensible approach is to ask your doctor for a sick-day plan before you become sick. Ask exactly what to do if you develop persistent vomiting or significant diarrhoea. Ask what happens if you cannot eat or drink normally. Write the instructions down.

If You Also Take Empagliflozin, Check the Instructions

Empagliflozin belongs to a group of medicines called SGLT2 inhibitors. These medicines are now used for more than glucose control. Depending on the patient’s condition, empagliflozin can provide cardiovascular, heart-failure and kidney benefits.

Current FDA prescribing information for Jardiance, the reference brand of empagliflozin, gives 10 mg once daily in the morning as the recommended starting dose. For additional glucose control, it can be increased to 25 mg once daily in appropriate patients.

If you think you have been told to take empagliflozin 10 mg twice daily, do not simply change the dose after reading an article online. Take the medicine box and prescription to your doctor or pharmacist and ask them to confirm exactly what was intended.

Five Tests Worth Discussing

A long-term metformin user does not necessarily need every possible blood test at every visit. A few measurements, however, deserve a conversation.

  • HbA1c to assess longer-term glucose control.
  • Serum creatinine and eGFR to assess kidney function.
  • Vitamin B12, particularly after several years of metformin treatment.
  • Complete blood count (CBC), which can help identify anemia and other abnormalities.
  • Urine albumin-to-creatinine ratio (UACR), an important test for detecting kidney damage associated with diabetes.

Your doctor may order additional investigations depending on your health, medicines and previous results. The point is not to arrive at the clinic demanding five tests. The point is to ask whether they are due.

Take Your Medication History With You

Patients often tell doctors, “I take one sugar tablet in the morning and another at night.” That is not enough information.

Before your appointment, photograph the front and back of every medicine box. Better still, take the medicines with you. Write down the exact dose and when you take each tablet.

“I have been taking metformin-containing treatment for several years. My dose and formulation have changed because I developed bowel problems. Could we review whether my current dose remains appropriate, check my kidney function and B12 status, and give me instructions for what to do with my diabetes medicines if I develop vomiting, diarrhoea or dehydration?”

That short history tells the doctor much more than “metformin doesn’t suit me.”

Do Not Stop a Useful Medicine Because of an Internet Article

Metformin has been used for decades and remains an important treatment for type 2 diabetes. Long-term use does not automatically mean that something has gone wrong.

Monitoring is the point.

A person who has taken metformin for years should know whether kidney function remains adequate. B12 deserves attention after prolonged treatment. Persistent bowel symptoms deserve a proper discussion rather than silent endurance.

I reached this subject by looking at my own medication history. The exercise reminded me how easily years of treatment disappear behind the latest prescription.

Take the boxes to the doctor. Take your laboratory reports too. Then ask the questions that years of treatment sometimes teach us to forget.

Sources

Medical note: This article provides general educational information and does not replace individual medical advice. Do not stop, start or change the dose of metformin, empagliflozin or another prescribed medicine without discussing it with your treating physician.

Taking Metformin for Years? What Older Adults With Diabetes Should Know in 2026

Metformin remains an important treatment for type 2 diabetes, but long-term use deserves monitoring. Here is what older adults should know about vitamin B12, kidney function, stomach problems and medication safety in 2026.

Metformin is one of those medicines that can quietly become part of everyday life.

A tablet after breakfast. Another with dinner. Months turn into years. If blood sugar remains reasonably controlled, it is easy to stop thinking about the medicine itself.

That may be a mistake, particularly as we grow older.

Metformin remains an important and widely used treatment for type 2 diabetes. Doctors have decades of experience with it, and when used on its own it has a relatively low risk of causing hypoglycaemia. The American Diabetes Association’s 2026 guidance for older adults continues to describe metformin as a useful glucose-lowering option for many older people.

But long experience with a medicine does not mean we should stop monitoring it. For somebody who has taken metformin for years, the better question is not simply, “Is metformin safe?” It is: What should my doctor and I continue checking as I get older?

The First Thing I Would Check: Vitamin B12

Metformin can reduce vitamin B12 levels. This is not merely a theoretical association. A long-term randomized trial published in The BMJ found lower B12 concentrations and a greater risk of biochemical B12 deficiency among people receiving metformin.

The problem is particularly relevant because B12 deficiency can be easy to overlook. Tiredness may be blamed on age. Tingling or numbness may be attributed to diabetic neuropathy. Weakness can have many explanations. Anaemia may develop gradually.

I have written separately about vitamin B12 deficiency in ageing, including why neurological symptoms and medication-related risk deserve attention. For long-term metformin users, that connection is especially important.

The 2026 ADA guidance for older adults recommends annual B12 monitoring in older adults who have been taking metformin for more than four years. The UK’s Medicines and Healthcare products Regulatory Agency also advises testing when deficiency is suspected and considering periodic monitoring in people with risk factors.

Finding low B12 does not automatically mean a patient should stop metformin. The deficiency can usually be investigated and treated while the diabetes regimen is reviewed separately by the treating clinician.

Kidney Function Matters More as We Age

Metformin leaves the body largely through the kidneys. That makes kidney function an important part of safe prescribing.

Doctors commonly assess kidney function using estimated glomerular filtration rate, or eGFR. According to the 2026 ADA guidance for older adults, metformin can generally be used when eGFR is 30 mL/min/1.73 m² or higher, with lower dosing appropriate when eGFR is between 30 and 45. Metformin should not be used below the recommended kidney-function threshold.

This does not mean everyone approaching an eGFR of 45 must suddenly stop taking it. It means the prescription needs more careful assessment. Kidney function can change with age and illness. A dose that was appropriate years ago may need reconsideration later.

The Rare Risk That Gets the Most Attention

Lactic acidosis is probably the metformin complication that frightens patients most when they read about it online. It is serious. It is also rare.

The useful question is therefore not whether the risk exists, but when that risk becomes more important. Advanced kidney impairment is one concern. Severe illness involving hypoxia or poor tissue perfusion can also change the risk assessment.

A clinician may temporarily stop metformin during a serious acute illness, hospitalization or in connection with certain procedures involving iodinated contrast. That does not necessarily mean the medicine has suddenly become dangerous. The patient’s circumstances have changed. Once the acute problem resolves and kidney function is satisfactory, the clinician can decide whether treatment should be restarted.

Diarrhoea and Stomach Problems Are Much More Common

For most people, the problem they are more likely to encounter is far less dramatic. The stomach complains.

Diarrhoea, nausea, abdominal discomfort and bloating are well-established adverse effects of metformin. Many people tolerate it perfectly well, while symptoms can be more noticeable when treatment begins or the dose increases.

Slow dose escalation can help. Extended-release metformin is another option doctors may consider when gastrointestinal tolerance becomes difficult. It would be too simplistic, however, to promise that changing formulations will eliminate every symptom.

Persistent diarrhoea should not simply be tolerated for months because “metformin always does this.” It deserves discussion with a doctor. There may be another cause, or the dose or formulation may need reconsideration.

Appetite Deserves Attention in Older Adults

Metformin can reduce appetite. For an overweight younger adult, modest appetite reduction may not sound concerning. The calculation can change in an older person who is already losing weight, eating poorly or becoming frail.

Unintentional weight loss in later life should not automatically be celebrated simply because someone has diabetes. Muscle mass matters. Nutrition matters. The ADA notes that appetite reduction from metformin can become problematic in some older adults.

This is a good example of why diabetes treatment cannot be reduced to one glucose number. Treatment has to fit the person.

What About Hypoglycaemia?

Metformin has an important advantage here. When taken by itself, it carries a low risk of hypoglycaemia.

Many people with type 2 diabetes do not take metformin alone. They may also use insulin or another glucose-lowering medicine. In that situation, a low glucose reading cannot automatically be blamed on metformin. The entire medication regimen needs to be examined.

What I Would Remove From My 2023 Article

Looking back at older health writing is useful because medical evidence forces a writer to be humble.

Some claims in my 2023 discussion of metformin were too broad. I mentioned anxiety, depression and muscular pain among possible long-term problems without giving readers enough evidence or context. I would not present those today as established routine long-term adverse effects of metformin.

That does not mean a person experiencing muscle pain, mood changes or other unexplained symptoms should ignore them. It means we should not automatically attribute such symptoms to metformin without evidence.

Five Conversations Worth Having With Your Doctor

If you have been taking metformin for years, you do not need to become frightened of the medicine. You need better questions.

  • When was my kidney function last checked, and what is my eGFR?
  • If I have used metformin for several years, should my vitamin B12 be measured?
  • Could persistent diarrhoea, nausea or loss of appetite be related to my treatment?
  • What should I do with metformin if I become seriously ill, dehydrated or am admitted to hospital?
  • Is my current dose and overall diabetes regimen still appropriate for me now?

That last question becomes more useful with age. A prescription should not remain unchanged merely because it has remained unchanged for years.

Metformin Is Not the Enemy

Updating this article has changed the way I would frame the subject. The interesting story is not that metformin has frightening hidden dangers. It doesn’t need that headline.

The more useful story is that a familiar medicine still deserves attention after years of use. For many older adults with type 2 diabetes, metformin remains useful. Its low risk of hypoglycaemia is valuable. Decades of clinical experience also mean doctors understand its benefits and limitations unusually well.

But ageing changes the patient even when the medicine remains the same. Kidney function can decline. Nutrition can change. Other medicines accumulate on the prescription. B12 levels may fall quietly.

Do not stop metformin because you are worried about its long-term effects. Make sure its long-term effects are actually being monitored.

Medical note: This article is for general health education and does not replace individual medical advice. Do not start, stop or change prescribed medication without consulting an appropriate healthcare professional.

The Hidden Health Risk After 65 May Be Inside the Medicine Cabinet

A new 2026 JAMA study finds that more than one in five older Americans used medication combinations with potentially major drug interactions. Here is what the findings mean, what they do not prove, and why people over 60 should periodically review prescriptions, OTC medicines and supplements together.

I recently looked at the medicines an older person can accumulate without doing anything obviously reckless. There may be tablets for blood pressure in one place, diabetes medicines nearby, perhaps aspirin or another heart medicine. Then come the things we hardly think of as medicines: a painkiller bought without prescription, a vitamin, an herbal preparation.

Each may have a perfectly sensible reason for being there.

The trouble can begin with the combination.

A new study published in JAMA on September 24, 2026 provides an uncomfortable reminder of this problem. Researchers found that more than one in five older Americans in their latest survey period were using a medication regimen containing at least one potentially major drug-drug interaction.

That does not mean one in five suffered serious harm. The distinction matters.

It does mean that medicine cabinets deserve more attention as we grow older.

More medicines, but not necessarily more safety

Researchers led by Dima Mazen Qato of the University of Southern California examined nationally representative data from community-dwelling Americans aged 62 to 85. They compared 2,754 people surveyed in 2015–2016 with 2,186 surveyed in 2021–2023.

The results contain an interesting contradiction.

Prescription polypharmacy, defined in this study as taking five or more prescription medicines concurrently, increased from 31.0 percent to 35.7 percent.

Supplement polypharmacy also increased, from 12.6 percent to 16.7 percent.

Yet exposure to regimens containing potentially major drug interactions actually declined, from 25.7 percent to 22.3 percent.

So the story is not simply that older people are swallowing more tablets and medicine has become less safe. Prescribing appears to have improved in some areas. Even so, 22.3 percent remains a striking figure.

Roughly one in five people in this American sample was still exposed to a combination that researchers classified as potentially capable of causing a major interaction.

The word potentially needs to stay in that sentence.

The study identified interacting medication regimens. It did not establish that every person taking them experienced an adverse event. The researchers themselves list the absence of data on actual adverse drug events as an important limitation.

That restraint makes the findings more useful, not less.

The 63,000 reports that caught my attention

Another number in the JAMA paper deserves careful reading.

The researchers report that between 2015 and 2025, approximately 63,000 serious adverse events attributed to drug-drug interactions were reported to the US Food and Drug Administration among adults aged 65 and older. About 10 percent of those reports involved a fatal outcome.

It would be tempting to turn that into a frightening headline. I will not.

Spontaneous adverse-event reports are valuable for detecting safety signals, but a report does not by itself prove that a particular interaction caused the patient’s injury or death. Reporting systems can also contain incomplete information and are not designed to calculate the incidence of an event in the whole population.

Still, 63,000 serious reports tell us something important.

Medication interaction is not an obscure theoretical problem.

Which medicines appeared most often?

The JAMA researchers also examined the therapeutic classes appearing in potentially major interacting regimens.

In 2021–2023, antidepressants were the most common, appearing in such regimens among an estimated 7.21 percent of older adults. Statins followed at 5.23 percent, while antiplatelet therapies appeared at 4.47 percent.

Those figures should not be read as warnings to abandon antidepressants, statins or antiplatelet medicines.

Quite the opposite.

These drugs can provide substantial benefits when properly prescribed. A person at cardiovascular risk may have a strong clinical reason for taking a statin or antiplatelet drug. Someone with depression may genuinely need an antidepressant.

The problem is the combination, dose, patient’s condition and other medicines being taken.

One change in the study particularly caught my eye. Potentially interacting regimens involving opioid analgesics declined from 5.56 percent to 4.04 percent. Those involving benzodiazepines fell from 2.05 percent to 0.87 percent.

But interacting regimens involving muscle relaxants increased from 1.35 percent to 2.49 percent.

The authors argue that greater attention should now be paid to those combinations.

Medicine safety, in other words, is a moving target.

Age changes what a medicine does to us

There is another reason this becomes important after 60.

Our bodies do not process medicines exactly as they did when we were 30.

The US Food and Drug Administration points out that ageing can change how medicines work in the body. Kidney and liver function may decline, affecting how drugs are broken down or eliminated.

A dose tolerated for years may therefore deserve review later.

Some medication effects can also look like new diseases. The FDA specifically mentions symptoms such as dizziness, sleepiness and memory difficulties.

Imagine what can happen.

An older person becomes dizzy. Everyone assumes it is simply age. He becomes unusually sleepy, so the family worries about weakness. Memory seems poorer and dementia enters the conversation.

Sometimes the explanation may indeed be disease.

But sometimes the medication list deserves inspection.

The tablet bought without a prescription still counts

Here in Karachi, I think this is where the issue becomes especially practical.

People often distinguish between a doctor’s medicine and something they bought themselves. The body makes no such distinction.

A painkiller from the pharmacy remains pharmacologically active. So does an antihistamine. So does an herbal preparation.

Supplements deserve the same attention.

The FDA warns that dietary supplements can alter the absorption, metabolism or excretion of medicines. That can increase or reduce the amount of a drug effectively reaching the body.

Some combinations can increase bleeding risk.

Others can change how well a medicine works.

“Natural” tells us something about marketing or origin. It does not establish that a product cannot interact with prescription medicine.

That small distinction belongs on every older person’s medication list.

Polypharmacy is not automatically bad medicine

There is another trap here.

After reading about polypharmacy, someone may conclude that taking five medicines is inherently dangerous and decide to eliminate a few.

Please don’t.

For someone living with several chronic illnesses, multiple medicines may represent entirely appropriate treatment.

The question is not simply: How many tablets am I taking?

A better question is: Do I still need each one, at this dose, in this combination?

The World Health Organization’s work on medication safety and polypharmacy takes this person-centred approach. WHO stresses the importance of medication review while recognising that people with several long-term illnesses may legitimately need multiple treatments.

Britain’s National Institute for Health and Care Excellence makes a similar point. It recommends considering structured medication reviews for older people, those with chronic conditions and people taking multiple medicines.

The purpose is not a tablet-counting exercise.

It is to determine whether treatment still makes sense for that particular person.

Bring the whole medicine cabinet to the conversation

A useful medication review should include more than prescriptions.

Write down every regular medicine. Add medicines taken only occasionally.

Then include vitamins, herbal preparations and dietary supplements.

For each item, record the dose and why you take it.

The FDA recommends keeping an up-to-date medication list and sharing it with healthcare professionals. Keeping one pharmacy involved where practical can also help because a pharmacist may see combinations prescribed by different doctors.

There are several questions worth asking during a review.

  • Why am I still taking this medicine?
  • Is the dose still appropriate for my age and kidney or liver function?
  • Could any of these medicines interact?
  • Could one of them explain dizziness, sleepiness, stomach trouble or another new symptom?
  • Does an over-the-counter medicine or supplement change the picture?

One question may lead to another. That is fine. Medication review is supposed to be a clinical conversation, not an attempt to reach a predetermined number of tablets.

Most importantly, do not stop a prescribed medicine because an interaction checker, article or social-media post frightened you.

Potential interactions vary enormously in clinical importance. Doctors sometimes prescribe interacting medicines deliberately because the expected benefit outweighs the risk, with dose adjustment or monitoring where appropriate.

Pakistan has a system for reporting suspected reactions

Medication safety is not solely an American issue.

Pakistan’s Drug Regulatory Authority of Pakistan operates a National Pharmacovigilance Centre for monitoring suspected adverse reactions to medicines and other therapeutic goods.

DRAP says patients and consumers can report suspected side effects. Its guidance asks for information about the medicine involved, dose, timing, other medicines being taken and relevant medical conditions.

That last detail matters.

A suspected reaction cannot be understood properly if nobody knows what else the patient swallowed.

DRAP reported in its MedSafetyWeek material that its National Pharmacovigilance Centre had received and processed more than 30,000 reports since 2018. That figure covers suspected medicine-safety reports generally and should not be confused with the US interaction figures in the JAMA study.

Different system. Different population.

The principle, however, travels well: unexplained adverse effects deserve investigation and reporting rather than assumption.

The doctor may know every medicine and still miss the complete picture

Modern medicine has become increasingly specialised.

A cardiologist may manage the heart. Another physician manages diabetes. A different doctor treats pain or depression.

Each can prescribe rationally within a particular field.

The patient remains the only person standing at the intersection of all those prescriptions.

That is why medication reconciliation matters so much.

The danger does not require a careless doctor. It can emerge from a fragmented system in which each prescription makes sense separately while nobody has recently examined the entire combination.

Then the patient adds an OTC painkiller.

Perhaps a supplement enters the cupboard.

Nothing dramatic happens that evening. Months pass.

The risk remains invisible because the medicine cabinet looks ordinary.

My medicine cabinet now looks different to me

The new JAMA study does not tell older people to fear medicine.

I take almost the opposite lesson from it.

Modern medicines allow millions of people to control illnesses that once shortened lives much earlier. Blood-pressure treatment prevents strokes. Diabetes medicines reduce complications. Cardiovascular drugs save lives.

Ageing successfully may therefore require more medicine, not less.

But more medicine creates another responsibility.

Every so often, someone needs to look at the complete list.

Not only the cardiologist’s medicines. Not only the latest prescription. Not merely the tablets we personally consider important.

Everything.

The most useful health check after 60 may occasionally begin without a blood test or scan.

It may begin with a sheet of paper and a surprisingly simple question:

“Do I still need all of these, together?”


Medical note: This article provides general health information and does not replace individual medical advice. Never stop, start or change the dose of a prescribed medicine without consulting an appropriate healthcare professional.

Pakistan Never Built the Iran Gas Pipeline. Now It Needs Tehran to Get LNG Through Hormuz

A Pakistani reader asked why the country is importing LNG through a war-disrupted Strait of Hormuz when Iran sits next door and a gas pipeline has been discussed for decades. The answer leads from sanctions and Pakistan’s unfinished pipeline to an extraordinary 2026 irony: Islamabad now needs Iranian cooperation to help Qatari LNG pass through Hormuz.

A reader asked why Pakistan is bringing gas through a war-disrupted chokepoint when Iran is next door. The answer leads from sanctions to Pakistan’s own failures, and an extraordinary irony created by Hormuz.

A reader left a comment under my recent discussion of Pakistan’s exposure to the Strait of Hormuz.

His question was written in capital letters:

“ALREADY IN PLACE IRAN-PAKISTAN GAS PIPE LINE PROJECT BUT UNDER US SANCTIONS ON IRAN, THIS CANNOT OPERATE?”

I understood what he meant.

I have been hearing versions of this argument in Pakistan for years. Iran has gas. Pakistan needs gas. We share a border.

Somewhere between the two sits the United States with its sanctions.

Why, then, are we bringing liquefied natural gas from Qatar through one of the most dangerous waterways in the world?

The question has become harder to dismiss.

In September, a tanker carrying about 82,000 tonnes of Qatari LNG reached Port Qasim after passing through the badly disrupted Strait of Hormuz. It was Pakistan’s first Qatar-origin LNG cargo through the strait since July. Another Pakistani-bound LNG tanker crossed later in the month.

Before the present war, roughly 125 large commercial vessels passed through Hormuz each day. Reuters counted only 17 commodity vessels crossing during the weekend of September 19–20. Some vessels may have been moving without normal tracking, but the collapse in visible commercial traffic was extraordinary.

I live in Karachi. Port Qasim is not an abstraction to me.

Neither is the gas shortage.

So I went back to the reader’s question.

It turns out that one part of his comment is right. Another part needs correcting.

Between the two lies a story Pakistan has avoided for more than twenty years.

The Pipeline Pakistan Never Built

The Iran-Pakistan pipeline is not a completed pipe waiting for someone to open a valve.

That distinction matters.

Under the original arrangement, Iran was to supply Pakistan with roughly 750 million cubic feet of gas a day. Pakistan was responsible for constructing approximately 781 kilometres of pipeline on its side.

Iran made substantial physical progress.

Pakistan did not build its section.

Petroleum Minister Ali Pervaiz Malik told the Senate in August that sanctions remained in place and Pakistan was therefore not taking practical construction steps. He also confirmed something more serious: the dispute between Pakistan and Iran had reached an arbitration tribunal in Paris. Dawn reported the minister’s account and the arbitration dispute.

Prime Minister Shehbaz Sharif has since established a high-level committee to examine the legal and energy questions surrounding the project, along with its financial implications.

There is another number that frequently appears whenever Pakistanis discuss this project: $18 billion.

I would be careful with it.

It has repeatedly been described as the penalty Pakistan might face for failing to fulfil its obligations. Pakistan’s parliamentary record makes clear, however, that the question of liability is tied to arbitration. Iran disputes Pakistan’s argument that sanctions created a force majeure or excusing event. Pakistan’s National Assembly record sets out the government’s sanctions position.

Pakistan does not currently have an established $18 billion bill sitting on a desk.

What it has is an unresolved international contractual dispute whose eventual cost remains uncertain.

What American Sanctions Actually Do

This is where Pakistani arguments often become too simple.

We sometimes speak of American sanctions as though Washington has placed a physical lock on the pipeline.

Pakistan’s Petroleum Division has explicitly told parliament that the project stalled because of international sanctions on Iran. It also said Pakistan had been unable to begin construction because of U.S. sanctions and had approached Washington through diplomatic channels seeking an exemption.

Sanctions cannot simply be dismissed as Islamabad’s excuse.

But consider what constructing and operating the pipeline would require.

Somebody has to finance it. Contractors willing to work on an Iranian project must then be found, equipment purchased and payments processed through banks that may have international exposure.

That is where sanctions begin to bite.

A bank does not need an American official to telephone its chief executive every morning.

If its compliance department believes an Iranian transaction creates unacceptable sanctions exposure, that can be enough. A contractor with international business may reach the same conclusion.

The project can stop without anyone physically blocking the pipe.

Pakistan’s Foreign Office added an important qualification in June. It said sanctions affecting economic cooperation with Iran were not exclusively American and specifically mentioned European restrictions as well. The Foreign Office briefing described the broader sanctions environment.

The reader who blamed U.S. sanctions therefore identified a major part of the problem.

He did not identify all of it.

Sanctions Are Not Pakistan’s Entire Alibi

This part makes me uncomfortable because Pakistanis, myself included, are accustomed to looking for the external power behind a national problem.

Sometimes it is there.

But twenty years is a long time.

Pakistan struggled with financing. Construction never began on the required scale. Commercial circumstances changed while governments came and went.

Iran waited.

Deadlines moved.

Eventually lawyers entered the story.

The result is peculiar. Pakistan needs gas and once signed a long-term agreement to buy Iranian gas, yet the country never constructed the infrastructure required to receive it.

Sanctions help explain that history.

They should not prevent us from examining Pakistan’s own decisions inside it.

Pakistan today is not the Pakistan that negotiated this pipeline.

The Pakistan That Signed This Deal No Longer Exists

Drive around Karachi in daylight and look upward.

Solar panels are difficult to miss now.

They are sitting on houses and shops. Industrial buildings have them too. Pakistan’s rapid solar expansion has started reshaping daytime electricity demand.

That matters to the pipeline debate.

Power Minister Awais Leghari told Reuters earlier this year that around 74% of Pakistan’s electricity was being generated from domestic sources in March. LNG accounted for roughly 10% of power generation and remained particularly useful for evening demand.

Pakistan had even cancelled 21 LNG cargoes scheduled for 2026–27 under its long-term arrangement with Italy’s Eni because demand had weakened.

That is quite a change from the Pakistan that negotiated the Iran gas deal.

We cannot take a twenty-year-old energy argument, dust it off and assume the economics remain identical.

The pipeline may still make sense.

Somebody needs to prove it with today’s numbers.

The $10 Gas Question

Geography plays tricks on us.

Iran is next door. Qatar is across the Gulf.

Surely Iranian gas must therefore be cheaper.

Perhaps.

Proximity alone doesn’t answer the question.

The Pakistan Institute of Development Economics recently revisited the project. Using the proposed Brent-linked pricing formula, PIDE calculated that at an illustrative Brent price of $75 a barrel, the gas commodity price would work out at about $10.09 per MMBtu. Read PIDE’s economic assessment.

That is an illustrative calculation, not a quotation for gas Pakistan could buy tomorrow.

Taking 750 million cubic feet every day could imply an annual gas-purchase commitment of roughly $2.84 billion, according to the same analysis.

Pakistan would still need to finance and construct its section of the pipeline.

Other analysts reach a more favourable conclusion. Energy-market specialists interviewed by S&P Global estimated that Iranian pipeline gas could save Pakistan roughly $3–$6 per MMBtu compared with LNG under their assumptions. They also cautioned that geopolitical obstacles would have to ease and commercial terms might require renegotiation. S&P Global reported the competing estimates.

I find the disagreement useful.

It tells us that “Iranian gas is cheap” is not an analysis.

Neither is “the pipeline is uneconomic.”

Run the numbers again.

The Pakistan of 2026 deserves a 2026 calculation.

Then Came the War

Pakistan’s LNG normally comes from Qatar.

To reach us by sea, it has to pass through Hormuz.

The war has turned that routine voyage into something requiring diplomacy.

In May, Reuters reported an extraordinary development. Pakistan had reached an arrangement with Iran concerning the passage of Qatari LNG shipments through Hormuz. Iran was increasingly regulating passage through the strait as normal commercial movement collapsed. Reuters reported on Pakistan’s Hormuz arrangement with Iran.

Read that again.

Pakistan could not complete a pipeline to bring Iranian gas across the land border.

Then Pakistan had to deal with Iran so that gas from somewhere else could get through the sea.

By September, this was no longer a one-off curiosity. Pakistan again secured passage for another Qatari LNG shipment through diplomatic engagement involving Iran.

That is the part of this story I cannot get out of my head.

For decades, sanctions made energy cooperation with Iran extraordinarily difficult.

Now the geography of the war has made cooperation with Iran relevant to Pakistan’s access to non-Iranian energy too.

The old debate has been turned upside down.

A Pipeline Would Solve One Problem, Not All of Them

At this point it would be easy to write the angry conclusion.

Build the pipeline.

Tell Washington Pakistan needs energy.

Problem solved.

I don’t think the evidence allows me to say that.

A land pipeline could reduce Pakistan’s exposure to the Strait of Hormuz for the volume of gas it carried. That is a genuine strategic advantage.

The gas, however, would come from Iran, a country under sanctions and at the centre of the present conflict. Pakistan would still need a workable payment mechanism.

There is also the physical route through Balochistan. Any serious costing of the project has to include the problem of protecting infrastructure over decades.

And while all this has been happening, Pakistan’s gas market itself has changed.

Solar has altered electricity-consumption patterns. The gas sector carries enormous circular debt. A long-term gas commitment that looked sensible in another era requires another look now.

This is why I don’t see the Iran pipeline as a magic route to Pakistani energy independence.

A pipeline can bypass Hormuz. It cannot bypass geopolitics.

The Reader’s Question Was Better Than It Looked

I went back to that capital-letter comment after doing this research.

“Already in place” was wrong.

Pakistan’s part isn’t.

The suggestion that sanctions have prevented the project from operating was much closer to reality, although sanctions are not the whole explanation.

Yet the reader had noticed something important.

Pakistan is struggling to obtain LNG through a maritime chokepoint while an unfinished gas project sits in our diplomatic files involving the country next door.

The irony has become stranger.

Pakistan has had to seek Iranian cooperation over the passage of Qatari LNG through Hormuz while the Iran-Pakistan land pipeline remains stalled.

I can imagine one of those tankers eventually approaching Port Qasim.

Most people in Karachi will never see it.

We will notice the consequences elsewhere, perhaps in a gas bill or another government announcement about energy conservation.

That is what has changed for me about this old pipeline debate.

I am not convinced that Pakistan should simply start laying pipe tomorrow. The sanctions problem is real. So are the contractual and financial questions.

But I am equally uncomfortable with pretending that doing nothing carries no cost.

For twenty years Pakistan has worried about the price of building the pipe.

Hormuz has now shown us the price of not having enough alternatives.

Raast Hawala Monitoring: The Money Looks Local. The Hawala Network May Not Be

A Raast transfer can be domestic while the economic deal behind it starts abroad. Pakistan’s AML challenge is to detect that hidden relationship.

FATF’s Oman case shows why Pakistani banks must detect cross-border relationships hidden inside ordinary domestic payments.

A Pakistani bank can receive a perfectly ordinary Raast transfer at 10:17 in the morning. Imagine Rs85,000 entering a personal account in Karachi. The beneficiary is known, the account is active, and the payment arrives through Pakistan’s national instant-payment system. Nothing in the payment message says Oman, hawaladar or informal remittance.

Yet the economic story behind the transfer may have begun in Muscat.

Raast hawala monitoring therefore cannot stop at the domestic payment message. FATF’s September 2026 report on underground banking and hawala describes an Oman case in which suspected operators offered expatriates cheaper remittance services and used payment channels in destination countries, including fee-free Raast transfers in Pakistan. SBP correctly responded that Raast itself does not process cross-border transfers and that FATF did not identify Raast as a money-laundering mechanism.

Both statements can be true. A domestic payment rail can remain technically sound while an informal network uses it for the local payout leg of a wider cross-border arrangement.

Raast Hawala Monitoring Cannot Depend on One Transaction

The first mistake would be to treat every unusual Raast payment as evidence of hawala. Raast has become too large and too ordinary for that approach.

SBP’s Q2 FY26 Payment Systems Review shows how quickly the system has expanded:

MeasureQ2 FY25Q2 FY26Change
Total Raast transactions295.7 million645.7 million+118%
Total valuePKR 6.36 trillionPKR 18.47 trillion+190%
P2P transactions293.7 million603.0 million+105%
P2P valuePKR 6.14 trillionPKR 15.69 trillion+156%
Percent changes calculated from SBP quarterly payment-system data.

At that scale, a crude rule based on transaction value will create noise. A salary account may suddenly receive money for a wedding. A small trader may collect payments from many customers. A family may move funds between relatives. None of those facts proves an informal remittance arrangement.

Banks need to ask a different question: does the behaviour fit what they know about the customer?

SBP’s AML/CFT/CPF rules already point in that direction. Regulated entities are expected to use automated transaction-monitoring systems and compare activity with customer profiles. Transactions that depart from the history or normal operation of an account require closer examination.

Raast adds speed and volume to an old monitoring problem. The answer should not be to make Raast slower.

The Account Pattern Matters More Than the Payment

A single domestic transfer often tells very little. A sequence can tell much more.

Compliance teams should pay attention when a personal account receives funds from many unrelated senders and quickly disperses them to other beneficiaries. Analysts often describe those patterns as fan-in and fan-out. Rapid pass-through matters too: money arrives and leaves so quickly that the account behaves more like a conduit than an account used for normal personal or business activity.

FMU’s own hawala typologies have repeatedly highlighted accounts with activity inconsistent with the customer’s profile, unrelated counterparties and rapid movement of funds. Older payment instruments produced those patterns before Raast existed. Instant payments can now compress the same behaviour into minutes.

No single indicator should trigger an accusation. A marketplace seller can show high fan-in. A payroll account can show fan-out. A charity can receive money from people who have no obvious relationship with one another.

Context decides whether the pattern deserves escalation. Banks need combinations of signals followed by human review.

KYC Must Become Behavioural, Not Merely Documentary

Know Your Customer often receives most attention when an account is opened. The customer provides an identity document, occupation, expected income and purpose of account. The file can look complete on day one and become stale months later.

Digital hawala makes ongoing profiling more important.

A stronger model would continuously compare actual account behaviour with the customer’s expected activity. A salaried person who suddenly begins receiving dozens of transfers from unrelated people deserves a different review from a retailer whose business naturally produces the same pattern.

Centralised KYC could help, but the phrase needs care. Pakistan should not create a giant pool of customer data that every institution can browse. Privacy and data-security rules must govern legal access.

A more defensible goal is consistent customer-risk information and stronger ecosystem-level analytics under clear regulatory authority. Banks still need responsibility for their own customers. SBP and FMU need enough visibility to identify patterns that cross institutional boundaries.

Better profiling should reduce false positives rather than multiply them.

From I. I. Chundrigar Road, the Gap Looks Familiar

Working around banking and SWIFT taught me to separate the message from the economic relationship behind it.

A SWIFT message can be technically valid while the underlying transaction still raises a compliance question. Nobody would conclude that SWIFT itself had failed simply because a suspicious payment used the network. Investigators would examine the parties and the economic purpose of the transaction.

Raast deserves the same distinction.

SBP’s September 4 clarification matters because some reporting blurred the line. Raast currently handles domestic payments. FATF did not say that Raast carried money from Oman into Pakistan.

The Oman case points to a different mechanism. A customer abroad can give value to a hawala operator. The network can create an obligation to pay a beneficiary in Pakistan. A counterpart in Pakistan can then use local funds to make the payout through Raast.

The Raast transaction remains domestic. The economic relationship does not.

Digitalisation therefore does not automatically eliminate hawala. It can give an informal network a cheaper domestic payout tool while the cross-border settlement happens somewhere else.

Banks Need Network Analysis, Not More Blanket Limits

Pakistan should resist the easiest response: lowering limits for everyone.

Blanket restrictions punish ordinary customers and weaken one of Raast’s main advantages. They can also push activity back toward cash, where monitoring becomes harder.

Banks should instead examine networks. An account that repeatedly receives funds from unrelated people may connect to another account showing the same behaviour. Several accounts may share devices or contact details where law and available data permit those links to be analysed. Recurring counterparties can reveal a pattern that no individual payment exposes.

FMU typologies already show the value of connected-account analysis. One published hawala case describes interlinked accounts with heavy turnover and unrelated counterparties. Another describes rapid movement of funds linked with people already suspected of illegal foreign-exchange activity.

Fraud monitoring and AML monitoring also need different questions. Fraud systems often ask whether the customer authorised a payment. AML systems ask whether an authorised payment makes economic sense in the customer’s broader activity. A transfer can pass authentication checks and still deserve AML review.

Graph analysis can help compliance teams find those relationships, but an algorithm should not become a verdict. Analysts still need evidence and customer context. Their reasoning should be documented before an STR is filed.

SBP Can See a Problem One Bank May Miss

One bank may see only one fragment.

Imagine an account at Bank A receiving money from several customers. Some funds move to Bank B. Another part reaches a wallet at a third institution. Each institution sees its own customer and its own transactions.

No bank necessarily sees the whole network.

SBP, Raast’s operator and FMU occupy different positions in the system. Their legal powers and responsibilities also differ. Pakistan should examine whether privacy-preserving, regulator-led analytics can identify cross-bank patterns without turning the payment system into an unrestricted customer-surveillance database.

The distinction matters. Central visibility should identify risk patterns and support lawful investigation. It should not erase institutional accountability or customer privacy.

A sensible model would allow regulators to identify suspicious network structures and then route intelligence to the institutions or authorities legally entitled to act on it.

Speed also matters. Instant payments can move through several accounts before a traditional case-review process begins. Monitoring has to become closer to the speed of the payment system without assuming that every fast transfer is suspicious.

The Missing Record May Sit Outside Pakistan

FATF’s Oman case exposes the hardest problem.

A Pakistani bank can see the domestic payout. It may know the account holder and counterparties in Pakistan. The bank may even detect rapid pass-through behaviour. Yet none of those records necessarily explains why someone in Oman handed money or value to an informal operator.

The missing information may sit with an Omani bank, an e-wallet provider or investigators who identified the suspected hawala network.

FMU already has a legal basis for cooperation with foreign financial-intelligence units. Its international-cooperation guidance explains that Section 6(4)(e) of the Anti-Money Laundering Act empowers FMU to exchange relevant information with counterpart financial-intelligence units through reciprocal arrangements.

That international connection is where Raast hawala monitoring becomes more than a software problem.

Pakistan can improve customer profiling while banks tune transaction-monitoring scenarios. Regulator-led analysis can also expose cross-bank patterns. Even together, those measures cannot reconstruct an offshore relationship that never appears in the domestic payment message.

The next test is whether Pakistan can connect a suspicious-looking domestic pattern with foreign intelligence quickly enough to understand what it means.

A payment in Karachi may look entirely local.

The record that explains it may be sitting in Muscat.


Related Reading: Pakistan Built Raast to Fight Cash. Hawala Found a Way In

This analysis was drafted under editorial direction with AI technical assistance, then verified and edited by Munaeem Jamal.