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.

“A Very Pakistani Problem”? How Palki Sharma Turned a Regional Energy Shock Into a Pakistan Punchline

Palki Sharma called Pakistan’s fuel crisis “a very Pakistani problem.” I examine the military exemption, Iran sanctions and the regional energy shock.

I was watching Palki Sharma explain Pakistan’s latest fuel-conservation measures when the tone changed.

At first, I recognised the country she was describing. Markets closing earlier. Government vehicles getting less fuel. Officials being told to cut travel. These are uncomfortable measures for people already watching petrol prices and household expenses.

Then came the jokes.

Pakistan’s attempt to conserve fuel became a “lockdown.” An exemption for operational military vehicles became a claim that the armed forces could use as much fuel as they wanted.

Later came the sharper line. Pakistan, viewers were told, may keep running out of resources, but apparently never runs out of bad decisions.

One sentence caught my attention because it sat awkwardly beside what followed.

“This is not a crisis of Pakistan’s making,” Sharma said.

Quite.

The interesting question is how a regional energy shock then became, in the same commentary, “a very Pakistani problem.”

Pakistan really has imposed painful restrictions

There is no reason for me to pretend Islamabad has handled energy security brilliantly.

It has not.

On September 17, the federal government announced a three-month austerity and fuel-conservation drive as higher international petroleum prices put Pakistan under growing pressure. Fuel allocations for official vehicles were cut by 50 percent. Purchases of new government vehicles were banned. Foreign official travel was heavily restricted for three months, according to the government announcement reported by Radio Pakistan.

Government departments were also told to make greater use of teleconferencing. Most official dinners were prohibited, except those involving visiting foreign delegations.

Commercial restrictions affect ordinary life more visibly.

Markets and most shops must close by 9 p.m. Marriage halls close by 10 p.m. Restaurants can operate until 11 p.m., while takeaway and home delivery remain exempt. Pharmacies and hospitals are among the essential services exempt from the closing restrictions. Fuel stations remain exempt as well.

The government has also retained the single-dish requirement for marriage functions.

Those measures are real.

Calling them a “lockdown” is editorial framing.

Pakistanis have not been ordered into their homes. Economic activity has not been generally suspended. Businesses are operating under restricted hours.

The word works well on television because anyone who lived through Covid immediately understands the image.

It also makes the policy sound more dramatic than the notification itself.

A regional energy crisis sits behind the Pakistani story

Pakistan did not suddenly wake up in September and forget how to buy oil.

The regional conflict has severely disrupted energy flows. Reuters reported on September 17 that the worsening Gulf conflict was putting Pakistan and other Asian energy importers under intense pressure.

Pakistan entered that crisis badly exposed.

Reuters reported in May that up to 90 percent of Pakistan’s oil and LNG imports depended on supplies moving through the Strait of Hormuz. The same report found that Pakistan had no strategic petroleum reserve. Islamabad was studying expanded storage and a reserve system, but those plans had not yet produced the buffer that a prolonged emergency demands.

That failure belongs to Pakistan.

An import-dependent country sitting close to one of the world’s most dangerous energy chokepoints should have spent years preparing for disruption. Governments knew the geography. They also knew how quickly an oil shock could damage Pakistan’s fragile balance of payments.

Yet the vulnerability remained.

Criticism should start there.

No, the military was not given unlimited fuel

The military section of Sharma’s commentary is where the difference between criticism and caricature becomes clearer.

“Of course, these rules are not for everyone,” she said.

Then came the claim: “They can use as much fuel as they want.”

The official measure is narrower.

The Cabinet Division measures exempt operational vehicles belonging to the Armed Forces and Civil Armed Forces. Operational vehicles of law-enforcement agencies are also exempt, as are those used by essential services and the Federal Board of Revenue. Administrative and non-operational formations do not receive that exemption, according to the officially reported measures.

That distinction matters.

An ambulance cannot simply stop responding because a monthly fuel allocation has been exhausted. The same practical problem applies to emergency law-enforcement operations. Military vehicles performing genuine operational duties raise a comparable issue.

None of this places Pakistan’s military beyond scrutiny.

Quite the reverse. The government should be able to explain how it defines “operational.” Public scrutiny also matters because a broad interpretation could undermine the savings promised by the policy.

Yet the debate should begin with the measure that actually exists.

“Operational military vehicles are exempt” and “they can use as much fuel as they want” are materially different descriptions.

The second one makes better television.

November is the real warning

The segment also leaves viewers with an impression that Pakistan is approaching the bottom of its fuel tanks.

Petroleum Minister Ali Pervaiz Malik gave a more precise account.

He said Pakistan had adequate stocks for September. The government had also reduced the risk to October supplies even under an adverse scenario.

November worried him.

“We have adequate stocks,” Malik said. Even under difficult conditions, he explained, October was covered, “but November I have to plan,” according to Business Recorder.

That is serious.

It is not the same as saying Pakistan will run out of fuel after two months.

Islamabad is now looking far beyond its traditional suppliers. Malik identified Oman and Fujairah as possible sources. He also said Pakistan was exploring Libya and the United States, while West African crude and Kazakhstan were under consideration.

One proposal reveals another Pakistani weakness.

The government is examining whether it can bring American crude in a Very Large Crude Carrier, or VLCC. Malik said such vessels can carry about four times the crude transported by the carriers Pakistan normally uses.

Then the infrastructure problem appears.

According to Malik, existing Pakistani ports lack the draft and infrastructure required to berth these giant vessels. One possibility would involve parking a VLCC near Hub or at Sohar in Oman, followed by ship-to-ship transfers into smaller vessels bound for Pakistan.

Pakistan also has a limited number of vessels available to manage these movements, Malik acknowledged.

Here is a genuine Pakistani problem.

Why did an import-dependent country enter a major energy emergency without a proper strategic reserve?

Why does port infrastructure still constrain the ability to diversify crude supplies quickly?

Those questions concern Pakistani choices. They deserve uncomfortable answers.

They do not require punchlines.

Then I looked west from Karachi

Something else bothered me while listening to the list of possible suppliers.

The United States. Libya. West Africa.

Iran sits next door.

From Karachi, the geography looks strange. Pakistan may consider bringing crude across an ocean while a major petroleum producer lies across our western border.

The explanation begins in the financial system.

For a short period this summer, Washington loosened part of the sanctions framework. OFAC issued General License X in June, authorising specified transactions involving Iranian-origin crude and petroleum products.

That opening did not last.

On July 7, OFAC revoked General License X and replaced it with General License X1 to wind down the June authorisation, according to the U.S. Treasury’s OFAC notice.

As of September, OFAC continues to maintain an extensive Iran sanctions programme. Its current Iran sanctions guidance makes clear that some Iran-related activities can proceed when specifically licensed, which is why saying simply that all Iranian oil transactions are “illegal” would be inaccurate.

For Pakistan, the practical problem goes beyond the wording of one American licence.

An Iranian barrel can be close and still difficult to buy

I work around cross-border payments, so this part of the story immediately catches my attention.

Buying crude requires more than finding a seller.

A payment has to move. Banks must accept the transaction and the counterparties involved. Shipping arrangements have to function under the applicable sanctions environment.

Once sanctions screening enters that chain, a commercially attractive transaction can become difficult very quickly.

That is the Iran paradox.

Pakistan and Iran share a border. Yet an Iranian barrel can be financially harder for Pakistan to obtain through conventional international channels than crude travelling a much greater physical distance.

That does not mean Iranian energy is irrelevant to Pakistan.

Quite the opposite.

During the present crisis, Iran has already demonstrated its importance to Pakistan’s energy security in another way. Reuters reported in May that Pakistan and Iraq had reached arrangements with Iran concerning passage of oil and LNG through the Gulf while Tehran exercised greater control over traffic through the Strait of Hormuz.

Geography still matters.

Financial architecture matters too.

A map shows only half the problem.

Pakistan still owns its failures

None of this absolves Islamabad.

The present crisis has exposed weaknesses that should have been addressed before energy routes came under severe pressure.

Strategic reserves provide the clearest example. Pakistan depends heavily on imported energy moving through Hormuz, yet Reuters found in May that the country lacked a dedicated strategic petroleum reserve.

Port capability creates another constraint.

If Pakistan wants a genuinely diversified crude supply, it needs infrastructure capable of handling economical long-distance shipments. Reliance on offshore transfers and smaller feeder vessels adds complexity when the country is already under pressure.

Energy diversification also requires more than finding another seller whenever war closes a route.

Asia as a whole has been learning that lesson during the Iran conflict. Reuters reported earlier in the crisis that governments across the region were scrambling for alternatives as disrupted supplies raised costs and exposed import dependence.

Pakistan has less financial room than many larger Asian economies to absorb such shocks.

That makes preparation more important, not less.

I do not need an Indian television presenter to tell me Pakistan has made poor energy decisions.

I live here.

Every increase at the petrol pump eventually reaches the household budget. Transport becomes more expensive. Food follows sooner or later.

For people dealing with those costs, the fuel crisis is not an amusing abstraction.

That is why accuracy matters.

When criticism turns into performance

Palki Sharma had the ingredients for a stronger story.

Pakistan entered this emergency dangerously dependent on Gulf energy routes. It lacked the strategic petroleum reserve that such exposure should have encouraged. Its port limitations now complicate attempts to diversify crude supplies quickly.

Then there is Iran.

A major petroleum producer lies next door, yet sanctions and the international financial system complicate the commercial value of that proximity. OFAC’s brief opening in June, followed by its July revocation and wind-down, shows how quickly that environment can change.

Those are difficult stories.

Instead, parts of the segment fall back on a familiar image of Pakistani dysfunction.

The most revealing moment remains Sharma’s acknowledgement:

“This is not a crisis of Pakistan’s making.”

She is right about the immediate external shock.

Pakistan did not create the regional conflict or the resulting disruption of energy flows.

Pakistan did, however, enter that crisis with vulnerabilities of its own making.

Both facts belong in the story.

A serious critique can ask why Pakistan lacked stronger reserves before the crisis arrived. It can investigate whether military exemptions remain tightly confined to operational use. It can examine why port constraints make emergency diversification harder.

There is enough there to make Islamabad uncomfortable without stretching the facts.

After checking the Cabinet Division notification and the petroleum minister’s remarks, I returned to the final minutes of the broadcast.

Pakistan, we are told, may keep running out of resources but never out of bad decisions.

Some Pakistani decisions certainly deserve their own investigation.

Yet I am left thinking about something else.

When a regional energy crisis crosses a border and enters a television studio, at what point does journalism stop explaining another country and begin performing that country for its audience?

How Does Physical Activity Affect Bone Health in Older Adults?

Physical activity can help protect ageing bones, but walking alone may not provide the strongest skeletal stimulus. Current evidence shows why resistance training, appropriate weight-bearing activity and balance exercise all have different roles in maintaining bone health and reducing fracture risk.

I often see older people walking in Karachi early in the morning. Some move briskly around a park. Others walk slowly along a neighbourhood road before the traffic becomes unbearable.

It looks like exactly what doctors have been telling us to do for years: keep moving.

But there is a question we rarely ask. Is walking enough to protect our bones as we grow older?

The answer is more complicated than I once thought.

Physical activity remains one of the most useful tools we have for healthy ageing. Yet current evidence shows that bones do not respond equally to every type of movement. Walking helps. Strength training can provide a different stimulus. Balance exercises matter for another reason entirely: they may stop the fall that causes the fracture.

For older adults, therefore, the important question is no longer simply whether we exercise.

It is what kind of exercise we do.

What Happens to Our Bones as We Age?

Bone looks permanent, but biologically it is active tissue.

Throughout life, the body continuously removes old bone and forms new bone. With ageing, particularly after menopause in women, bone breakdown can outpace bone formation. Bone mineral density may decline, and the skeleton can become more vulnerable to fractures.

Ageing also affects muscle.

That combination matters. Weaker bones increase the consequences of a fall, while weaker muscles and poorer balance can increase the chance of falling in the first place.

This is why exercise has more than one role in protecting an older person.

According to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, physical activity can support bone health while also improving muscle strength, coordination and balance.

The last two benefits deserve more attention than they usually receive.

A stronger hip is useful.

Not falling on that hip may be even more useful.

Exercise Cannot Turn an Older Skeleton Back into a Young One

Health articles sometimes exaggerate what exercise can achieve.

The claim that exercise simply “builds strong bones” needs qualification when we talk about older adults.

Exercise during childhood and early adulthood helps build bone mass. Later in life, the objective changes. The NIAMS guidance on osteoporosis explains that exercise in older adults is particularly valuable for maintaining function, improving strength and balance, and limiting the consequences of age-related decline.

Changes in bone mineral density from exercise can be modest.

That does not make exercise ineffective.

Recent systematic reviews and meta-analyses show that resistance-training effects vary according to exercise intensity, frequency and the skeletal site being measured. Some programmes produce measurable improvements, while differences at other sites are less certain.

The research also illustrates why simple statements such as “lifting weights increases bone density” can mislead readers.

The response depends on the programme and the person.

Walking Is Excellent, but Walking Alone May Not Be Enough

This point deserves special attention because walking is probably the most accessible exercise for older adults.

Walking has many advantages. It keeps us mobile. Brisk walking counts as weight-bearing activity, and it supports cardiovascular fitness and independence.

I would never tell an older person who has started walking that the activity is unimportant.

But walking should not automatically become the entire bone-health programme.

Bones respond to mechanical loading. Different activities impose different forces on the skeleton. Ordinary walking generally creates less skeletal stimulus than appropriately designed resistance or impact exercise.

The Royal Osteoporosis Society recommends combining impact activity with strength exercise when this is appropriate for the individual.

So a daily walk remains valuable.

The better question is what can safely accompany it.

Strength Training Becomes Increasingly Important

This is where the evidence becomes particularly useful.

Resistance training means making muscles work against resistance. That resistance does not have to come from a barbell in a gym.

It can come from dumbbells or resistance bands. Body weight can also provide resistance.

When muscles contract against resistance, they place forces on bones. The body can respond to this mechanical loading.

The Royal Osteoporosis Society’s strength-exercise guidance recommends strength exercise two or three days a week for people who can perform it safely, with appropriate progression and technique.

Research continues to refine exactly how hard older adults need to train.

Recent systematic reviews comparing resistance-training programmes suggest that greater intensity can improve strength, but bone-density responses are not identical at every skeletal site. That is a useful warning against turning “heavier is better” into another simplistic rule.

The goal is not to make every 70-year-old lift the heaviest weight possible.

The goal is to provide an appropriate and progressive stimulus.

What About Jogging, Jumping and Other Impact Exercise?

Here we need caution.

Impact exercise produces forces through the skeleton. Depending on the person, activities involving greater impact may provide a useful bone stimulus.

But this does not mean every older adult should start jogging or jumping.

The Royal Osteoporosis Society classifies walking and stair climbing as relatively low-impact activities. Jogging, small jumps and some forms of dancing create greater impact.

Its guidance makes an important distinction. Moderate-impact activity may benefit bones, but high-impact exercise is not specifically required for people with osteoporosis. Someone who already performs higher-impact activity comfortably may be in a different situation from an older person with spinal fractures who suddenly decides to start jumping.

Medical history changes the equation.

A person with osteoporosis, previous fragility fractures, painful arthritis or significant balance problems may need a modified programme.

This is precisely why an exercise that is good for one 65-year-old may be unsuitable for another.

Stronger Bones Are Only Half the Story

Imagine two older adults with similar bone density.

One has strong legs and good balance. The other struggles when rising from a chair and becomes unstable when turning quickly.

Their fracture risks are not necessarily identical.

Many fractures occur after falls. Preventing the fall therefore becomes part of protecting the skeleton.

The NIAMS exercise guidance specifically recommends balance training for older adults.

Balance work can take several forms. Tai chi is one example. Carefully performed step-ups and weight-shifting exercises are others.

The purpose is practical.

An older person who can recover after stumbling over a doorstep may avoid the event that would otherwise produce a hip fracture.

Exercise therefore protects us through two different mechanisms.

Some activities load the skeleton and help preserve bone strength. Others improve the muscles, coordination and balance that help keep us upright.

A good programme considers both.

Bone Density Is Not the Whole Measure of Success

This also changes how we should interpret research.

Bone mineral density, usually measured by a DXA scan, is an important marker of osteoporosis and fracture risk. But it does not capture every benefit of exercise.

Suppose an older person’s DXA result changes very little after months of exercise.

Was the programme useless?

Not necessarily.

If that person has stronger legs, walks more confidently and can recover balance more effectively, the exercise may still have reduced important contributors to fracture risk.

This distinction explains why relatively modest changes in bone mineral density should not be interpreted as evidence that exercise does little for older adults.

Healthy ageing is not a laboratory number alone.

It is also the ability to stand, walk and remain independent.

Exercise Does Not Replace Osteoporosis Treatment

Another correction is necessary.

Exercise is sometimes presented online as a natural alternative to osteoporosis medication.

The evidence does not support that claim.

The Royal Osteoporosis Society states that exercise and healthy habits do not replace osteoporosis medicine when medication is clinically indicated.

Someone at high risk of fracture may need medical treatment in addition to exercise.

Nutrition matters as well. Adequate calcium, vitamin D and protein form part of the wider picture, depending on individual dietary intake and medical circumstances.

Exercise belongs inside that framework.

It should not be sold as a cure.

Who Should Be Particularly Careful?

Most older adults can benefit from becoming more active, but the starting point matters.

A healthy 65-year-old who already walks several kilometres and has good balance is not in the same position as an 80-year-old with vertebral fractures.

The Royal Osteoporosis Society’s safety guidance recommends seeking professional advice when someone has spinal fractures, multiple previous fractures, recurrent falls or medical problems that make exercise difficult.

People who have been inactive should also progress gradually.

Technique matters during resistance exercise. So does balance before attempting more demanding impact movements.

Pain, severe breathlessness, dizziness or chest symptoms during exercise should not simply be ignored in the hope of becoming fitter.

Age should not frighten us away from movement.

Medical circumstances should shape how we move.

So What Should an Older Adult Actually Do?

I would resist the temptation to prescribe one universal routine.

The evidence instead points toward a combination.

Regular walking or another suitable aerobic activity can keep a person moving. Progressive resistance exercise can challenge muscles and bones more directly. Balance work can reduce one of the major pathways to fracture: falling.

The precise intensity must depend on fitness, bone health and previous fractures.

This approach is less dramatic than promising that one exercise will rebuild ageing bones.

It is also much closer to the evidence.

The Question Has Changed for Me

When I see older people walking in the morning now, I still regard that habit as something worth protecting.

Getting out of the chair matters.

Walking matters.

But our understanding of bone health should move beyond the advice to “stay active.”

An ageing skeleton needs appropriate loading. An ageing body also needs enough muscle and balance to avoid the fall that can turn low bone density into a broken hip.

Physical activity cannot stop ageing.

It can, however, change how we age.

For many older adults, the most useful programme may therefore be neither endless walking nor aggressive gym training. It is a carefully chosen combination of movement, resistance and balance, adjusted as the body changes.

And when osteoporosis or previous fractures enter the picture, the exercise should adapt with them.

Medical note: This article provides general health information and does not replace individual medical advice. People with osteoporosis, previous fragility or spinal fractures, recurrent falls, significant joint disease, or other medical conditions should discuss new or substantially more intensive exercise with an appropriate healthcare professional.

Iran Does Not Have to Close Hormuz to Hurt Pakistan. The Bill Has Already Arrived

Pakistan is not fighting the Iran war, yet disrupted Hormuz shipping is already raising energy costs and forcing fuel relief at home. Here is how the Gulf crisis reaches a Karachi petrol pump.

I can stand at a petrol station in Karachi and see nothing that resembles a war.

Motorcycles crowd around the pumps. Cars edge forward. An attendant watches the meter and asks for payment. Another customer checks his phone before filling his motorcycle.

Yet the price of that fuel is being shaped by events more than a thousand kilometres away.

A tanker attacked near the Strait of Hormuz does not have to be carrying Pakistani oil. Iran does not need to achieve a total shutdown of the waterway. Pakistan does not have to fire a shot.

For Pakistan, this is no longer a risk scenario.

The transmission has already begun.

Visible commercial traffic through Hormuz has collapsed from normal pre-war levels. Reuters reported only 17 commodity-vessel crossings during the weekend of September 19-20, compared with 37 the previous weekend. Before the conflict began on February 28, roughly 125 large commercial vessels normally crossed each day. Some vessels are apparently travelling without normal tracking, so visible traffic does not capture everything moving through the strait.

Then came a detail that should interest every Pakistani.

The Shandong Redwood, carrying LNG loaded at Qatar’s Ras Laffan terminal, passed through Hormuz on September 19.

Its destination was Pakistan.

Suddenly Hormuz is not an abstract line on a geopolitical map. It is part of Pakistan’s energy supply chain.

Hormuz Is Not Operating Normally

For years, discussion about Hormuz followed a familiar script. Iran threatens the strait. Oil markets become nervous. Analysts debate whether Tehran can close it. Eventually attention shifts elsewhere.

The present crisis is different.

The useful distinction is no longer simply between an open strait and a closed one. Normal commercial movement has been severely disrupted, while energy continues to move through extraordinary arrangements.

Before the conflict, roughly one-fifth of global petroleum liquids consumption moved through Hormuz. The waterway also handled around a quarter of internationally traded LNG, making disruption there a problem far beyond the Gulf, according to the IMF.

The scale of the change is extraordinary.

The U.S. Energy Information Administration estimates that total oil flows through Hormuz fell from 21.6 million barrels per day in the fourth quarter of 2025 to 4.9 million barrels per day during the second quarter of 2026. LNG flows dropped from 10.5 billion cubic feet per day to 0.8 billion.

Yet oil has not stopped moving completely. The industry has improvised.

Tankers perform ship-to-ship transfers outside the strait. Some vessels shuttle crude through dangerous waters and transfer their cargo near Oman. Other movements may occur without normal AIS tracking.

September oil exports through Hormuz recovered to around 6.5 million barrels per day through these unusual arrangements, according to Reuters.

It works.

It is also expensive.

Reuters reported benchmark freight rates above $30 per barrel for a very large crude carrier moving Gulf oil to China. Before the war, freight represented only a small fraction of the delivered cost.

That distinction matters for Pakistan.

We often watch Brent crude as though it were the petrol-pump price written in another currency. It isn’t.

Pakistan ultimately pays for delivered energy. Freight charges rise. Insurance becomes more expensive, while a regional risk premium can push the delivered price higher still.

A barrel does not become cheap merely because it survives the journey.

Pakistan Cannot Declare Economic Neutrality

Pakistan can try to remain outside a regional war.

Its import bill cannot.

The IMF put the exposure rather starkly in its April 2026 assessment. Pakistan is a net importer of oil and gas, leaving the economy particularly vulnerable to a Middle Eastern energy shock.

More strikingly, the IMF estimated that 81 percent of Pakistan’s fuel imports came from Gulf Cooperation Council suppliers. It also found Pakistan was being affected not only by higher international energy prices but by regional premiums above international benchmarks, particularly for refined petroleum products.

There is the mechanism.

Pakistan does not have to lose access to every Gulf cargo. The cargo merely has to become more expensive.

The State Bank recognised the seriousness of the situation in April. It changed foreign-exchange procedures to facilitate imports of crude oil, petroleum products and LNG amid the geopolitical disruption.

Pakistan’s dependence on imported energy is hardly new.

The State Bank’s annual report noted that even when the country’s energy import bill fell by 5.8 percent in FY2025, petroleum import volumes remained broadly unchanged in recent years. It warned that import dependence increases the external account’s sensitivity to international energy prices.

March 2026 trade data gives some idea of the scale.

Pakistan imported about Rs181 billion of crude petroleum during that month. Petroleum products accounted for roughly another Rs116 billion, according to the Pakistan Bureau of Statistics.

A larger energy bill consumes more foreign exchange. If the wider shock also puts pressure on the rupee, the same dollar-priced cargo becomes still more expensive domestically.

Eventually the shock travels inland.

Hormuz Does Not Need a Total Shutdown

I think this is the part Pakistan needs to understand better.

We tend to imagine disruption as an on-off switch.

Strait open: safe.

Strait closed: crisis.

Shipping does not work like that.

A shipowner decides whether a voyage justifies the risk. The insurer puts a price on that danger. Traders then incorporate additional costs and possible delays into their decisions.

The market starts charging for insecurity long before every ship becomes physically incapable of passing.

On September 21, only two commodity vessels were visible crossing Hormuz, according to preliminary tracking data reported by Reuters. Two other vessels had recently been struck in separate incidents. Responsibility for those attacks had not been established when Reuters reported them.

Energy still moved. But normality did not return.

That distinction matters. Pakistan pays for the extraordinary measures that keep cargoes moving too.

LNG May Be the More Uncomfortable Story

Oil receives most of the headlines because everyone understands petrol. Gas deserves equal attention.

Qatar has historically been central to Asian LNG supply, including Pakistan’s. The Hormuz crisis has disrupted those flows, while attacks on Qatar’s Ras Laffan complex have damaged production capacity.

Reuters reported in September that Asian spot LNG prices had risen from a pre-war range of around $10 per million British thermal units to nearly $30. High prices pushed Asian buyers towards alternatives and suppressed demand among customers unable to absorb the increase.

Pakistan LNG CEO Masood Nabi told Reuters that Pakistani demand could recover if additional supplies brought prices back to affordable levels.

Pakistan still needs LNG. At nearly $30 per million BTU, however, need and affordability become two very different things.

Pakistan has partly reduced its vulnerability through rapid solar adoption, especially among electricity consumers able to generate some of their own power. Gas still matters elsewhere in the economy.

Qatar’s problem may also survive the shooting.

QatarEnergy said on September 21 that damage at Ras Laffan had knocked out 17 percent of the country’s LNG capacity. Repairs to two damaged LNG trains could take as long as three years. The company said disruption at Hormuz was also interfering with equipment deliveries for its North Field expansion.

Pakistan therefore faces uncertainty over physical supply and price. A cargo getting through Hormuz solves little if Pakistan cannot afford to buy enough of it.

The IMF Has Already Run the Stress Test

We do not need to manufacture frightening numbers.

The IMF has already modelled the economic transmission.

Under its April baseline, the Middle East conflict was expected to reduce Pakistan’s GDP growth by about 0.2 percentage points in FY2026 and 0.6 points in FY2027 compared with the pre-conflict baseline.

Average inflation was estimated to rise by roughly half a percentage point in FY2026 and 1.5 points in FY2027. The current-account balance was projected to deteriorate by around 0.2 percent of GDP in FY2026 and 0.4 percent in FY2027.

Its adverse scenario was considerably worse.

The IMF estimated a cumulative GDP hit of roughly 1.5 percentage points by FY2027. Current-account deterioration in FY2027 could reach around 1.5 percent of GDP relative to the pre-conflict baseline.

These numbers describe stress scenarios rather than certain outcomes, but the economic mechanism behind them is already visible.

We can see part of it at Pakistan’s petrol pumps.

Pakistan Is Already Subsidising the Shock

We do not have to speculate about whether higher energy costs will eventually force Islamabad to intervene.

It already has.

On September 14, the Economic Coordination Committee approved the Prime Minister’s Fuel Relief Scheme, with around Rs75 billion allocated for a three-month programme. The government linked the intervention to higher petroleum prices and designed it as targeted relief rather than a universal petrol subsidy. See the Ministry of Finance releases.

Motorcycle, rickshaw and Qingqi users can receive Rs500 in petrol relief each week, giving them up to Rs2,000 over four weekly tokens.

Owners of eligible non-commercial cars with engines of up to 800cc can receive Rs1,000 every ten days, based on Rs100-per-litre relief on 10 litres. The monthly ceiling is effectively 30 litres, or as much as Rs3,000 in relief.

One vehicle is allowed for each eligible owner or user.

The government subsequently changed some of the motorcycle rules after complaints. A rider no longer has to purchase five litres in a single transaction to receive the benefit. The eligible age of two- and three-wheelers was extended from 15 years to 20 years.

Another change is socially important. Motorcycle and rickshaw users of rented vehicles can now qualify without satisfying the original ownership requirement, Radio Pakistan reported.

By September 25, IT Minister Shaza Fatima Khawaja said more than 5.8 million people had registered. Around 6.1 million tokens had been generated, while approximately 4.7 million people had obtained fuel through the programme.

I find those numbers more revealing than another speech about international oil markets.

They show the transmission mechanism operating almost in real time.

A military confrontation disrupts Gulf energy flows. Pakistan pays more to keep energy moving towards its economy.

Then Islamabad pays again to shield selected consumers from part of the increase.

The missile may fall hundreds of kilometres from Karachi.

The subsidy is paid in rupees.

A Rs500 Token Does Not Make the Cost Disappear

A motorcycle in Karachi is often not discretionary transport. It takes a worker to his office. A delivery rider depends on it for his income. A father may simply need it to reach the market.

For someone using a motorcycle every day, Rs2,000 a month therefore matters. A family running an old 660cc or 800cc car can similarly gain some protection from expensive petrol.

But Pakistan still has to finance that protection.

The targeted fuel scheme was allocated around Rs75 billion for three months.

There is another government intervention that must be kept separate.

The ECC also approved a Rs100 billion technical supplementary grant for the Prime Minister’s Austerity Fund 2026. The government said the money would meet petroleum price-differential requirements and cushion consumers against price volatility associated with Gulf developments.

It is being financed through the rationalisation and surrender of Public Sector Development Programme funds.

The distinction matters. The Rs75 billion programme provides targeted fuel relief. The Rs100 billion allocation addresses broader petroleum-price volatility.

Neither makes the underlying imported energy cost disappear.

Part of the burden simply moves from the petrol pump towards the federal budget. When development funds help finance the response, another part can move into spending that no longer happens elsewhere.

Why Motorcycles Tell Us More Than SUVs

The government could have reduced the petrol price for everyone. It didn’t.

Instead, it targeted two- and three-wheelers and restricted eligible cars to engines no larger than 800cc. Someone filling a large SUV does not receive the same protection.

There is an economic logic behind the distinction.

A motorcycle in Karachi often represents basic mobility rather than discretionary consumption. Subsidising the fuel used by a worker commuting across the city is economically different from subsidising the petrol bill of a large SUV.

That does not mean every motorcycle owner is poor. Nor does targeting guarantee perfect delivery.

A vehicle record may not match an applicant’s details. Even a problem with a registered mobile number can interfere with access. Poor connectivity has caused difficulties in some areas as well.

The government has already had to adjust parts of the programme.

Still, its basic structure tells us something.

Pakistan is trying to protect smaller consumers without completely insulating the domestic economy from international energy prices.

The motorcycle subsidy is therefore not a separate welfare story sitting somewhere below the geopolitical headlines. It is one consequence of those headlines.

Islamabad Is Also Trying to Burn Less Fuel

Subsidies are only one side of the government’s response.

On September 17, Pakistan announced austerity measures intended to conserve fuel as the Gulf conflict intensified. The measures included restrictions on fuel use by official vehicles and limits on government vehicle purchases, Reuters reported.

The combination is revealing.

Islamabad is trying to protect selected household consumers while reducing fuel use inside government.

That is not the behaviour of a country facing a theoretical problem. It is the behaviour of a government responding to an energy shock that has already arrived.

Whether these measures save enough fuel or public money is a separate question. Their existence tells us something more immediate about the severity of Pakistan’s exposure.

Hormuz is already influencing domestic policy.

From a Tanker in Hormuz to a Motorcycle in Karachi

Consider the distance between the two ends of this story.

A tanker approaches Hormuz. Its owner considers the danger. The insurer recalculates risk.

Pakistan then needs dollars to pay for energy whose journey has become more difficult and expensive.

Eventually, one morning, a man rides his motorcycle into a Karachi petrol station. He uses a government fuel-relief token because petrol has become painfully expensive.

At first glance, the tanker and the motorcycle have nothing to do with each other.

Economically, they are connected.

I began at a Karachi petrol station because that is where this distant war becomes easier to see.

Pakistan is not fighting Iran. The motorcyclist filling his tank did not create the crisis in Hormuz either. Yet the cost has travelled from a Gulf shipping lane into Pakistan’s budget and, eventually, towards his pocket.

Islamabad can soften that journey with a Rs500 token.

It cannot make the underlying cost disappear.

A complete shutdown of Hormuz would be far worse.

Pakistan does not need one to suffer. The war has already entered our economy without asking permission.

Did Mohammed bin Salman Clash With His Brother? What We Can Actually Verify

Saudi opposition sources claim Mohammed bin Salman and Defence Minister Khalid bin Salman are locked in a serious dispute over Saudi Arabia’s failures against the Houthis. The alleged confrontation remains unverified, but the military crisis beneath the rumour is real.

Late this week, an extraordinary story began circulating through Saudi opposition channels. Crown Prince Mohammed bin Salman, the story claimed, had turned furiously against his younger brother, Defence Minister Khalid bin Salman.

The allegation went much further than an ordinary disagreement. According to versions circulating online, Mohammed bin Salman accused Khalid of failing to build a military capable of defeating Yemen’s Houthis despite enormous defence expenditure. Some versions allege accusations of corruption and embezzlement. Khalid supposedly answered that the real mistake belonged to Mohammed himself because he had taken Saudi Arabia into the Yemen war.

It is explosive material. There is just one problem. I cannot verify that confrontation happened.

What I can verify is something arguably more important. Saudi Arabia is facing a serious military challenge from the Houthis, missiles and drones are again threatening the kingdom, questions are being asked about Saudi military effectiveness, and Washington has shown limits to the support Riyadh can expect.

What the Saudi opposition story actually claims

One version of the allegation, citing reports from the Saudi opposition, says the relationship between Mohammed and Khalid bin Salman has deteriorated into a serious dispute. It claims Mohammed blamed his brother for failing to construct an effective military force against Ansar Allah, the formal name used by the Houthi movement.

The same account alleges that Mohammed accused Khalid of administrative corruption and misappropriation of money. Khalid supposedly replied that weapons and money could not repair strategic mistakes made when Mohammed led Saudi policy toward Yemen.

Those are enormous accusations. Yet the published versions provide no documents establishing the exchange, no recording, and no independently attributable palace source who witnessed it.

An opposition source can sometimes reveal information that official media will never publish. Closed political systems create precisely this verification problem. Official silence cannot prove an allegation false. But opposition status does not make an allegation true either. For now, the alleged confrontation should be described as unverified.

Something real is happening underneath the rumour

The security situation is much easier to establish. On 26 September, the Saudi-led coalition said it intercepted two ballistic missiles heading toward Khamis Mushait and two drones heading toward the Riyadh region. Reuters reported the coalition’s announcement.

Recent reporting has also documented Houthi advances and weaknesses among Saudi-backed forces in Yemen. Intelligence failures, divisions among local allies and underestimation of Houthi preparations have all featured in accounts of the setback. The opposition rumour therefore lands in a political environment already filled with questions about deterrence and military performance.

That does not prove a royal fight. It explains why the allegation has acquired such force.

Saudi Arabia has spent heavily on defence

Saudi military expenditure makes the controversy sharper. The Stockholm International Peace Research Institute estimates that Saudi Arabia spent $83.2 billion on its military in 2025, making the kingdom one of the world’s largest military spenders.

So asking why a state with expensive aircraft, missiles and sophisticated Western weapons still struggles to deter the Houthis is legitimate. But expenditure cannot answer that question by itself.

Saudi difficulties in Yemen involve intelligence and command arrangements. Terrain matters enormously. So does the effectiveness of local allies and the Houthis’ accumulated combat experience. The important distinction is between possessing advanced weapons and converting them into political control on a difficult battlefield.

Saudi Arabia can destroy targets from the air. Holding territory and producing a durable political settlement in Yemen require something different. That problem has followed Riyadh for more than a decade.

There is an awkward historical problem with blaming Khalid

The circulating allegation contains a weakness that should immediately interest anyone familiar with the history of the Yemen war. Khalid bin Salman did not start it as Saudi defence minister.

Mohammed bin Salman was defence minister when Saudi Arabia launched its military intervention in Yemen in March 2015. Riyadh intervened after the Houthis had driven the internationally recognised government from Sanaa and expanded their territorial control.

Khalid became defence minister only in September 2022. The Saudi Press Agency’s record of the royal appointment states that King Salman appointed Mohammed bin Salman prime minister and Khalid bin Salman defence minister on 27 September 2022.

That chronology does not tell us whether the brothers are arguing today. It does tell us something important about responsibility. Saudi Arabia’s Yemen strategy cannot simply be attributed to Khalid’s management of the Defence Ministry. Mohammed was central to the original intervention and has remained the kingdom’s dominant political decision-maker.

A genuine internal Saudi reckoning over Yemen would therefore involve more than procurement or the performance of one minister. It would eventually reach the strategic decisions made in 2015.

Yet Khalid does not look like a minister who has been pushed aside

There is another problem with the most dramatic versions of the rumour. Khalid bin Salman remains publicly active in highly sensitive defence business.

On Saudi National Day, he publicly praised the leadership of King Salman and Crown Prince Mohammed bin Salman. Whatever may happen privately inside the royal family, his public language showed no political separation from his brother.

More important, Khalid has continued meeting senior foreign military officials as the Houthi crisis has intensified. These are not merely ceremonial duties. They place him at the centre of Saudi Arabia’s response to a live security problem.

None of this proves that relations between the brothers are harmonious. Governments routinely conceal internal disputes. Brothers can disagree bitterly while continuing to work together. But observable evidence matters. If Khalid had lost Mohammed’s confidence completely, his continued role in sensitive defence diplomacy would require explanation. At present, the public evidence points to continuity.

The deeper crisis may concern America

There is another figure hovering over this story: Donald Trump. Saudi Arabia spent decades building its security architecture around its relationship with the United States. The current Houthi crisis is testing what that relationship actually guarantees.

Recent reporting has described Saudi frustration with Washington’s reluctance to become more deeply involved militarily against the Houthis. The Financial Times has examined that tension.

This changes the strategic calculation inside Riyadh. The kingdom must calculate how much American military support it can expect when a regional crisis threatens Saudi interests but Washington does not consider direct intervention worthwhile.

I suspect this question matters far more than palace gossip.

Why rumours flourish inside closed political systems

Saudi Arabia presents journalists with an unusual verification problem. Major decisions emerge from a narrow ruling structure. Independent reporting on internal royal deliberations is difficult, while officials rarely discuss disagreements publicly.

The information vacuum produces two competing temptations. One is to believe Saudi official media too easily. The other is to believe Saudi opposition media simply because official Saudi media cannot be trusted to disclose internal conflict. Neither method works.

A serious reader should ask who originated the allegation and what direct evidence that source possesses. Has another source independently confirmed it? Do subsequent appointments, dismissals or changes in responsibility support the story?

In this case, those tests produce an uncomfortable but useful answer. I can verify the Saudi security crisis. I can verify the enormous defence expenditure. I can verify renewed Houthi attacks. I can also verify that Khalid remains publicly active as defence minister. I cannot verify the alleged private confrontation between the brothers.

That is not the same as proving that it never happened.

The story worth watching

I would therefore watch Khalid bin Salman rather than the rumour. Does he continue meeting foreign military leaders? Does responsibility for Yemen move elsewhere? Do senior commanders disappear from public view? Does Saudi Arabia restructure its defence establishment?

Concrete changes of that kind would provide evidence of political consequences.

For now, Saudi Arabia’s larger predicament is serious enough without embellishment. A movement Riyadh went to war against in 2015 remains capable of launching missiles and drones toward Saudi targets more than eleven years later. Saudi Arabia spent $83.2 billion on its military last year, yet the Houthi challenge continues to expose questions about intelligence, command and deterrence.

Washington, meanwhile, has shown limits to what it will do for Riyadh.

Perhaps Mohammed bin Salman and Khalid bin Salman are arguing about all of this behind palace walls. It would hardly be surprising if Saudi leaders were conducting a severe internal review after military setbacks.

But surprise is not evidence.

The more revealing question is already in front of us. After more than a decade of war, enormous military expenditure and deep dependence on foreign security partnerships, why is Saudi Arabia once again struggling to deter the Houthis?

Whatever is being said inside the royal palace, Riyadh now has to answer that question outside it.