It is easy to be cynical about governance in Pakistan. We are used to a cycle of ambitious groundbreakings followed by stalled machinery, cost overruns, and eventual abandonment. Yet, amidst the noise of political theatre, a quiet but radical shift in how the state does business has been taking root in Sindh. It is a shift that doesn’t just rely on government coffers but acknowledges a simple reality: the state cannot do it alone.
While the media cycle often fixates on urban waste management or political squabbles, the Sindh government’s Public-Private Partnership (PPP) unit has been building a portfolio that the rest of the federation would do well to study. This isn’t just partisan rhetoric; the Economist Intelligence Unit has ranked Sindh 6th in Asia for its enabling environment for PPPs. That ranking didn’t happen by accident. It happened because the province decided to treat the private sector as a partner rather than a contractor.
The most visible success is, naturally, on the tarmac. For decades, road infrastructure in
Pakistan was synonymous with federal largesse. Sindh flipped the script. Take the Hyderabad-Mirpurkhas Dual Carriageway or the Karachi-Thatta Dual Carriageway. These aren’t just roads; they are financial case studies. Both projects have retired their commercial debt. In a country where public enterprises bleed trillions annually, here we have state assets that are not only self-sustaining but are actually paying for themselves.
The Shahrah-e-Shaheed Zulfikar Ali Bhutto is the latest iteration of this logic. Critics will argue about alignment or ecology, and those are valid democratic debates, but from a purely execution standpoint, the Design-Build-Finance-Operate-Transfer (DBFOT) model ensures that the road is built fast and built to last, simply because the private partner’s profit depends on it being operational.
But concrete is easy; human development is hard. This is where the “Sindh Model” becomes truly interesting. The management of public hospitals is a nightmare across the developing world. Sindh’s answer was to stop pretending the bureaucracy could run complex cardiac units and instead hand the keys to professionals.
The National Institute of Cardiovascular Diseases (NICVD) is the headline grabber, offering world-class cardiac care for free—a luxury even in developed nations. But we saw the ultimate validation of this model just days ago, when PPP Chairman Bilawal Bhutto-Zardari inaugurated the new building of the Indus Hospital. This isn’t a small clinic; it is a massive world-class healthcare complex expanding to 1,350 beds, making it the largest hospital in the country.
The financial architecture behind it is what matters. The Sindh Government didn’t just cut a ribbon; it put serious skin in the game, providing Rs 18 billion for the construction of this new facility. More importantly, they have committed a further Rs 8 billion annual grant. This ensures that while the building is state-funded, the management remains independent and efficient, and the patient pays absolutely nothing. It proves that the government’s job isn’t to micromanage the hospital; the government’s job is to ensure the patient is treated with no financial burden.
We see the same pragmatism in Thar. For years, the coal fields were a mirage a “game changer” that never changed anything. It took the Sindh Engro Coal Mining Company (SECMC), a joint venture, to finally unlock that energy. Now, as the province moves to produce fertilizer from Thar coal under a similar PPP mode, we are seeing an ecosystem develop where the state provides the sovereign guarantee and the private sector provides the efficiency.
Is it perfect? No. There are still gaps in education and municipal services where this model needs to be more aggressively applied. But in a federation starving for fiscal space, the Sindh government has found a way to leverage private capital for public good.
The old model of “the government will do everything” is dead; the fiscal reality of 2026 simply won‘t allow it. Sindh realized this a decade ago. It is time the rest of the country caught up.
Copyright Business Recorder, 2025
The writer is the Spokesperson for the Government of Sindh and hails from Lyari. The views expressed in this article are not necessarily those of the newspaper
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