The man who stayed

Between 2005 and 2010, as Pakistan lost much of its trained health talent to hospitals abroad, one clinical research professional made the opposite choice. Syed Munawar Ali stayed.

He stayed to work in a sector that barely existed. The Ministry of Health had no defined clinical trial approval process. Few hospitals had phase-specific trial experience. Universities produced graduates who had never encountered the field. Ethics review structures were still forming. Clearing investigational supplies through customs was often harder than finding patients. Multinational sponsors did not treat Pakistan as a serious option.

Munawar built his early career at Pakistan’s first local contract research organization (CRO), working on the parts nobody writes about: policies, site development, review board structures, ministry approval pathways. Offers came from abroad. He declined them, choosing to build his own country’s system rather than staff another’s.

Twenty-one years later the record is substantial. Close to 120 clinical trials. Three national disease registries. More than 2,000 professionals trained, over 50 workshops and roughly 100 awareness sessions, with more than 20 international webinars. Voluntary advisory work with the World Health Organization on strengthening the national trial ecosystem. Membership of six national health societies, and contributions to policy development.

The system was not there. To me that was the reason to stay, not the reason to leave.

The environment changed with him and likeminded experts. The Bio-Study Rules, 2017, notified in June 2018, brought trial sites and contract research organizations under DRAP licensing, with oversight by its Clinical Studies Committee. The regulator now runs a dedicated clinical trials function with assigned reviewers. The National Bioethics Committee, despite limited resources, reviews protocols in parallel. More than 50 sites are active.

In 2019 Munawar joined one of the world’s largest clinical research organizations as country head. In five years he has helped bring more than USD 200 million of international trial investment into Pakistan: hospital grants, international laboratory testing, specialized logistics, patient care, and access to therapies otherwise unavailable here.

His view of what follows is measured. Pakistan could join Malaysia and the Philippines among the Asian countries sponsors consider by default. Attracting close to USD 200 million a year from a global clinical trials market worth roughly USD 90 billion is an ambition worth setting, not a forecast.

He claims none of this as a personal achievement. The measure that matters to him is simpler: a young Pakistani research expert now enters a working system instead of an empty one.

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