Government approves Rs13 billion expansion of AFIC cardiac facility

The federal government has approved a Rs13 billion expansion project for the Armed Forces Institute of Cardiology (AFIC) and National Institute of Heart Diseases (NIHD), Rawalpindi, using savings from slow-moving schemes under the Public Sector Development Programme (PSDP), according to an official summary of a meeting of the Executive Committee of the National Economic Council (Ecnec).

The Ecnec meeting, chaired by Deputy Prime Minister Ishaq Dar, approved four major development projects with a combined cost of more than Rs240 billion, including the AFIC-NIHD expansion, the Prime Minister’s Youth Skill Development Programme, the Karachi Yellow Line Bus Rapid Transit (BRT) Corridor, and the Harpo Hydropower Project in Gilgit-Baltistan.

Under the approved plan, Rs6 billion of the total Rs13 billion will be sourced from foreign financing. Of the remaining amount, Rs10.5 billion is earmarked for capital-work costs, with the rest allocated for consultancies and contingent liabilities. The expansion aims to increase the institute’s tertiary-level cardiac care capacity by building additional hospital infrastructure. AFIC treats both military and civilian patients and currently faces capacity constraints.

Officials said existing federal cardiac care facilities were insufficient to meet patient loads, leading to congestion, delayed treatment, and increased referrals to other public sector hospitals.

Ecnec was informed that the Central Development Working Party (CDWP), chaired by Planning Minister Ahsan Iqbal, had earlier recommended that, due to fiscal constraints, the project should be financed outside the PSDP. The CDWP also recommended that the existing PSDP allocation of Rs50 million for the AFIC expansion should be utilised only after third-party vetting and that procurements start only after full funds of Rs13 billion are arranged.

For the current fiscal year, authorities will need Rs2 billion of the total project cost, officials said. The Rs50 million already allocated for AFIC is part of the PSDP funding available this year against the overall Rs13 billion requirement.

During the CDWP meeting, the planning minister noted that the PSDP was fully stretched and approving large projects like the AFIC expansion could lead to displacement or under-funding of other national priority projects, as there was “no fiscal space” to accommodate such large new schemes without adversely affecting the development portfolio.

The Ministry of Defence was advised to seek fiscal support from the Ministry of Finance. However, records showed the finance ministry clarified that under the current budgetary framework, no grant financing was available for projects outside the PSDP, and therefore no financial commitment could be assured beyond the approved PSDP allocations.

Ecnec also approved the revised Prime Minister’s Youth Skill Development Project for four years (2023-27) at a total cost of Rs23.5 billion, which has a cumulative allocation of Rs12.9 billion for the current fiscal year. The project aims to impart information technology and industrial skills to thousands of young people.

In addition, Ecnec cleared the Rs178.5 billion Karachi Yellow Line BRT project, to be funded by the Sindh government through a $550 million World Bank loan repayable over 18 years. The revised plan calls for a 21-kilometre dedicated BRT system with 28 stations and the purchase of 256 buses to serve an estimated 300,000 passengers daily.