Today marks a milestone in #Pakistan that hasn& #39;t attracted much attention-the 10-year anniversary of the 18th constitutional amendment.
It devolved power & resources from the center to the provinces.
It& #39;s had major and lasting political impacts, including for the COVID response.

What was initially encouraging about the 18th amendment was its democratizing potential-the opportunity to empower governments and communities, including minorities and other marginalized demographics, often given short shrift by central authorities. And yet there was a problem.

The devolution set in motion by the 18th amendment doesn& #39;t go far enough-it doesn& #39;t extend to sub-provincial levels, where service delivery is a key function. @MadihaAfzal wrote an excellent essay on this dynamic in this volume I edited several years ago: https://www.wilsoncenter.org/sites/default/files/media/documents/publication/2018-06-pakistansinstitutions.pdf">https://www.wilsoncenter.org/sites/def...

Health was a key sector devolved to the provinces, resulting in the elimination of the fed health ministry. Health is now a provincial issue. But health policy still must be coordinated w/ the center (a new fed health svcs regs ministry emerged in & #39;12 & focuses on coordination).

Accordingly, one of the persistent questions about Pakistan& #39;s response to COVID so far has been the level and efficacy of coordination between the provinces-which thanks in great part to the 18th amendment are overseeing their own responses-and the Imran Khan government.