Observations BMJ Confidential

Sania Nishtar: Acting with intent

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1781 (Published 16 May 2018) Cite this as: BMJ 2018;361:k1781


Sania Nishtar is a Pakistani physician. She graduated from Khyber Medical University in 1986, did her PhD at King’s College, London, and is a fellow of the Royal College of Physicians. She is the founder and president of Heartfile, a policy think tank in Islamabad. Nishtar served as a minister in the Pakistan government in 2013 and was its nominee for director general of the World Health Organization in 2017, making the final shortlist of three. She currently co-chairs WHO’s independent high level global commission on non-communicable diseases, as well as the World Economic Forum’s global future council on health and healthcare and the US National Academy of Sciences’ global study on healthcare quality.

What was your earliest ambition?

To become a scratch golf player. I never made it below a handicap of 12, but golf taught me many things in life: the importance of developing a vision, problem solving, practice, persistence, graciousness, and respect. In my first golf lesson my father told me that it’s critical to “keep your eye on the ball, no matter what.” That’s been the most useful tip in life.

What was your best career move?

Quitting the catheterisation lab when I was asked to use recycled catheters for poor patients. That day I decided that I wouldn’t proceed with business as usual, so I embarked on a journey to find a solution. That journey has taken me from patients to governance and systems, from hospitals to boardrooms, from civil society to a ministerial role, from founding grassroots institutions to chairing multilateral initiatives—and my journey continues.

What was the worst mistake in your career?

Rushing breakfast regularly.

How is your work-life balance?

Skewed to the former.

How do you keep fit and healthy?

I’ve integrated physical activity into everyday life: a standing desk, walking to work, joining my kids for a workout, stretching when I wake and before I sleep. I keep free weights and an aerobic step in my bedroom and try to meditate when I’m in the car.

What do you wish that you had known when you were younger?

That it’s OK to make mistakes if you learn from them.

Do doctors get paid enough?

It depends which country you’re in; often not. Nurses and community health workers definitely don’t get paid anywhere near enough.

To whom would you most like to apologise?

My family, for being away from home too much.

What do you usually wear to work?

Once in a while, when I don’t have a formal meeting, I go to work in a tracksuit and running shoes, which is what I love to wear.

Which living doctor do you most admire, and why?

Many—but I truly admired all of the nurses in the coronary care unit where I trained, who taught me how to read rhythm strips and treat heart failure during my residency. As silent “heroes,” they made us look good while staying in the background.

What is the worst job you have done?

Having to tell relatives, as a doctor, that their loved one is not going to survive.

What single unheralded change has made the most difference in your field in your lifetime?

Mobile phones have ushered in a massive change, but their potential remains untapped for systemic improvements in the health sector and for bridging inequalities. Simple solutions such as breast feeding and oral rehydration salts have saved millions but rarely get the attention they deserve.

What new technology or development are you most looking forward to?

Blockchain technology [a continuously growing list of linked records] and artificial intelligence. The stunning developments we’ve had in the past 24 months could help us bridge many inequalities if appropriately deployed in systems.

What book should every doctor read?

Anything by Atul Gawande.

What is your guiltiest pleasure?


Where are or when were you happiest?

At home in Islamabad with my family.

What television programmes do you like?

The Big Bang Theory! It’s such an amazing blend of humour and science. I love to watch it with my daughter, Leena.

What personal ambition do you still have?

To see to it that no one forgoes healthcare because of inability to pay. I’ve sown a small seed in Pakistan by the name of Heartfile Financing to develop a systemic solution to this problem, and my ambition is to take it global.

Summarise your personality in three words

Act with intent.

What is your pet hate?

All-male panels.

What would be on the menu for your last supper?

Homemade spinach and ricotta ravioli.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

Something that resonates success with integrity.

Is the thought of retirement a dream or a nightmare?

Neither, really, as I’ve never thought about it. I can never retire.

If you weren’t in your present position what would you be doing instead?

Professionally, I’d be pursuing the same objectives and trying to uphold the same principles.

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