A match without a ball: Multiple sclerosis patients in Khyber Pakhtunkhwa, the Sehat Card Plus card and the line between life and death that sport cannot ignore

I planned to write about a football match, but the material I received had no referee, no passes and no players. It was about multiple sclerosis patients in Khyber Pakhtunkhwa, a health insurance scheme called Sehat Card Plus, and the expensive disease-modifying medicines they cannot afford.

Multiple sclerosis is a chronic autoimmune disease of the central nervous system. It affects young adults and can lead to long-term disability. Disease-modifying medicines, known as DMDs, can reduce relapses and slow progression. Yet in Khyber Pakhtunkhwa, these medicines remain out of reach for most patients because Sehat Card Plus does not cover multiple sclerosis.

Data from the 2026 Global Burden of Disease analysis shows Pakistan had an age-standardised prevalence of 9.80 cases per 100,000 people in 2026. Among women, the rate was 12.31 per 100,000. This matters for sport. Women's football in Pakistan already struggles for resources. When a chronic disease falls harder on women, the gap in health, nutrition and opportunity widens.

Sport cannot be separated from public health. A society can build modern academies, but it will still lose if children are not protected by basic care and adults cannot treat chronic illness. A sustainable sporting culture is built not only by training centres but by a health system that leaves no one behind.

What many football fans call an off-field story is actually the deepest on-field story. A child cannot play without health. A mother cannot take her child to football practice if she cannot access treatment. The real match is not on the pitch. It happens in clinics, at pharmacy counters, and in the gap between a policy that sounds good and a policy that works. If we stay silent, even the final whistle will not save anyone.