Politics in Pakistan could leave an indelible mark on health. The country’s Parliament has signed off on a constitutional amendment that paves the way for the abolition of the Ministry of Health. By June this year, Pakistan could be the first country without an institutional structure—a ministry, state department, directorate, or equivalent structure—at the federal level in charge of national responsibilities for health. This amendment comes at a time when there is a dire need to increase the capacity of the health system in view of many serious challenges.