The Next Prime Minister of Nuclear-Armed Pakistan Really Hates the U.S.

The Next Prime Minister of Nuclear-Armed Pakistan Really Hates the U.S.


07.26.18 8:00 PM ET


The most dangerous country in the world just got considerably more dangerous. Pakistan, home to the fastest growing nuclear weapons arsenal on earth, has broken the decades old domination of its electoral politics by two family dynasties. Imran Khan, a world champion cricketer, is poised to be the next prime minister backed by the powerful army. Khan blames Pakistan’s problems on America and is the most anti-American politician in South Asia.

Imran Khan, 66, is charismatic and bold. He has campaigned for decades to break the logjam of Pakistan’s revolving elections in which either Nawaz Sharif or Benazir Bhutto and her heirs dominate the highest office of the country. Sharif, 65 and a three-time prime minister, is now in jail along with his daughter on trumped-up charges of corruption. Benazir’s son Bilawal, 29, ran an impressive campaign on his own for the first time but came in third place. Khan’s Pakistan Justice Movement (PTI) is leading the parliamentary elections with around 110-120 seats out of 272. Sharif’s party is around 60 and Bhutto at 45. These numbers are not final and there are several independents and small local parties.

Khan will need to persuade independents and small parties to join in a coalition government. He has ruled out working with either Sharif or Bhutto. The horse trading may be prolonged before a government is set—and volatile once created. There are widespread charges of fraud and tampering with the vote. Protests and boycotts are likely. A central question is which party will take control of the Punjab, the country’s largest province and the traditional base of the Sharif clan.


The symptoms

of depression

can be


Overall score of symptom reduction was

measured on a standardized depression

rating scale in multiple short-term

studies and a maintenance study.

Take a step forward,


in improving your

depression (MDD).


prescription medicine used

to treat Major Depressive

Disorder (MDD) in adults.

Talk to your healthcare


Take the first step.

Individual results may vary.


Important Safety Information

Suicidal Thoughts and Actions and Antidepressant Drugs

Antidepressants may increase suicidal thoughts or actions in some children, teens or young adults within the first few months of treatment or when the dose is changed. Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. People who have (or have a family history of) bipolar illness, or suicidal thoughts or actions may have a particularly high risk. Pay close attention to any changes, especially sudden changes in mood, behavior, thoughts or feelings. Call your healthcare provider right away if symptoms such as anxiety, irritability, impulsivity, trouble sleeping, aggressive behavior or suicidal thoughts are new, worse or worry you. TRINTELLIX has not been evaluated for use in patients under 18.

Do not take TRINTELLIX if you:

• Are allergic to vortioxetine or any of the ingredients in TRINTELLIX

• Take a Monoamine Oxidase Inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid; do not take an MAOI within 21 days of stopping TRINTELLIX; do not start TRINTELLIX if you stopped taking an MAOI in the last 14 days

TRINTELLIX may cause serious side effects including:
Serotonin Syndrome:
 A potentially life-threatening problem that can happen when medicines such as TRINTELLIX are taken with certain other medicines. Symptoms may include agitation, hallucinations, coma or other changes in mental status; problems controlling movements or muscle twitching, stiffness or tightness; fast heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting or diarrhea.
Abnormal bleeding or bruising: TRINTELLIX and other serotonergic antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin.
Manic episode: Symptoms may include greatly increased energy; severe trouble sleeping; racing thoughts; reckless behavior; unusually grand ideas; excessive happiness or irritability; talking more or faster than usual.
Visual problems: May include eye pain, changes in vision, swelling or redness in or around the eye. Only some people are at risk for these problems. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are.
Low salt (sodium) levels in the blood: Symptoms may include headache; difficulty concentrating, memory changes or confusion; weakness and unsteadiness on your feet; and in severe or sudden cases hallucinations, fainting, seizures or coma. If not treated, severe low sodium levels can cause death.
Before starting TRINTELLIX, tell your healthcare provider if you have or had liver problems, seizures or convulsions, bipolar disorder (manic depression) or mania, low salt (sodium) levels in your blood, bleeding problems, drink alcohol, have any other medical conditions or if you are pregnant, nursing, plan to become pregnant, or plan to nurse.
TRINTELLIX and some medicines may interact with each other, may not work as well, or may cause serious side effects when taken together. Tell your healthcare provider if you plan on or are taking any other prescription and non-prescription medicines, vitamins and herbal supplements including medicines for migraine headaches, such as triptans; medicines used to treat mood, anxiety, psychotic or thought disorders such as tricyclics, lithium, SSRIs, SNRIs, bupropion, buspirone or antipsychotics; MAOIs including linezolid (a specific antibiotic); over-the-counter supplements such as tryptophan or St. John’s wort; and the following medicines: aspirin, NSAIDs, warfarin (Coumadin®, Jantoven®), diuretics, rifampin, carbamazepine, phenytoin, quinidine, tramadol or fentanyl.
Common side effects of TRINTELLIX include: nausea, constipation or vomiting. These are not all the possible side effects of TRINTELLIX.
Do not start or stop taking TRINTELLIX without talking to your healthcare provider first. Suddenly stopping TRINTELLIX when you take higher doses may cause you to have side effects including headache, stiff muscles, mood swings, sudden outbursts of anger, dizziness or feeling lightheaded, or runny nose.
Talk to your healthcare provider.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.
Indication for TRINTELLIX
TRINTELLIX is a prescription medicine used to treat Major Depressive Disorder (MDD) in adults.
Please see Prescribing Information, including Medication Guide for TRINTELLIX.

TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.
©2017 Takeda Pharmaceuticals U.S.A., Inc.

The central platform of Imran Khan’s movement has always been to fight corruption. Pakistan’s politics are certainly full of corruption as is the judicial process. But the most corrupt institution in the country is the army. Pakistani analysts like Aeysha Saddiqa have long documented how the army has become a major land owner and business maestro to enrich the pockets of the officer corps. The generals for decades have manipulated the judicial system to punish their enemies.

There is compelling evidence that the army is supporting Khan, intimidating his opponents and suppressing the press to get him to power. The army soured on Nawaz Sharif years ago and was especially alarmed when he blamed the 2008 Mumbai terrorist attack on the army intelligence service known as the ISI. The ISI was certainly responsible for the Mumbai operation, but to acknowledge that is verboten in Pakistan.

Khan is an outspoken defender of the army and is closely aligned with the Islamist movements patronized by the ISI. He is a frequent critic of the United States which he says treats Pakistan like a “doormat.” Khan says the American war on terror since 9/11 has cost Pakistan billions of dollars and tens of thousands of lives. While domestic violence has gone down in the last couple of years it spiked during the election season.

Pakistan and the United States have had a deeply troubled relationship for decades with great highs and lows. Both sides have used the other and been unreliable partners. Donald Trump’s administration has been outspoken about Pakistan’s connections to terrorism and its support for the Afghan Taliban. Military assistance has been suspended, although the Congress soured on aid for Pakistan in the Obama years.

Imran Khan has said that it would be a “bitter pill” to have to meet with Trump if he Khan is prime minister, but one he would swallow. He probably doesn’t have to worry. South Asia is not a priority for the Trump administration. The president has made clear he wants to bring Americans home from Afghanistan and wash his hands of the war there. His hard line rhetoric on Pakistan is unlikely to persuade Khan and the army to press the Taliban to peace negotiations. So far Trump has been all talk and no action about Pakistan’s ties to terrorism. His generals have persuaded him to stay in Afghanistan, but he is not persuaded they have a viable strategy. He may well be right.

I have been impressed by Khan’s determination when I’ve met him, but also by his proclivity for conspiracy theories no matter how irresponsible. He has a reputation for independence and volatility. His political movement is almost a cult of personality. The generals may find him hard to control.

The election is Pakistan’s second consecutive transfer of power by the ballot box, an important milestone for the country. The democratic process is still weak but it has now produced an outcome not in the old family.

Pakistan desperately needs good governance and a healthy civil-military relationship with the civilians in charge. It needs to abandon terrorism and slow down its nuclear weapons drive to devote attention and resources to development and infrastructure. It is becoming dangerously dependent on China. It has a self interest in warming relations with India. Above all it needs stable and experienced leadership.

None of that seems likely. Get ready for an uncharted future.


0 comments on “The Next Prime Minister of Nuclear-Armed Pakistan Really Hates the U.S.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: