The mobilisation threatens to deepen Pakistan’s political confrontation, with PTI demanding the implementation of court orders concerning its imprisoned leader while federal officials warn of security risks and the possibility of emergency measures in the party-governed province of Khyber Pakhtunkhwa.

PTI supporters began assembling and travelling in convoys on Sunday, with former provincial chief minister Ali Amin Gandapur leading a procession from Dera Ismail Khan. Khyber Pakhtunkhwa Chief Minister Sohail Afridi was scheduled to lead a separate convoy from Lakki Marwat, although Dawn reported that his procession had yet to begin at the time of its latest update. The party’s initial plan is to bring regional convoys together in Swabi before announcing the next phase.

The march was originally scheduled for September 27 but was postponed as PTI leaders pursued negotiations with the federal government. Two rounds of talks ended without an agreement, leaving the planned protest in place.

The former prime minister’s medical condition has become a central issue in the dispute between PTI and the federal government.

Khan, 73, has been imprisoned since August 2023 following a series of criminal cases after his removal from office in April 2022. He and his party maintain that the prosecutions are politically motivated, while the authorities have pursued the cases through Pakistan’s judicial system.

In February, a report submitted to the Supreme Court by court-appointed lawyer Salman Safdar said Khan had been left with only 15% vision in his right eye following a serious retinal condition. The court subsequently ordered medical examinations and further assessment of his condition. A government medical board later reported improvement in his eyesight following treatment, although concerns over his access to medical care continued.

On August 18, the Supreme Court ordered that Khan be transferred to Shifa International Hospital in Islamabad for medical assessment and treatment. The federal government challenged the order, arguing that he should instead be examined at a public hospital. Khan was subsequently taken to hospital for a procedure and returned to prison within days.

PTI is demanding that authorities ensure appropriate medical care, access to Khan’s personal physicians and family, and compliance with court directions. The government maintains that Khan is receiving medical attention and says arrangements concerning his custody must account for security considerations.

The protest has also intensified tensions between the federal government and the PTI-led administration in Khyber Pakhtunkhwa, a province bordering Afghanistan that has faced persistent militant violence.

Khyber Pakhtunkhwa Governor Faisal Karim Kundi said on Sunday that an emergency could be imposed if necessary to “save the province,” according to The Express Tribune. His remarks came as the opposition began its march and the two sides remained at an impasse.

The possibility of federal intervention in the province has raised concerns about a further escalation of the political confrontation. PTI leaders have warned that imposing an emergency or governor’s rule would deepen instability rather than resolve the dispute.

The government, meanwhile, has cited an increase in militant attacks in northwestern Pakistan and questioned whether the provincial administration would cooperate fully in counterterrorism efforts. PTI rejects accusations that it is sympathetic to militants and says security concerns should not be used to suppress political opposition.

Authorities have placed shipping containers and other barriers along key roads leading to Islamabad and sensitive areas of the capital, anticipating the arrival of opposition supporters. The restrictions have already caused traffic disruption and raised concerns about access to major routes.

PTI says its campaign is intended to secure Khan’s release, protect his rights and press the authorities to implement court decisions. Party leaders have urged supporters to remain peaceful, while the government has warned of potential security risks and the possibility of clashes.

The scale and duration of the march remain uncertain. Under the party’s announced plan, convoys from different parts of Khyber Pakhtunkhwa are expected to converge in Swabi, where Afridi will announce the next phase of the campaign.

The failed negotiations and renewed street mobilisation underscore the depth of Pakistan’s political divide. With Khan’s imprisonment, his disputed medical treatment and the threat of emergency measures in Khyber Pakhtunkhwa all driving the confrontation, the coming days could prove consequential for the country’s political stability.