The focus of this roundtable was how to ensure that the political parties that were not in power could also set the social agenda for the country. The MQM team was led by Dr. Farooq Sattar (Parliamentary Leader & Convener MQM and Federal Minister Overseas Pakistanis) assisted by Senator Nasreen Jaleel (Dy. Convener MQM & Member Senate Standing Committee on Health, Social Welfare and Youth Affairs) along with Mr. Raza Haroon (Ex-Minister Science & Technology, Sindh and Senior Member MQM Central Coordination Committee). Opening the meeting, Dr Moeed Pirzada said that as a political party MQM is unique Pakistani politics as being the only truly urban party representing educated middle classes of Karachi and Hyderabad. However, Dr. Farooq Sattar said MQM was a mere 6 percent in National Assembly and 30 percent in Sindh and had serious limitations in terms of forcing legislative agendas. He expressed his concern that perhaps the kind of democracy being practiced in Pakistan was not very well helpful for addressing fundamental issues. He said that health delivery and its quality had shown improvements during General Musharraf’s era despite the fact that there was a democratic deficit at the top in Islamabad. Dr. Farooq said that the reason he thought was that there was more real and genuine democracy at the grassroots level in the form of local governments. Dr. Farooq Sattar shared copies of two documents with the participants: Draft of MQM Health Sector Manifesto & Contributions of MQM in Health Sector in Pakistan and briefly went over the draft manifesto explaining that MQM – in this final health policy document to be issued soon – will emphasize the role of local governments, need for a comprehensive health sector strategy, population control, primary health care, increasing health spending to 5 percent of GDP in the next 5-10 years, harnessing and regulating private sector in health, commercially viable initiatives in human resource development in health, developing contingency planning for emergencies, service structure attractive for medics and paramedics and finally a social sector insurance.