During his government, Khan addressed a balance of payments crisis with a bailout from the International Monetary Fund. He presided over a shrinking current account deficit, and limited defence spending to curtail the fiscal deficit, leading to some general economic growth.He enacted policies which increased tax collection and investment, and reforms were made to the social safety net. His government committed to a renewable energy transition, launched a national reforestation initiative and expanded protected areas, and led the country during the COVID-19 pandemic. However, his failure to revive the economy and the rising inflation rate caused him political problems. Despite his promised anti-corruption campaign, the perception of corruption in Pakistan worsened during his rule.He was accused of political victimisation of opponents and clamping down on freedom of expression and dissent.
In foreign relations, he dealt with border skirmishes against India and strengthened relations with China and Russia, while relations with the United States cooled. Following the Taliban takeover of Kabul in 2021, Khan congratulated the Taliban for their victory in the 2001–2021 war, and urged the international community to support their new government. He was also sympathetic to the Pakistani Taliban (Tehreek-i-Taliban Pakistan or TTP), and said that his government was negotiating a peace deal with TTP with the help of the Afghan Taliban. On 10 April 2022, Khan became the country's first prime minister to be deposed through a no-confidence motion in parliament. On 22 August 2022, Khan was charged by the Pakistani police under anti-terror laws after Khan accused the police and judiciary of detaining and torturing his close aide.
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