Infectious diseases experts have issued a stark warning: Pakistan’s HIV epidemic is rapidly expanding beyond traditional high-risk groups, with nearly 40% of new infections now occurring among women, children, and the general population. This shift is being driven by systemic failures in the healthcare system, including rampant unsafe injection practices and contaminated blood transfusions.
A Deadly Trajectory: Cases and Deaths Skyrocket
Data presented in a recent white paper reveals a devastating trend. Since 2010, the number of people living with HIV in Pakistan has increased 4.3 times, reaching an estimated 350,000 by 2024. More critically, AIDS-related deaths have risen by over 500%, soaring from approximately 2,200 to nearly 14,000 annual fatalities. Experts attribute this dramatic increase to late diagnosis and critically low treatment coverage.
“The HIV outbreak situation in Karachi hospitals demonstrates that safe injections and safe blood are urgently needed,” said Dr. Samreen Sarfaraz, an infectious diseases consultant. “Recent HIV outbreaks among children have highlighted critical gaps in healthcare delivery. The current crisis traces directly to unsafe blood and unsafe injections.”
The “Injection Culture” and Healthcare-Associated Outbreaks
Pakistan has one of the world’s highest rates of therapeutic injections, with individuals receiving between 8 and 14 injections per year on average. This “injection culture,” coupled with weak regulatory enforcement, has repeatedly triggered outbreaks. The 2019 Ratodero outbreak, which infected over 1,000 children, was conclusively linked to syringe reuse, as most infected children had received injections while their mothers tested negative for HIV.
This pattern has continued with recent clusters, including a 31-case outbreak linked to a dialysis unit in Multan and infections among children in Karachi’s SITE Area, raising serious concerns about ongoing transmission within medical facilities.
Low Diagnosis and Treatment Rates Fuel Silent Spread
Despite the growing burden, Pakistan’s healthcare system is failing to identify and treat those infected. Only about 21% of people living with HIV have been diagnosed, and a mere 16% are receiving antiretroviral therapy. This leaves a vast reservoir of undetected infection, facilitating further community spread.
Dr. Asma Nasim warned that basic lapses in infection control are enabling the spread of multiple pathogens in hospitals. Other experts highlighted unsafe blood transfusion practices at poorly regulated private blood banks as a major contributor to the spread of HIV, hepatitis B, and hepatitis C.
A Concurrent Crisis: Mpox and Parallel Outbreaks
Compounding the HIV emergency, experts warned of a concurrent mpox outbreak affecting neonates and young children, with early indications of hospital-acquired transmission. “Mpox outbreak among children and neonates presents an urgent crisis requiring immediate action,” said Dr. Fatima Mir, a professor of paediatric infectious diseases.
Dr. Naseem Salahuddin termed the parallel outbreaks of HIV and mpox a reflection of serious systemic gaps, calling for the immediate enforcement of safe injection practices, universal blood screening, and stricter regulation of all healthcare facilities to prevent further preventable suffering and death.
