M. Waqar Bhatti
Islamabad – In a disturbing recurrence of Pakistan’s worst pediatric HIV tragedy, fresh cases of HIV infections among children are being quietly detected across districts in Sindh and Punjab, reigniting fears of systemic healthcare failures and government inaction.
As provincial authorities maintain a strict blackout on updated case data, federal health officials confirm the consistent emergence of new pediatric HIV cases in Larkana, Mirpurkhas, Hyderabad, and the Taunsa sub-district of Dera Ghazi Khan.
The epicenter of Pakistan’s pediatric HIV crisis remains Larkana, where the 2019 outbreak in Ratodero shocked the nation. Over 30,000 people were screened in just a few months, with 876 testing positive—82% of them children under the age of 15.
By the end of 2019, confirmed infections had crossed 1,100, with nearly 900 children affected. Despite provincial pledges for infection prevention and control, the virus has never truly stopped spreading.
In 2024 alone, Sindh reported 568 new pediatric HIV cases. Mirpurkhas emerged as the most affected district, with 150 cases—78 boys and 72 girls—accounting for over a quarter of all child infections reported that year.
Larkana followed with 87 new pediatric cases, including 52 boys and 35 girls, while Hyderabad (61), Shikarpur (46), and Jacobabad (38) also recorded significant numbers. Sindh’s average monthly pediatric HIV detection rate stood at 48, indicating a steady and troubling trend.
Health experts attribute the continued spread to rampant unsafe medical practices, particularly in rural clinics and unregulated private healthcare setups. Reused syringes, unsterilized instruments, and poorly screened blood transfusions remain common, especially in underserved areas.
Alarmingly, many infected children have parents and siblings who tested negative, strongly suggesting treatment-related (iatrogenic) transmission rather than maternal or perinatal causes. The failure to implement robust infection control systems continues to put children at avoidable risk.
Despite repeated formal requests, the Sindh Health Department and its Communicable Disease Control (CDC) unit have refused to release updated data for the current year. Instead, officials dismissed reports of rising infections as “inaccurate and misleading,” attributing the increase to expanded screening campaigns.
This refusal to share verified figures has left families, health professionals, and journalists in the dark. The lack of transparency makes it nearly impossible to assess the true scale of the crisis or mount an effective public health response.
In Punjab, the situation is no less alarming, as a silent pediatric outbreak is underway in Taunsa Sharif, a tehsil of Dera Ghazi Khan. Between December 2024 and March 2025, over 100 children tested HIV-positive, with more than 85% having recently received injections or treatment at the local Tehsil Headquarters (THQ) Hospital.
Subsequent investigations revealed widespread unsafe injection practices, poor sterilization protocols, and the presence of dozens of unauthorized clinics. During an emergency screening campaign, more than 5,400 people were tested, and multiple unlicensed facilities were sealed.
The total number of registered HIV patients in Dera Ghazi Khan now exceeds 4,700, though unofficial estimates suggest the actual number may be twice as high. Federal officials say they are still detecting 30 to 40 new pediatric cases monthly from the area but continue to face resistance in obtaining data from provincial authorities.
This lack of cooperation from Punjab’s health department has triggered serious concerns at the national level. Even the federal government has been denied access to critical surveillance data necessary for epidemic control.
Despite repeated calls for action and systemic reform since the 2019 Larkana outbreak, the core drivers of transmission remain unchanged—unsafe healthcare, lax regulation, and poor infection control. The re-emergence of outbreaks in both Sindh and Punjab highlights a fundamental failure of provincial health governance.
In towns like Ratodero and Taunsa, low-income families continue to seek medical care from informal and unregulated practitioners, often unaware of the risks involved. Children pay the ultimate price for this neglect, contracting a lifelong, preventable disease.
While provincial officials urge journalists to avoid sensationalism and rely on official sources, they simultaneously block access to the very data that ensures responsible reporting. Without facts, there can be no public accountability, no targeted interventions, and no community awareness to prevent the spread of HIV.
A senior official at the National Institute of Health (NIH) expressed serious concern over the withholding of HIV data by Sindh and Punjab, stating that even federal authorities are denied access to real-time figures. “This lack of transparency hampers our ability to conduct effective surveillance and respond promptly to emerging outbreaks,” the official warned.
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