YET another hospital in Pakistan, yet another tragedy. This time, Nishtar Hospital’s renal dialysis unit is in the spotlight for all the wrong reasons—a burgeoning HIV outbreak, courtesy of abysmal infection control practices. Naturally, some senior medical personnel are facing disciplinary action, because what better way to address systemic failure than to scapegoat a handful of individuals?
For over a decade, I have studied and written extensively about Pakistan’s HIV epidemic. Eight research articles published, numerous op-eds written, countless conferences attended, yet, here we are. The epidemic spreads like wildfire, and the health system, our supposed firewall, fans the flames.
We know the high-risk groups: intravenous drug users, sex workers (male, female, transgender, and child), and bridge populations like truckers, migrant men, and the unfortunate spouses of drug users. But these groups are not the main culprits. No, the star agent in Pakistan’s HIV epidemic is our crumbling health system itself.
Imagine this: a country with less than one percent of its GDP allocated to health, a population growing like weeds after a monsoon, and a government that prioritizes reactive band-aids over proactive solutions. In this glorious setup, sterilization practices in public hospitals resemble medieval alchemy. Blood transfusion protocols are straight out of a horror film, and health waste management? It’s a phrase we barely understand, let alone practice. Let’s not even talk about the periphery, where quacks wield unsterilized syringes like magic wands, conjuring more diseases than they cure. Meanwhile, tertiary care hospitals in urban centres—those supposed beacons of medical excellence—can’t keep their own infection control protocols straight. Nishtar’s fiasco is not an anomaly; it’s a symptom of a terminally ill health system.
I’ve screamed myself hoarse in academic journals, hoping someone in a position of power would notice. But who has time to read peer-reviewed articles when you’re too busy reacting to one disaster after another? Evidence-based decision-making? That’s a quaint concept reserved for textbooks, not governance. And yet, we act shocked every time an outbreak like this happens. It’s as though no one could have predicted that cutting corners on sterilization or reusing syringes might lead to the spread of HIV. What’s next? A groundbreaking discovery that clean water prevents cholera?
The root of the problem lies in a complete lack of prioritization. Infection prevention and control is not rocket science; it’s basic public health. Yet, it’s treated like an optional luxury in Pakistan. We can afford lavish wedding halls and luxury SUVs, but heaven forbid we invest in functioning autoclaves or proper medical waste disposal.
The Nishtar incident is not just a health crisis; it’s a reflection of how we, as a nation, value human life. Until we stop patching up holes in a sinking ship and start rebuilding the vessel, the HIV epidemic will continue to grow. The system is broken, and the costs are paid in human lives. But don’t worry. We’ll hold a few inquiries, suspend a few doctors, and maybe even promise reforms. Then, we’ll wait for the next outbreak to rinse and repeat the cycle of blame and neglect. After all, why fix a system when you can simply react to its failures? And so, here we are, watching a tragedy unfold, knowing full well it will happen again. Unless, of course, we muster the courage to treat the disease instead of endlessly managing the symptoms.
—The writer is Associate Professor, Health Services Academy Islamabad.
