KARACHI – Sindh has witnessed four major HIV outbreaks over the past decade, affecting hundreds of children and exposing persistent shortcomings in infection control, blood screening, medical safety and healthcare regulation, according to public health experts.
Despite repeated outbreaks, experts say authorities have yet to implement a comprehensive and sustainable strategy to improve infection control, ensure the safe use of syringes, strengthen blood transfusion screening, regulate private clinics and eliminate unsafe medical practices.
The first major outbreak occurred in 2016, when several dialysis patients in Larkana contracted HIV. The incident raised serious concerns about the Sindh Blood Transfusion Authority and the province’s blood safety system, prompting action against some blood banks. However, experts say the reforms that followed were insufficient.
A far larger outbreak emerged in Ratodero in 2019, where more than 1,000 people tested positive for HIV, with over 80% of the cases involving children. The outbreak drew international attention, with the World Health Organization and other global health agencies describing it as an extraordinary public health event. Investigations identified unsafe injection practices and the reuse of contaminated syringes as key factors behind the spread of the virus.
In May 2026, another alarming incident surfaced at the Gambat Institute of Medical Sciences in Khairpur, where more than two dozen HIV-positive children were brought to the hospital, once again raising concerns about the spread of HIV among children in Sindh.
Separately, HIV cases among children began emerging at Kulsum Bai Valika Hospital in Karachi in November 2025, with new cases continuing to be reported. Authorities acknowledged negligence in the matter and initiated action against those found responsible. However, public health experts argue that isolated disciplinary measures are not enough and that systemic reforms are urgently needed.
The health experts say all four outbreaks share common causes, including unsafe medical practices, particularly the reuse of syringes, weak infection control measures and inadequate regulatory oversight. They maintain that stronger reforms implemented after earlier outbreaks could have prevented many of the later cases.
The experts also warn that the recurrence of such incidents highlights the failure to establish a robust healthcare monitoring system, allowing HIV transmission to evolve into a growing public health crisis.
In April this year, the Medical Microbiology and Infectious Diseases Society of Pakistan released a white paper warning that the number of people living with HIV in Pakistan has increased 4.3-fold since 2010, while annual AIDS-related deaths have also risen significantly.
The report further noted that only 21% of people living with HIV are diagnosed, while just 16% receive treatment, underscoring major gaps in disease detection and access to care.
