Pakistan urged to tighten infection control as HIV, mpox risks rise

Pakistan's public health community issued one of its sharpest warnings of the year on Saturday, as infectious disease specialists called for immediate nationwide enforcement of infection-control rules, saying repeated HIV outbreaks and renewed concern around mpox are exposing dangerous weaknesses in hospitals and clinics. Speaking at a Karachi Press Club briefing organised by the Medical Microbiology and Infectious Diseases Society of Pakistan, doctors said unsafe care practices are no longer isolated failures but a broader systemic threat.

The experts said the first priority should be strict single-use syringe policies, tighter oversight of blood transfusions, better sterilisation standards and stronger supervision of both public and private health facilities. They argued that Pakistan has repeatedly drawn local and international scrutiny because infections linked to treatment settings continue to emerge, suggesting that routine lapses in clinical safety are allowing preventable diseases to spread to patients who entered the system for completely different medical needs.

Doctors at the event presented troubling examples from Karachi's paediatric caseload. One speaker said a cluster detected in November 2025 in Site Town involved more than 15 children, some of them very young, who tested positive after attending a health facility, with fatalities also reported. At Indus Hospital, 72 HIV-positive children under 15 have been registered for care since August 2025, and 12 of them have died. Only six were believed to have contracted the virus from their mothers, while most of the rest had histories consistent with unsafe healthcare exposure such as reused needles, poorly screened transfusions, surgery or repeated hospital visits.

Clinicians said the pattern points away from traditional assumptions about HIV transmission and toward failures inside the healthcare system itself. They described overcrowded hospitals, thin staffing, supply shortages and a persistent preference for injections over oral medicines as factors that increase risk. They also warned that interruptions in antiretroviral and anti-tuberculosis drug supplies could worsen outcomes for patients already in treatment and raise the danger of drug-resistant infections, making an already serious health challenge even harder to control.

The white paper launched alongside the briefing painted an even grimmer national picture. It said AIDS-related deaths in Pakistan rose from 2,200 a year in 2010 to 14,000 in 2024, marking a 6.4-fold increase. Even with that steep rise, diagnosis and treatment coverage remain alarmingly low. Health experts said only about 21 per cent of people living with HIV in Pakistan have been diagnosed, while roughly 16 per cent are on treatment, a gap that means many patients are being identified late, after the disease has already advanced.

The warning also drew strength from Pakistan's own outbreak history. Specialists cited a review that found at least seven major HIV outbreaks between 2000 and 2019, many linked to unsafe medical practices rather than mother-to-child transmission. The 2019 Ratodero crisis in Larkana remains the most widely known example, becoming one of the world's largest paediatric HIV outbreaks. Earlier and later episodes in places such as Jalalpur Jattan, Kot Imrana, Faisalabad and Multan showed that the problem was never limited to one district, one province or one moment in time.

More recent data suggests the threat has not eased. Sindh reported 894 new HIV cases in the first quarter of 2026, including 329 children, according to health officials cited by Pakistani media. By the end of 2024, Larkana alone had recorded 2,747 new diagnoses, with children still accounting for more than half of the cases. Investigations into earlier outbreaks found that the overwhelming majority of infected children had received medical injections in the year before diagnosis, reinforcing the suspicion that unsafe treatment remains a major pathway for transmission.

The implications extend far beyond raw case counts. Children who survive HIV face lifelong treatment, repeated hospital visits, developmental complications and lasting social stigma, while families are left doubting whether routine medical care can be trusted. Public health specialists say the overlap with other infectious threats, including tuberculosis and mpox, makes weak infection control even more dangerous. If screening stays patchy and drug supplies remain unstable, Pakistan risks more preventable deaths, greater drug resistance and deeper pressure on an already strained health system.

The next test for federal and provincial authorities will be whether these warnings produce enforcement rather than another cycle of alarm followed by delay. Doctors want inspections, mandatory single-use injection practices, safer blood screening, better training, stronger regulation of unauthorised practitioners and uninterrupted access to treatment. Their message was direct: unless infection control becomes a non-negotiable standard across Pakistan's healthcare system, outbreaks that should have been stopped years ago will continue to move from vulnerable groups into the wider population.