KARACHI: A concerning rise in paediatric cases of Human Immunodeficiency Virus has been recorded across three major hospitals in Karachi over the past nine months, raising serious questions about healthcare safety practices.
According to hospital data, the Sindh Infectious Diseases Hospital and Research Centre (SIDH&RC) reported just 10 HIV-positive children in 2024. That number surged to over 70 in 2025, while 30 new cases have already been admitted in the current year.
At The Indus Hospital, 144 HIV cases were recorded in 2024, increasing to 176 in 2025. In the first quarter of this year alone, 69 cases have been registered.
Highlighting the severity of the situation, Dr Samreen Sarfaraz revealed that since August 2025, 72 children under the age of 14 have been diagnosed with HIV at her facility, with nearly 68% of them under five years old. Alarmingly, only 8% of these children had HIV-positive mothers, while 72% had clear histories of healthcare-related transmission.
Experts believe unsafe medical practices are a major contributor to the spike. These include the reuse of syringes, needles, intravenous drip sets, and poorly sterilised instruments, along with transfusion of unscreened blood.
Dr Sarfaraz warned that critical lessons from the Ratodero HIV outbreak one of the largest paediatric HIV outbreaks globally have not been effectively implemented, allowing similar risks to persist.
She further noted that excessive reliance on injectable treatments in both public and private sectors, sometimes driven by financial incentives, continues to endanger patients. “It is deeply concerning that children are acquiring a lifelong infection due to preventable healthcare failures,” she said, adding that trends in Hepatitis B and Hepatitis C mirror similar transmission patterns.
Treatment Challenges Intensify Crisis
The situation is further complicated by limited availability of specialised paediatric infectious disease experts. Many children are presenting at advanced stages of immune suppression, often with serious opportunistic infections.
Additionally, disruptions in drug supplies particularly antiretroviral therapy and tuberculosis medications have worsened due to funding constraints linked to United States Agency for International Development.
With Tuberculosis being the most common co-infection among HIV patients in Pakistan, experts fear that shortages could lead to drug-resistant strains and increased mortality.
Cases Linked to Interior Sindh
A third major paediatric hospital in Karachi has also reported over 60 HIV-positive children, many from Thatta and other parts of interior Sindh. Most cases were identified during routine pre-surgical screenings.
Preliminary findings suggest repeated exposure to intramuscular injections may have played a role in transmission. Several affected children had reportedly received prior treatment at Kulsoom Bai Valika Social Security Hospital in SITE Town, which last year experienced an outbreak affecting more than 80 children and resulting in at least two deaths.
Officials Downplay Concerns
While health officials acknowledged an increase in cases, some suggested the figures may be overstated, attributing the rise to improved detection and surveillance systems.
However, experts stress that enforcement gaps remain. Responsibility for infection control lies with regulatory bodies such as the Sindh Healthcare Commission and the Sindh Blood Transfusion Authority, yet implementation appears inconsistent.
Fastest-Growing HIV Epidemic in Region
Pakistan is currently witnessing the fastest-growing HIV epidemic in the World Health Organization’s Eastern Mediterranean region, with rising numbers among both children and adults.
Dr Sarfaraz has urged immediate enforcement of the National Action Plan for Injection Safety (2019), along with strict action against unsafe medical practices, including reuse of syringes and improper sterilisation.
Without urgent intervention, experts warn, the crisis could escalate further putting thousands of children at risk of a preventable yet lifelong disease.
