In recent weeks, a troubling public health crisis has emerged in Karachi, Pakistan, where over 130 individuals, primarily children, have tested positive for HIV linked to a government-run hospital. This alarming outbreak has not only highlighted the critical state of healthcare practices in the region but also raises questions about underlying systemic issues within Pakistan’s health sector. Efforts are underway to address the crisis, but comprehensive reform is essential to prevent similar outbreaks in the future.
Islamabad, Pakistan – At least 130 individuals, mostly children, have tested HIV-positive in connection to a serious outbreak associated with Kulsum Bai Valika (KBV) Hospital, a government facility in Karachi, the largest city in Pakistan. Sindh Labour Minister Saeed Ghani announced earlier this week that in excess of 10,500 people have been screened in and around the hospital, revealing that more than 120 tested positive, with an additional 10 cases found in a separate screening at another SESSI facility in Karachi’s Landhi area. The Sindh Employees’ Social Security Institution (SESSI), which operates KBV Hospital, provides healthcare and financial assistance to industrial workers and their dependents throughout the Sindh province.
The health crisis at KBV Hospital first gained attention in November 2025 when residents of Karachi’s SITE Town reported a cluster of infections among children who had received treatment there. Officials have traced the outbreak back to October 2025, when the initial reports of six HIV-positive cases were submitted to the provincial health department.
In light of the developing situation, Chief Minister Murad Ali Shah received a briefing on July 14 indicating severe lapses in infection prevention protocols at the facility. Internal inquiries revealed inadequate use of protective equipment and improper handling of single-use syringes, contributing to the outbreak’s rapid increase. The first inquiry highlighted 16 HIV-positive children primarily linked to the paediatrics department, while a subsequent investigation discovered 78 infections alongside six fatalities and attributed negligence to certain hospital personnel.
Minister Ghani confirmed that all current cases can be traced back to earlier exposures, reiterating a commitment to continue screening despite concerns over possible additional cases. Thirty-seven doctors and hospital staff received show-cause notices demanding explanations within 14 days. The minister stated that accountability measures, including potential criminal charges and terminations, would follow for those deemed responsible for the outbreak. Reacting to inquiries regarding his own accountability, Ghani expressed willingness to resign if deemed necessary for addressing the crisis effectively.
In response to suggestions that the outbreak resulted from reused syringes, Ghani clarified that KBV Hospital utilizes auto-disable syringes, designed to prevent reuse. However, the official inquiries have pointed to a broader failure in maintaining infection control standards throughout the facility. A petition submitted to the Sindh High Court indicated that the true scale of the outbreak might exceed current official counts.
The crisis in Sindh is not an isolated incident. In December, the World Health Organization (WHO) and UNAIDS highlighted that Pakistan has one of the fastest-growing HIV epidemics in the Eastern Mediterranean region, with annual infections increasing significantly from 16,000 in 2010 to 48,000 in 2024. Estimates suggest that approximately 350,000 people live with HIV in Pakistan, with nearly 80 percent unaware of their status. Alarmingly, HIV cases among children aged 0 to 14 rose from 530 in 2010 to 1,800 in 2023, illustrating a dire need for systemic reform in healthcare access and awareness.
Concerned experts emphasize that while repeated outbreaks underscore unsafe medical practices, comprehensive surveillance is crucial in determining how HIV infections are acquired, whether through healthcare settings or other transmission routes. Dr. Syed Faisal Mahmood, a professor of infectious diseases at Aga Khan University Hospital, stressed the absence of systematic data regarding how many infections stem from visiting clinics compared to other transmission methods. The trend of pediatric HIV cases extends to other Karachi hospitals, highlighting widespread challenges within the healthcare system.
In response to the ongoing situation, the Sindh High Court has mandated that the provincial government answer allegations of regulatory failures regarding syringe disposal. At the federal level, Prime Minister Shehbaz Sharif instituted a nationwide prohibition on substandard syringes. Subsequently, the Drug Regulatory Authority of Pakistan announced a ban on retail sales of reusable syringes effective from January 2027.
In addition, Federal Health Minister Mustafa Kamal stated that mandatory HIV screening will be introduced nationwide prior to surgical procedures. The Sindh government also approved a significant 2 billion-rupee (.2 million) fund aimed at ensuring long-term care for affected children, along with initiating an audit of KBV Hospital’s procurement and infection control practices.
While these measures represent important steps forward, experts warn that without addressing the broader issues within Pakistan’s healthcare system, including the predominance of private sector services, the persistence of unsafe medical practices is likely to continue. Dr. Mahmood emphasized the urgent need for comprehensive reform, positing that the challenges stem from a confluence of extensive medical practices, insufficient governance, and a lack of community awareness regarding infection prevention.
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