Medical negligence in Pakistan is often discussed in the abstract — as a system failure, a resource constraint or an unfortunate by-product of poverty. But when nearly 4,000 children in Sindh are living with HIV, many of them infected not at birth or through personal behaviour but in healthcare facilities meant to heal them, negligence ceases to be an abstract concept. It becomes a crime in plain sight.
The Pakistan Medical Association’s “high-level alert” on the alarming rise in paediatric HIV cases should jolt authorities out of their habitual inertia. The numbers alone are damning: 3,995 registered HIV-positive children in Sindh and over 100 new cases reported in Karachi in 2025. These numbers point to a systemic collapse of infection control and regulation. This is not Pakistan’s first warning.
The 2019 Ratodero tragedy, where hundreds of children were infected, was supposed to be a turning point. It triggered inquiries and promises of reform. Yet six years later, the PMA is forced to state the current numbers, which is a shame for any health administration. If lessons were learned, they had not translated into practice.
What makes this crisis particularly disturbing is that it is largely preventable. Unsafe injections, reused syringes, unregulated blood banks and illegal clinics run by quacks continue to operate with impunity. Inability — or unwillingness — to enforce minimum standards has turned clinics into sites of contagion. The PMA rightly warns that this is no longer just a medical emergency but a socio-economic catastrophe in the making.
The response now must go beyond statements and alerts. Strict enforcement of infection-control practices and a decisive crackdown on quackery, coupled with regulation of blood banks and criminal accountability for negligence, are non-negotiable. Health officials who preside over repeated failures must be held to account.
Editorial Published in Express Tribune on January 24th, 2026.
