Pakistani Officials Look for Any Cause but Negligence To Explain Surge in HIV Cases Among Children

A local doctor at the mid-sized city of Taunsa in Pakistan’s Punjab province, first noticed something was wrong in late 2024. The children showing up at his private clinic were HIV-positive, and most of them had no obvious reason to be. Their parents were testing clean. They were too young for drug use or any of the standard risk factors that health officials tend to reach for when a case is inconvenient. What they had in common was simpler and more damning: they had all been treated at the same government hospital.BBC Eye has since identified at least 331 children who tested positive for HIV at Taunsa between November 2024 and October 2025. The infections trace back to the Tehsil Headquarters Hospital — known locally as THQ Taunsa — a state-run facility in Punjab province.Of 97 children whose families were also tested, only four mothers tested positive, suggesting that mother-to-child transmission accounts for a fraction of these cases. The provincial AIDS screening program’s own records list contaminated needles as the mode of transmission in more than half of all 331 cases. Nine children have died.This week, Pakistan’s federal health minister told a press conference in Islamabad that the Taunsa cases date back to 2024 and that any apparent rise in infections nationally reflected expanded screening rather than a genuine surge. The federal government is blaming anything but its own negligence for the outbreak, say global health authorities.“This is a failure of the adoption and enforcement of universal basic precautions to prevent blood-borne pathogens in Pakistan,” the Hock Distinguished Professor of Global Health and Director of the Duke Global Health Institute, Dr. Chris Beyrer, told The New York Sun. “The reuse of medical equipment, especially for injections and infusions, is a way for clinics and providers to save money, but it puts children at risk for HIV and other infectious agents. This is totally unacceptable in 2026,” he said.Caught on camera — then dismissedUndercover filming at THQ Taunsa captured syringes being reused on multi-dose medicine vials on 10 separate occasions. Nurses were seen injecting children through their clothing, unqualified volunteers administered injections from blood-contaminated vials, and medical waste was handled with bare hands — all while unofficial helpers, officially barred from the ward, operated without supervision.Research on HIV survival inside syringes has found viable HIV-1 recoverable at room temperature up to 21 days after storage, meaning the risk from reused equipment is not theoretical.“The mechanism is biologically simple but epidemiologically devastating,” Professor Fatima Mir, head of pediatric infectious diseases at Aga Khan University at Karachi, told the Sun.When a syringe is reused or reinserted into a shared vial, it can introduce infected blood into the entire supply.“That vial then becomes a vehicle for transmitting HIV to every subsequent patient,” Ms. Mir said.The hospital’s current medical superintendent, Dr. Qasim Buzdar, claimed the footage may have been staged — then, after being told it was recorded during his tenure, he maintained it could not be authentic.His predecessor, Dr. Tayyab Farooq Chandio, suspended in March 2025 after the case count crossed 100, was back working with children within three months at a rural health center on Taunsa’s outskirts. Officials said no legal findings prohibited him from practicing.The pushback has climbed up the chain. While denying culpability, Pakistan’s federal health minister, Syed Mustafa Kamal announced a ban on 10cc syringes — devices that hold 10 milliliters of fluid and, because of their larger barrel, retain more blood after use, increasing the risk of HIV transmission when reinserted into a shared medicine vial or used on a second patient. Pakistan banned conventional disposable syringes outright in 2021, mandating auto-destruct syringes that lock after a single use.The 10cc announcement extends enforcement pressure to larger-barrel devices — though the earlier ban has done little to clear the market. Reusable syringes are reportedly still sold across Pakistani cities and enforcement is widely described as weak.Separately, the National Assembly’s standing committee on health declared the rising case numbers alarming and called for a full briefing at its next meeting.A pattern the government cannot plausibly denyPakistan has been here before. The 2019 pediatric HIV outbreak in Ratodero, Sindh province, followed the same pattern: children under 10 testing positive, parents testing negative. By April 2020, 1,353 people had tested positive, with 75 percent being children and adolescents under 15; across the broader Sindh outbreak, children accounted for 80 percent of confirmed cases.The numbers suggest little has improved in antiseptic policy. A 2025 review in Trends in Pharmacology and Toxicology found syringe reuse rates in Pakistan ranged from 17 to 67 percent, with the highest rates in rural areas. Pakistanis receive an average of 8.5 to 9.6 injections per person per year, among the highest globally, and between 70 and 99 percent are medically unnecessary. Some providers charge more for injections, and patients often equate them with more serious treatment, compounding the problem.A joint World Health Organization and UNICEF mission flagged serious lapses in infection control at local facilities. Its leaked April 2025 inspection report found the pediatric emergency room conditions “especially concerning” — including missing essential medications, unlabeled cannulas, used IV sets left hanging on stands, and no hand sanitizers available.Officials deflect as families grieveNew HIV infections in Pakistan have risen 200 percent over 15 years — from 16,000 in 2010 to 48,000 in 2024, according to the World Health Organization and UNAIDS— now spreading to children, spouses, and wider communities through unsafe injections and blood transfusions. The national health budget allocates almost nothing to HIV control, with most prevention programming funded by foreign governments and international organizations.The local government says no validated epidemiological evidence conclusively establishes THQ as the source of the latest outbreak, pointing instead to unregulated private practices and unscreened blood transfusions. Islamabad says it acted promptly and dispatched infection control guidelines in March 2025. Punjab health officials decried irresponsible journalism.Public health professionals say precautionary principles should supersede attempts at crisis communications.“Accountability should apply not only to individual providers, but also to hospital leadership and health authorities responsible for oversight,” the founder of the Humanitarian Research Lab at Yale School of Public Health, Professor Kaveh Khoshnood, told the Sun.“Anyone credibly implicated in unsafe practices that may have harmed children should be removed from patient-facing duties while an independent investigation is conducted. There should be transparent findings, licensing review, disciplinary action where warranted, and safeguards to prevent quiet reassignment into another clinical role involving children.”Nineteen new cases were identified in Taunsa in the four months before publication of the BBCEye probe, and the families living with the consequences face a stigma so thick that neighbors keep their children away and classmates become strangers.“Children should never acquire HIV from seeking care at a hospital or clinic,” Mr. Khoshnood adds. “When that happens, it represents a profound breach of public trust and a failure of patient safety.”

Pakistani Officials Look for Any Cause but Negligence To Explain Surge in HIV Cases Among Children

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