MEDICAL negligence in Pakistan is often discussed in the abstract as a systemic problem, a lack of resources, or an unfortunate by-product of poverty. But when nearly four thousand children in Sindh province are living with HIV, many infected not at birth or through personal behaviour but in healthcare facilities meant to heal them, negligence ceases to be abstract. It becomes a crime unfolding in plain sight. Pakistan Medical Association has recently issued a high-level alert on the alarming rise in paediatric HIV cases, which should jolt authorities out of their habitual inertia. The numbers alone are damning. There are three thousand nine hundred ninety-five registered HIV positive children in Sindh and over one hundred new cases reported in Karachi in 2025. These figures point to a collapse of basic infection control and regulatory oversight, not a mystery.

This is not Pakistan’s first warning. In 2019, an unprecedented outbreak in Ratodero infected hundreds of children after exposure to unsafe medical practices.

By mid-2019, nearly nine hundred people had tested positive for HIV in that outbreak, with children accounting for the overwhelming majority. That tragedy was meant to be a turning point. Yet six years later, the PMA finds itself reiterating what ought to be incontrovertible. Preventable medical practices such as unsafe injections, reused syringes, unregulated blood transfusions, and clinics run without oversight continue to expose Pakistani children to one of the world’s deadliest viruses.

Globally, health systems monitor and........

© Pakistan Observer