Karachi’s three major hospitals have recorded a dramatic spike in HIV diagnoses among children in recent months, with cases rising from single digits in 2024 to over 170 admissions across facilities in 2025, according to hospital officials and medical records reviewed on Friday. The surge has triggered urgent warnings from infectious disease specialists about widespread failures in basic infection control protocols across healthcare settings in Pakistan’s largest city, raising critical questions about patient safety and the adequacy of regulatory oversight in the provincial health system.
The scale of the outbreak is particularly striking at the Sindh Infectious Diseases Hospital and Research Centre (SIDH&RC), where paediatric HIV admissions jumped from 10 cases in 2024 to over 70 by early 2025. At the Indus Hospital, documented HIV cases among all age groups rose from 144 in 2024 to 176 in 2025, with 69 new patients reported in the first quarter of 2025 alone. Since August 2025, the Indus Hospital has registered 72 children under 14 years of age with HIV status, of whom 68 percent are under five years old—an age group at particular vulnerability given their dependence on caregivers and healthcare systems for protection.
Medical experts attribute the majority of these cases to healthcare-acquired transmission rather than mother-to-child infection, a distinction that points to systemic failures within hospital environments themselves. Dr Samreen Sarfaraz, Chair of Infection Control Services and consultant infectious diseases at the Indus Hospital, stated that only eight percent of the paediatric cases had HIV-positive mothers, while 72 percent had clear histories of healthcare-related HIV transmission. The remaining cases involved unknown exposures, but the overwhelming preponderance of hospital-linked transmission suggests that unsafe injection practices, inadequate sterilization of medical equipment, or contaminated blood products may be implicated in the outbreak.
The findings underscore persistent vulnerabilities in Pakistan’s healthcare infrastructure that have drawn international attention in previous years. In 2018 and 2019, Karachi experienced major HIV outbreaks linked to unsafe injection practices at private clinics, infections that ultimately affected hundreds of individuals, predominantly children. Those episodes exposed gaps in regulatory capacity, poor enforcement of biosafety standards, and limited training among healthcare workers on infection prevention and control. The current surge suggests that systemic remedial measures may not have been adequately implemented or sustained across the health sector in the intervening years.
Hospital administrators and disease control officials face mounting pressure to identify the specific sources of transmission and implement corrective measures at affected facilities. Regulatory bodies, including the Sindh Health Department and the federal National Institute of Health, must conduct urgent investigations into infection control practices, including equipment sterilization protocols, blood screening procedures, and staff training programmes. International health organizations monitoring the situation have emphasized the importance of transparent reporting and rapid public health response to prevent further transmission and restore confidence in healthcare institutions.
The outbreak carries broader implications for public health messaging in Pakistan, where vaccine hesitancy and health sector distrust already present significant challenges. Parents may become further reluctant to seek necessary medical care for their children if hospital environments are perceived as vectors for serious infections. Conversely, the crisis presents an opportunity for provincial authorities to demonstrate commitment to accountability and systemic reform, potentially strengthening institutional credibility if handled transparently and with demonstrable urgency.
Health officials and hospital management have indicated that enhanced surveillance, epidemiological investigation, and immediate implementation of strengthened infection control measures are underway. The coming weeks will be critical in determining whether authorities can arrest the outbreak’s momentum and identify its origins. Parallel efforts to audit infection control standards across private and public healthcare facilities in Karachi, combined with public communication strategies, will be essential to preventing similar surges and restoring trust in the city’s healthcare system.
