Pakistan has suspended 37 health officials, including doctors, after a mass HIV outbreak among children, reports The Lancet. At least 78 children contracted HIV at the government-run Kulsoom Bai Valika Hospital in Sindh province, amid allegations that contaminated syringes were reused.
A government inquiry has since found widespread lapses in infection prevention and control at the hospital and suspended staff, including administrators, doctors, nurses, lab workers, and support personnel, over failures that included “inadequate supervision of sterilisation practices” and “negligence and violations of medical protocols”.
The outbreak was first reported in October last year, when 16 children treated for different diseases at the hospital contracted HIV. Their families alleged that disposable syringes had been reused and called for an independent inquiry.
When the government failed to conduct an independent investigation and register criminal proceedings against health officials, the families petitioned the Sindh High Court. On 2 July, the court ordered provincial authorities to explain within two weeks how the outbreak occurred and what action had been taken.
Families have said that more than 200 children may have been infected and that at least nine have died.
Tariq Mansoor, families’ lawyer, gave the court the names of 200 children who had contracted HIV after contaminated syringes were allegedly reused.
Sindh's Chief Minister Saeed Murad Ali Shah confirmed 78 HIV infections among paediatric patients treated at the hospital. “This … must serve as a turning point for strengthening patient safety standards across our healthcare system…the lives of children are sacred. Any lapse in medical protocols that endangers patients is unacceptable and will be dealt with strictly.”
He ordered a review of infection-control practices in all facilities in Sindh and directed officials to ensure strict compliance with sterilisation and patient-safety protocols: they were also to ensure that all affected children receive uninterrupted care and follow-up free of cost.
“Our foremost responsibility is to stand with the affected children and their families. Every child must receive the best available treatment, counselling, and rehabilitation support without financial burden,” he said.
The inquiry painted a broader picture of systemic failures. Investigators found no standard operating procedures governing infection prevention, inadequate supervision of sterilisation practices, improper biomedical waste disposal, shortages of biohazard containers, weak inventory controls, inadequate HIV testing facilities, and failures to provide structured follow-up for children diagnosed with HIV and their families.
The investigation also found that health workers did not consistently follow infection prevention protocols or personal protective equipment requirements and that single-use medical equipment, including syringes, may have been improperly handled.
In April, three hospitals in Karachi reported sharp increases in paediatric HIV cases. At the Sindh Infectious Diseases Hospital and Research Centre, admissions of HIV-positive children rose from 10 in 2024 to more than 70 in 2025.
At least 30 children have been admitted so far this year, most of whom had previously received treatment at Valika Hospital. According to Sindh's health ministry, of 894 total HIV infections across the province between January and March this year, 329 were in children.
Also in April, the Pakistan Medical Association warned that the reported unsafe practices, including the reuse of needles in unauthorised clinics, remained a serious public health concern. It said that screening was minimal and estimated that the true number of infected children could be four-fold higher than currently documented, because of the critical failures in infection control.
Pakistan has reported multiple health-associated HIV outbreaks in recent years. The largest occurred in 2019 in Rotodero in Sindh, where more than 800 children receiving intravenous drips for routine ailments acquired HIV.
On the heels of that outbreak, a WHO-led investigation concluded that repeated use of contaminated needles was the principal driver of transmission. At least 331 children tested positive for HIV after an outbreak at a government hospital in Taunsa, Punjab, between November 2024, and October 2025, reportedly due to unsafe clinical practices.
The UN estimates a total of 310 000 people had HIV in 2023 in Pakistan, up from 67 000 in 2010. Prime Minister Shehbaz Sharif has asked the Drug Regulatory Authority of Pakistan (DRAP) to devise a national strategy to prevent such transmissions and use of unsafe syringes. Pakistan has already banned 2 mL and 5 mL reusable syringes.
The 10 mL reusable syringes will be replaced with auto-disable or self-destructive syringes from 1 January 2027.
The Lancet article – Health officials suspended over paediatric HIV infections (Open access)
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