HIV's silent spread

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Pakistan is in the middle of an HIV epidemic that has largely stayed out of the headlines. However, recent reports indicate that approximately 72,000 people are currently living with AIDS in the country, a number that continues to rise alarmingly, particularly in Lahore and Khyber-Pakhtunkhwa. While these numbers may seem low compared to some of the world's worst-affected countries, we must remember that social taboos around sexuality mean many people who live high-risk lifestyles refuse to get checked for sexually transmitted diseases, and people who do know they are infected often can't afford top-line treatments, or chose to go for quack 'cures' for the incurable disease, rather than proven therapies - including some offered for free by the government - that significantly improve quality of life and can even make a person non-infectious. This is why known HIV cases grew by a frightening 22% in 2024 alone.

Some critics have also pointed at the role of NGOs in Pakistan's HIV response. While they are crucial for outreach and service delivery, their reliance on foreign aid and external funding has created a fragile system that lacks long-term sustainability. Many NGOs also seem to operate in a vacuum, creating solutions that may not align with the local context or culture. Moreover, the pressure to meet certain targets set by donors can lead to compromised monitoring and accountability, leaving significant gaps in the effectiveness of the overall response.

An article published last year in The Lancet, a respected British medical journal, made several important observations, including that Pakistan needs to improve integration of HIV services within general healthcare settings. However, its most easily implementable suggestion shows the laughable level of attention that some treatment centres pay to their own work: if you want to encourage people to seek treatment, offer them some discretion and stop writing HIV treatment centre in big red letters outside the clinic.