Children with HIV

Health Minister Dr Azra Pechuho recently chaired a meeting on the "extremely alarming" spread of HIV, and the figures revealed to her state that nearly 4,000 children in Sindh are registered as HIV-positive, while simultaneously over 600,000 unlicensed doctors operate across the province. The current figures expose a devastating failure of public health and governance, and a lack of structural response is on its way to make matters much worse.

These figures are not two separate crises but two sides of the same coin. The uncontrolled proliferation of unregistered clinics, unsafe blood banks and the unethical re-use of syringes and dental tools by these quack doctors are explicitly named as major causes of the virus' spread. This negligence transforms the very institutions meant to heal into vectors of disease, particularly victimising the most vulnerable sector of society - children.

The core social issue here is the compromise of healthcare standards driven by poverty and the lack of access to regulated facilities. While the public remains uninformed about the significance of vetted and certified clinics for sensitive practices such as blood transfusions and dental check-ups, it is also to an extent helpless against the rising cost of healthcare in the province, forced to turn towards shady clinics that offer respite. If they are well aware of the risks attached, it eventually becomes a risk they are willing to take.

The government's recent directive for a zero-tolerance policy, mandatory pregnancy screening and the immediate closure of illegal facilities is a necessary step, but only beneficial if enforcement is swift and uncompromising. The Sindh Healthcare Commission and law enforcement must coordinate effective and sustained action against quackery and the illegal sale of hospital waste. But efforts to subsidise healthcare must supplement such actions. Providing compassionate care and ensuring access to treatment is as vital as curtailing the spread.