Ending HIV for mothers and children: a call to action

Children have the right to health, yet in Pakistan thousands continue to face a rising number of preventable HIV (human immunodeficiency virus) infections that jeopardise their futures, and Pakistan's progress.

We have the science to protect and save these children, but concerted action and political and financial commitment are needed to end this public health threat.

Despite progress in treatment access and joint efforts by the government, UN entities and partners, Pakistan has one of the fastest-growing HIV epidemics in Asia with new infections rising 200 per cent from 16,000 in 2010 to 48,000 in 2024. Children are increasingly affected: among those aged 0-14, cases have surged from 530 cases in 2010 to 1,800 in 2025. While HIV predominantly affected high-risk groups, it is now spreading to children, spouses and the wider community due to unsafe medical practices, gaps in maternal testing and weak infection prevention.

Without urgent action, the number of new HIV infections and deaths will rise, health systems will face greater strain and the goal of ending AIDS by 2030 will be missed.

In Pakistan, children were tragically exposed to HIV through unsafe injections and blood transfusions in recent outbreaks in Shaheed Benazirabad, Hyderabad, Naushahro Feroze and Pathan Colony in Karachi, with earlier outbreaks reported in Taunsa, Mirpur Khas, Jacobabad, Shikarpur and Larkana.

In some outbreaks, over 80 per cent of detected cases involved children.

Investigations revealed missed cases of mother-to-child transmission due to late testing, diagnostic delays and poor integration between HIV and maternal, newborn and child health (MNCH) services.

Only 14 per cent of pregnant women in need of antiretroviral therapy (ART) receive it to prevent mother-to-child transmission of HIV, leaving thousands of children at risk. Among children aged 0-14 living with HIV, only 38 per cent receive treatment, with over 1,100 AIDS-related deaths reported in 2024.

Globally, the UN has set the 95-95-95 targets: 95 per cent of people living with HIV should know their status; 95 per cent of those diagnosed should receive treatment; and 95 per cent of those on treatment should achieve viral suppression.

Pakistan's coverage for HIV services remains low — only 21 per cent of people living with HIV know their status, 16 per cent of those living with HIV are on treatment, and just 7 per cent of those living with HIV have suppressed viral load. This gap underscores the urgent need for expanded prevention, testing, treatment and care, particularly for women and children.

UN agencies and partners stand with Pakistan and the Ministry of Health to strengthen infection prevention, testing, blood safety and injection practices, and regulations; train health workers; improve access to treatment; respond to outbreaks; enhance community outreach; and prevent mother-to-child transmission.

Ending pediatric HIV in Pakistan requires a concerted, multisectoral response. Evidence demonstrates promising results when governments, healthcare providers, civil society and communities work together to prevent unsafe blood management and injection practices, while integrating HIV testing into antenatal care, delivery, postnatal and family planning services in high-burden districts. Routine "triple testing" for HIV, hepatitis B and syphilis for all obstetric facilities can reduce missed opportunities and curb stigma.

Investment is urgently needed in early infant diagnosis, pediatric ART provision and integration of HIV with MNCH services. We advocate for the development of a National Elimination of Mother-to-Child Transmission Roadmap with strong monitoring systems and regulatory approvals.

Improved national data systems are critical to track HIV-exposed infants and women living with HIV, allowing timely action and accountability.

Addressing stigma is equally important. Fear of disclosure remains a major barrier, limiting access to care and undermining prevention. UN agencies work with religious leaders, civil society and people living with HIV to provide counselling, raise awareness and normalise testing and treatment. Communities that understand HIV are empowered to protect mothers and children and ensure no one is left behind.

Mobilising domestic financing is vital to sustain lifesaving programmes. On World AIDS Day, we call for decisive action. By expanding testing, strengthening infection control, integrating services, reducing stigma and investing in health systems, we can change the trajectory of this epidemic in Pakistan.

Together, we can create a future where every child is protected from HIV and every mother has access to the care she deserves.