Hidden epidemic

HIV in Sindh is more widespread than initially believed: this is the inescapable conclusion one has to draw from the latest infections uncovered at the Sindh Employees' Social Security Institution's hospital in Landhi neighbourood of Karachi. What began as an outbreak centred on the Kulsum Bai Valika Hospital has steadily expanded with every new round of screening. More than 120 people have now tested positive near Valika Hospital, while another 10 cases have surfaced in Landhi. Each expansion of testing is revealing more infections than previously known, suggesting that the city's HIV burden extends well beyond what official figures have captured.

HIV cases do not suddenly emerge in clusters overnight. It spreads silently, often remaining undetected for years before diagnosis. If screening a few thousand people near two hospitals has uncovered well over a hundred infections, it is reasonable to ask how many more cases remain hidden across Karachi, particularly among people who have never been tested. In the light of this, the government's decision to constitute another inquiry committee is a necessary but reactive initiative. Pakistan has become adept at investigating HIV outbreaks without preventing them. Ratodero should have been the watershed moment. Instead, it became the first in a series of warnings. If identical failures continue to emerge after every investigation, then the problem is no longer one of negligence alone but of systemic regulatory collapse.

The response, therefore, cannot end with fixing responsibility at two hospitals. Karachi's outbreaks should trigger a province-wide reassessment of infection control across every public and private healthcare facility. Routine inspections, mandatory compliance audits, criminal prosecution for unsafe medical practices and expanded HIV screening must become permanent features of the healthcare system rather than emergency measures adopted after tragedy strikes. Otherwise, the cost of inaction will be tremendous for the common man.