Avoidable loss

More than five years ago, Pakistan was jolted by a harrowing story from rural Sindh: hundreds of children infected with HIV, the outbreak traced back to a local clinic and a doctor’s negligence. It was a national disgrace that exposed the flaws in our healthcare system. One would have expected urgent reforms, stringent oversight and sustained investment in public health infrastructure. Instead, we have squandered time and resources – and the consequences are now painfully clear. A recent audit by the Global Fund has revealed a staggering collapse in Pakistan’s fight against HIV, tuberculosis (TB) and malaria. From 2021 to 2023, AIDS-related deaths in the country soared by 400 per cent, rising from 2,200 to 11,000. New HIV infections increased by 64 per cent in five years. Meanwhile, nearly 70 per cent of drug-resistant TB cases went undetected last year. These numbers are simply damning, reflecting a failed health response amid a broader crisis of governance, accountability and political will.

What makes this failure even more unforgivable is that it has occurred despite Pakistan receiving over $1.1 billion in aid for disease control since 2003. This support was intended to enhance our capacity to prevent, diagnose and treat precisely the types of outbreaks we are now seeing escalate. But the money appears to have disappeared into the black hole of weak institutions, lack of coordination and chronically mismanaged health programmes. Projects are launched with fanfare, only to fizzle out without results. Expensive equipment gathers dust in understaffed facilities. Life-saving medications run out. And in some of the poorest clinics, doctors are left with no option but to reuse syringes – a practice that directly contributes to the spread of infections like HIV. In other parts of the world, TB is nearing eradication. In Pakistan, it continues to thrive. The absence of consistent policies, reliable health services and functioning oversight has allowed diseases long under control elsewhere to remain a persistent threat here. And this isn’t just about HIV or TB. It’s about the broader decay of a public health system that is neither equipped nor empowered to protect its citizens. Budget constraints prevent facilities from functioning effectively. Public hygiene – whether in clinics, restaurants or other public spaces – is rarely monitored and entire communities are left without access to basic screening or care.

The health of a population is the backbone of a functioning society. Without it, there is no productivity, no prosperity and no future. A clear and practical roadmap is essential. First, immediate hygiene and safety inspections must be carried out across all healthcare facilities. Second, mobile screening units should be deployed nationwide to provide basic diagnostics in underserved areas. Third, large-scale public awareness campaigns must be launched to inform citizens of how diseases spread and how to prevent them. These steps are not expensive or complicated. Most importantly, the government must stop treating healthcare as an afterthought. No infrastructure project, economic reform or foreign policy breakthrough can substitute for a nation in declining health. The lives lost to HIV, TB and other preventable diseases are a permanent and irreversible tragedy. But what’s worse is knowing that it didn’t have to be this way.