Islamabad: Pakistan is on track to record its highest number of newly detected HIV cases in a single year, with more than 10,000 people already confirmed positive in the first nine months of 2025, officials revealed on Wednesday, warning that the total is likely to exceed 14,000 by the end of the year, surpassing last year’s 13,001 reported cases.
Federal health ministry officials said 6,459 new infections were reported till June but a sharp rise in detections during medical screenings for surgeries, emergency procedures and visa requirements pushed the tally beyond 10,000 by September, making 2025 the fastest year of HIV case escalation in the country.
Officials confirmed that most of these detections were accidental, discovered only when individuals were asked to undergo HIV testing before going abroad, ahead of surgery or when physicians suspected infection. Pakistan still has no law mandating HIV screening for high-risk groups, deported migrants or sex workers, which means thousands continue to live with the virus without ever being tested or treated and unknowingly passing it on to others.
Modelling by UNAIDS, WHO and UNICEF estimates that as many as 40,000 people could contract HIV in Pakistan by the end of 2025, but the majority would never be diagnosed or start treatment due to the absence of a structured screening and surveillance system.
Recent outbreaks in Mirpurkhas and Taunsa, where dozens of children contracted HIV due to reuse of syringes and poor infection control practices, have already shown that the virus is no longer restricted to so-called high-risk populations and is now spreading within general families, including mothers and infants.
Experts warn that the sharpest rise is being seen among men having sex with men, with chemsex, sexual activity under the influence of methamphetamine, emerging as a major driver behind unprotected encounters. They said this trend is also fuelling transmission among transgender persons and female sex workers who are often unaware of their HIV status and continue to work without any protective protocols.
Another growing source of infection is deported Pakistani workers returning from Gulf states and Europe. Over 50,000 people are deported annually and senior officials estimate that even if five percent are HIV positive, around 2,500 people carrying the virus re-enter the country every year with no screening at airports, no referral to HIV centres and no treatment.
Officials alleged that some NGOs working with migrant returnees discourage authorities from screening deportees under the pretext of protecting their rights, leaving a major gap in public health surveillance.
Officially, Pakistan estimates that 369,593 people are currently living with HIV but only 78,734 are registered with HIV treatment centres and around 55,690 are reported to be on antiretroviral therapy. Programme insiders, however, say these numbers are inflated to satisfy donors and claim that no more than 20,000 patients are consistently on treatment, while thousands who know their status have either dropped out or never initiated therapy, posing a serious risk of onward transmission.
The Common Management Unit (CMU) of the Ministry of Health, which oversees HIV, tuberculosis and malaria, is currently being run by a non-medical additional secretary holding multiple portfolios, making the programme largely administrative and donor-driven rather than technical and public health-focused.
At the moment, there is no permanent Deputy National Coordinator for HIV, and the additional charge of three major disease control programmes, backed by millions of dollars in external funding, has been handed to an officer who is not even a medical doctor and has no background in infectious diseases or outbreak response.
Experts say Pakistan’s HIV response remains passive and detection continues to depend on lab slips issued by embassies and surgeons. Public health professionals warn that without immediate introduction of mandatory screening protocols, infection control enforcement and a technically led HIV programme, the country risks allowing a silent epidemic to expand unchecked while officially detected cases continue to be recorded only when people prepare to leave the country or enter an operation theatre.
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