Islamabad: While several countries across Asia, Europe and Latin America have demonstrated that babies can be born free of HIV, Pakistan continues to fall dangerously behind, trapped by denial, weak governance and a failure to protect women and children from a largely preventable infection, public health experts warn.
Recently, the World Health Organization validated Brazil for eliminating mother-to-child transmission of HIV, making it the most populous country to achieve this milestone. Years earlier, Sri Lanka earned the same validation, followed by Thailand, Armenia, Belarus and Oman. These countries proved that with routine antenatal testing, timely treatment and transparent reporting, HIV-free births are not an aspiration but a public health reality.
Pakistan, however, tells a very different story.
Health officials estimate that around 350,000 people are currently living with HIV in Pakistan, with the epidemic now considered among the fastest growing in Asia. Yet barely 21 percent of people living with HIV know their status, while only around 16 percent are on antiretroviral treatment. Even more alarming, just 7 to 8 percent have achieved viral suppression, meaning the overwhelming majority remain capable of transmitting the virus.
Official data shared recently revealed that around 13,000 new HIV cases were detected, while the actual number of new infections is estimated to be as high as 48,000 in a single year. At least 1,100 AIDS-related deaths were recorded, highlighting the widening gap between detection, treatment and prevention.
Children are increasingly paying the price for these systemic failures. Pakistan has witnessed repeated HIV outbreaks involving children, particularly in Sindh, exposing deep flaws in infection control, surveillance and maternal health services. New HIV infections among children aged 0 to 14 years have risen sharply over the past decade, with experts warning that undiagnosed mothers and missed opportunities during pregnancy are fuelling preventable infections.
Under WHO standards, countries seeking validation must ensure that fewer than two percent of babies born to HIV-positive mothers acquire the virus, supported by near-universal antenatal care, routine HIV testing during pregnancy and immediate lifelong treatment for women who test positive. Countries like Brazil and Sri Lanka embedded HIV testing into maternal and child health services and allowed independent scrutiny of their data and systems.
In Pakistan, HIV testing during pregnancy is still not routine in most public hospitals. Many women are never offered an HIV test unless they present with advanced illness. As a result, countless women learn of their HIV status only after their newborns fall sick or test positive.
“A large number of women contract HIV from their spouses but remain completely unaware,” said a clinician working in Sindh. “They are not counselled, they are not tested in time, and they are not told how to protect their babies. This is not just a medical failure, it is a system failure.”
Experts say stigma, silence and ignorance within families compound the problem. Many women do not know their husbands’ HIV status, particularly in cases involving injecting drug use or untreated infections. Without testing, counselling and treatment during pregnancy, these women unknowingly pass the virus to their children, despite the fact that timely intervention can reduce transmission to almost zero.
Pakistan’s National HIV and AIDS Control Programme acknowledges rising infections but has been repeatedly criticised for withholding detailed data, particularly on mother-to-child transmission. Researchers and activists allege that statistics remain tightly controlled, with limited sharing even within government circles, undermining evidence-based planning and accountability.
“When numbers are hidden, policymakers remain comfortable and the crisis stays invisible,” said a former government adviser on infectious diseases. “That is why HIV continues to spread quietly, especially among women and children.”
Health officials concede that despite expansion in treatment centres over the past decade, nearly eight out of ten people living with HIV remain undiagnosed, allowing the epidemic to grow unchecked. Repeated outbreaks among children, unsafe medical practices, delayed diagnosis and weak surveillance have further deepened the crisis.
Public health specialists warn that unless Pakistan urgently expands antenatal HIV testing, ensures lifelong treatment for HIV-positive women, actively educates mothers on preventing transmission and openly shares data, it risks entrenching HIV in yet another generation.
“Elimination is not a slogan,” said a senior public health expert. “It is a system built on honesty, testing and treatment. Other countries proved it can be done. Pakistan’s failure is not scientific. It is political and administrative.”
For now, the gap between global progress and Pakistan’s reality continues to widen, leaving HIV-free births a distant promise rather than a public health priority.
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