Islamabad: Public health experts have called for an independent audit of more than $1.1 billion provided to Pakistan by the Global Fund over the past two decades, questioning the impact of international funding as HIV infections continue to rise and the epidemic spreads into the general population.
Speaking at a press conference at the National Press Club, former federal health minister Dr. Zafar Mirza, along with Dr. Quaid Saeed and epidemiologist Dr. Rana Jawad Asghar, said the continued increase in HIV, tuberculosis and malaria cases raises serious concerns about governance, utilisation of funds and effectiveness of programmes supported through international assistance.
They stressed that the demand for an audit was not aimed at blaming any single government but to ensure transparency and accountability in the use of resources meant for controlling major infectious diseases.
Dr. Zafar Mirza said Pakistan is facing a worsening HIV situation, with an estimated 370,000 people living with the virus. He noted that around 79 percent of infected individuals remain unaware of their status, while a large proportion of those diagnosed are not on treatment, contributing to continued transmission.
He said unsafe healthcare practices, including reuse of syringes and inadequately screened blood transfusions, are major drivers of the epidemic. “Around 70 percent of blood transfusions may not be properly screened, which is a serious concern for the spread of HIV and other infections,” he said.
Referring to recent outbreaks, including cases among children, he described the situation as a reflection of systemic gaps in infection prevention and control. He also criticised the lack of transparency in reporting data, saying concealment of information hinders effective response and prevention.
The experts pointed out that despite sustained international support, Pakistan continues to report thousands of new HIV infections annually, along with a high burden of tuberculosis and malaria, indicating gaps in programme implementation.
Dr. Quaid Saeed said HIV outbreaks have been occurring in Pakistan since the early 2000s, but recent trends show the infection moving beyond traditionally high-risk groups into the general population. He said prevalence among key populations has also increased, with estimates suggesting around 8 percent among men who have sex with men and about 7 percent among transgender persons.
He also highlighted governance challenges, noting frequent changes in leadership within the Common Management Unit responsible for HIV, TB and malaria programmes. According to him, repeated transitions in key positions have affected continuity, planning and execution of public health interventions.
The speakers referred to findings of the Office of the Inspector General of the Global Fund, which has previously identified weaknesses in programme management and implementation, and stressed the need for a transparent review of how funds have been utilised and what outcomes have been achieved.
Dr. Rana Jawad Asghar said repeated outbreaks, including the 2019 Ratodero incident that affected a large number of children, point to persistent failures in healthcare delivery and regulatory oversight. He added that Pakistan’s high burden of hepatitis C, affecting an estimated 10 million people, reflects broader issues in infection control that also contribute to HIV transmission.
He emphasised the need to strengthen blood screening systems, enforce safe injection practices and improve surveillance to prevent further spread of infectious diseases.
The experts also noted that Pakistan continues to rely heavily on external funding for HIV prevention and treatment, with limited domestic financial contribution. They called on the government to prioritise funding for public health programmes and improve regulatory mechanisms.
They urged authorities to make public reports of recent outbreaks, including the Taunsa incident, and to introduce stronger accountability mechanisms to prevent negligence in healthcare settings.
Warning of a growing public health challenge, the speakers said that without improved governance, transparency and sustained policy action, Pakistan may face increasing difficulty in controlling the spread of HIV and other infectious diseases.
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