Islamabad: A joint investigation by Punjab AIDS Control Programme and United Nations agencies has found that contaminated needles and syringes were linked to 169 HIV cases while blood transfusions were associated with another 89 cases in Taunsa, DG Khan, where 275 people, mostly children, had been diagnosed with HIV by early July 2025 in one of Pakistan’s worst pediatric HIV outbreaks in recent years.
The investigation revealed that 169 of the 275 reported cases, or 61.5 percent, were linked to reused and contaminated needles and syringes while 89 cases, or 32.4 percent, were associated with blood transfusions.
Another seven cases were linked to blood products while only seven cases, or 2.5 percent, were associated with mother to child transmission, strongly indicating that the outbreak was overwhelmingly linked to unsafe medical practices rather than vertical transmission.
According to the joint mission report prepared by WHO, UNAIDS, UNICEF, UNDP, Punjab AIDS Control Programme and Punjab health authorities, the outbreak was predominantly “iatrogenic”, meaning HIV spread through healthcare procedures including unsafe injections, reused intravenous drips, contaminated surgical and dental equipment and transfusion of unscreened blood.
The epidemiological analysis showed that 147 of the 275 HIV positive cases, or 53.5 percent, were children aged between one and five years while the overall mean age of infected children was only 3.65 years. Investigators said the age pattern strongly pointed towards non sexual horizontal transmission through unsafe healthcare procedures.
The report said the outbreak first came to light in December 2024 when children suffering from persistent fever, recurrent infections and anaemia started testing positive for HIV. Cases rose from 18 in December 2024 to 26 each in January and February 2025 before increasing to 48 in March and 56 in April, indicating ongoing active transmission in the community.
Investigators found that mothers of nearly all infected children tested HIV negative, effectively ruling out maternal transmission as the principal source of infection. The report noted that the outbreak resembled the Ratodero HIV outbreak of 2019 in Sindh where unsafe injections infected hundreds of children.
The geographical analysis identified Urban City Union Council as the biggest hotspot with 62 HIV cases, followed by Bohar with 21 cases and Mangrotha with 17 cases. Investigators warned that the clustering of cases near the borders of Punjab, Sindh and Balochistan posed a serious risk of wider spread to other provinces.
The joint mission found serious deficiencies at Tehsil Headquarters Hospital Taunsa and surrounding healthcare facilities. The ART centre lacked trained pediatric HIV specialists, counsellors and essential diagnostic infrastructure while the blood bank was reportedly functioning without proper licensing and adequate blood safety mechanisms.
The investigation also documented use of non WHO approved HIV testing kits, weak contact tracing systems, poor infection prevention and control practices and inadequate compliance with international HIV testing standards.
Investigators observed that healthcare workers in some settings were not properly adhering to infection prevention protocols while reuse of syringes and intravenous sets was also reported during discussions with healthcare workers and affected families.
Focus group discussions with affected families revealed that many infected children had received repeated injections, intravenous drips and medical procedures from both private practitioners and public sector facilities for common illnesses. Families also disclosed that blood was often purchased without proper screening due to poor regulation and weak oversight.
Healthcare workers interviewed during the investigation blamed widespread quackery, unsafe injection practices, poor hazardous waste management and shortages of medical supplies for fuelling the HIV outbreak. The report also highlighted the presence of unlicensed clinics and informal healthcare providers in the region who were reportedly involved in unsafe injection practices and unregulated blood transfusions.
The report recommended an immediate crackdown on quacks and unlicensed blood banks, mandatory use of auto disable syringes, strict enforcement of infection prevention protocols, expansion of HIV testing and treatment services, large scale screening in affected areas and improved surveillance systems to prevent further spread of HIV among children.
Meanwhile, a recent investigation by BBC Eye in April 2026 found that unsafe injection practices were still continuing at Tehsil Headquarters Hospital Taunsa months after the HIV outbreak among children surfaced. Undercover filming reportedly showed staff and volunteers repeatedly using syringes on multidose medicine vials that were later used for multiple children.
The investigation also documented injections being administered without proper infection prevention measures, including absence of sterile gloves in several cases. Experts warned that even if needles are changed, reuse of syringe bodies or contamination of multidose vials can still transmit HIV and other bloodborne infections.
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