Islamabad: The United Nations Development Program (UNDP) and a non-governmental organisations received around 75 percent of the US$192.5 million provided by the Global Fund for HIV programmes in Pakistan over the last two decades, even as the country’s HIV burden more than doubled during the past six years, official data reviewed by The News revealed.
Collectively, the United Nations Development Programme (UNDP) and Nai Zindagi Trust received more than US$146 million, equivalent to over Rs41 billion, for HIV prevention, treatment, surveillance, awareness campaigns, harm reduction programmes and related interventions in Pakistan.
UNDP alone received approximately US$80.58 million, or around Rs22.7 billion, between 2021 and 2026, while Nai Zindagi Trust received more than US$66 million, equivalent to over Rs18.6 billion, between 2011 and 2026.
In comparison, the Government of Pakistan, through the Ministry of National Health Services and National AIDS Control Programme (NACP), received approximately US$45.93 million, or nearly Rs13 billion, in HIV grants during last 22 years between 2004 and 2026.
The data analysis comes at a time when Pakistan is witnessing an alarming rise in HIV infections, with 14,182 new HIV cases reported in 2025, almost double the nearly 7,000 annual HIV cases reported around 2020, according to official programme data.
Official figures presented in a recent briefing showed that active HIV registrations in Pakistan increased from 39,529 in 2019 to 84,421 in 2025, while the number of HIV patients on treatment rose from 22,947 to 60,785 during the same period.
An analysis of Global Fund HIV grants for Pakistan from January 2004 to December 2026 showed that approximately US$192.5 million, or over Rs54 billion at the current exchange rate, was approved or signed for HIV related interventions in Pakistan, out of which more than US$180 million appears to have been disbursed, signed or committed for implementation.
The analysis showed that UNDP emerged as the single largest recipient of HIV financing in Pakistan after the Global Fund invoked its Additional Safeguard Policy (ASP), under which major HIV grants were routed through international and non governmental entities instead of the Government of Pakistan.
Under grant code PAK-H-UNDP, active from March 2021 to December 2026, UNDP received approval for approximately US$80.58 million, while about US$72.61 million had been disbursed.
Nai Zindagi Trust was the second largest recipient of HIV related funding. Data showed that Nai Zindagi received more than US$66 million under different HIV grants between March 2011 and December 2026, including the earlier PAK-911-G14-H grant worth US$3.13 million and the much larger PAK-H-NZT grant cycle exceeding US$63 million.
Government managed HIV grants included PAK-202-G01-H-00 from 2004 to 2010 worth US$7.65 million, PAK-911-G13-H from 2011 to 2013 worth US$3.16 million, and the ongoing PAK-H-NACP grant from 2013 to 2026 worth US$35.12 million.
A senior federal health ministry official claimed that the Global Fund used the Additional Safeguard Policy (ASP) to route most HIV funding through UNDP and Nai Zindagi Trust instead of the Government of Pakistan, but there was little accountability of the two organisations regarding utilisation of the funds.
The official said the federal health ministry and NACP, despite receiving comparatively meager funding, remained under constant scrutiny from the Prime Minister’s Office, media, civil society and healthcare fraternity and were held responsible for rising HIV cases and weaknesses in prevention and treatment programmes.
Public health experts say the sharp increase in HIV cases despite massive international financing raises serious questions regarding prevention effectiveness, surveillance gaps, treatment retention and accountability mechanisms.
Pakistan is currently facing one of the fastest growing HIV epidemics in the region, with officials increasingly warning that the infection is spreading beyond traditional high risk groups into the general population through unsafe injections, reuse of syringes, unsafe blood transfusions and unprotected sexual practices.
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