Pakistan is facing a rapidly intensifying public-health emergency as HIV infections continue to rise at an alarming pace, prompting the World Health Organization (WHO) and UNAIDS to issue a strong call for immediate, coordinated action. As World AIDS Day approached, both organizations urged the government, healthcare institutions, and civil-society networks to respond to what they describe as one of the fastest-growing HIV epidemics in the WHO Eastern Mediterranean Region.

Over the past 15 years, Pakistan has witnessed a dramatic increase in HIV cases. New infections have reportedly tripled—from approximately 16,000 in 2010 to an estimated 48,000 by 2024—reflecting deep structural issues in the country’s public-health system as well as persistent social challenges. The situation is especially concerning in key populations such as people who inject drugs (PWID), transgender communities, sex workers, and men who have sex with men (MSM), where rapid transmission continues due to limited preventive measures, stigma, and inadequate access to testing and treatment.

Public-health officials warn that without decisive intervention, Pakistan may face an irreversible escalation in HIV transmission, one that could overwhelm its healthcare infrastructure and set back decades of global progress in controlling the disease.

A Growing Epidemic Rooted in Systemic Gaps

Experts attribute the rising number of infections to multiple interconnected factors. Poor healthcare regulation, unsafe medical practices, widespread stigma, and a lack of public awareness have all contributed to the epidemic’s acceleration.

One of the most frequently highlighted concerns is the prevalence of unsafe injection practices. Pakistan has one of the highest rates of therapeutic injections per capita in the world, and a significant proportion of these are administered with reused or improperly sterilized needles. This allows HIV to move quickly through communities, even among individuals who are not part of traditionally “high-risk” groups.

Additionally, the failure of small clinics, informal healthcare providers, and roadside quacks to follow infection-control protocols has played a major role in spreading the virus. Several high-profile outbreaks—particularly among children—have been linked to unsafe injections by untrained practitioners. These incidents reveal a systemic vulnerability that urgently needs to be addressed.

Meanwhile, social stigma and misconceptions surrounding HIV continue to keep people from seeking timely testing or treatment. Many individuals fear discrimination, job loss, and social exclusion if they are diagnosed. This fear creates an environment where the virus can spread silently, as people remain unaware of their status.

WHO and UNAIDS: A Direct Warning

In their joint statement, WHO and UNAIDS emphasized that Pakistan’s epidemic demands immediate, decisive action. They stressed the importance of strengthening HIV prevention efforts, expanding harm-reduction programs, increasing testing accessibility, and ensuring the availability of antiretroviral therapy (ART).

According to the organizations, Pakistan must adopt a more comprehensive, evidence-based approach to public health. This involves not only providing medical services but also confronting long-standing cultural and social barriers.

Both agencies also highlighted the disproportionate impact of the epidemic on marginalized groups. Key populations in Pakistan continue to face discrimination, violence, and exclusion from the healthcare system—factors that hinder national progress in controlling HIV. WHO and UNAIDS urged policymakers to protect these communities through inclusive strategies, legal reforms, and stronger outreach mechanisms.

The State of Treatment and Prevention in Pakistan

HIV treatment has improved globally, but Pakistan still struggles with gaps in access and availability. Although the government provides free ART at designated treatment centers, many patients live far from these facilities or are unaware of the services.

Additionally, shortages of essential medicines, irregular supply chains, and staffing constraints at treatment centers often disrupt continuity of care. Health officials report that thousands of people who have been diagnosed with HIV are not consistently receiving treatment—placing both themselves and others at risk.

The country’s limited testing infrastructure is another major concern. Without widespread, routine testing, many individuals remain undiagnosed. WHO estimates that a large portion of Pakistan’s HIV-positive population is unaware of its status. This contributes to unintentional transmission and delays in seeking treatment, which can lead to more severe health outcomes.

Some progress, however, has been made. Needle-exchange programs and opioid-substitution therapy initiatives have been introduced in certain regions to help reduce infections among people who inject drugs. Community-based organizations are also working to educate high-risk populations and connect them with healthcare providers. But despite these efforts, coverage remains far too low to reverse national trends.

Children and Women at Increasing Risk

While HIV in Pakistan has traditionally been concentrated among specific adult populations, recent reports indicate that children and women are increasingly affected. Outbreaks in Sindh, for example, shocked the nation when hundreds of children tested positive due to unsafe medical practices.

These incidents reveal how fragile infection-control systems are, particularly in rural areas. Mothers and children often receive medical care from informal providers who lack proper training. Because HIV symptoms can remain hidden for long periods, infections may go unnoticed until large clusters are detected.

Women also face unique barriers: social constraints, lack of mobility, economic dependence, and limited reproductive healthcare options all contribute to increased vulnerability. Many women who test positive acquired the virus through their husbands highlighting the need for broader public awareness campaigns directed at men as well as women.