Pakistan has reached the point where monkeypox can no longer be treated as a passing scare: the warning signs now point to a wider public health failure that the state has seen before and still not repaired. The trigger may have come from Khairpur, where seven newborns were infected, and four died, yet the meaning of the episode reaches far beyond one district.
Ours is a country of constant movement, with workers, traders and families moving across provincial lines every day through crowded transport networks and overburdened hospitals. More worryingly, we have enough evidence from the pandemic days to realise how, once a virus enters the circulation, the old habit of passing the burden around like a hot potato becomes a way of avoiding harder questions.
The state cannot claim surprise. Its own disease surveillance roadmap lays bare the weaknesses in open, from fragmented reporting and weak coordination to the need for stronger laboratories and deeper integration of public and private health services.
Pakistan has already been taught what happens when unsafe care crosses paths with weak oversight. Ratodero should have settled that lesson for a generation after children were infected with HIV through medical negligence and a neglected health system that reacted only after the scale of harm became undeniable.
The World Health Organisation has already reported wider international spread, including infections in places where no recent travel history was recorded, which is another way of saying that the virus is capable of moving quietly before governments understand the pattern.
What should the government do now? It should widen diagnostic capacity beyond a few major centres, compel private hospitals and laboratories to report suspected cases at once, and push a single clinical protocol into every province so that early signs are recognised before patients are shuffled from one facility to another.
There is also a social danger that our society is notorious for handling badly. WHO has warned that stigma drives people away from care, and mpox is exactly the kind of disease around which rumour, innuendo and prejudice can gather faster than facts.
No serious state can wait for an outbreak to become politically expensive before treating it as nationally important. Pakistan does not need panic. It needs competence, candour, inspection, data, and the sort of federal grip that turns a warning into a response before another cluster appears. *