The Nishtar Hospital inquiry should worry Punjab for reasons larger than the nine names now facing disciplinary action. The reported failure was not only that a patient was operated upon before mandatory HIV-screening procedures had been properly completed. The deeper failure was that a tertiary hospital could not reliably move a laboratory result through the chain of command before a patient entered the operating theatre.
The answer cannot be another round of suspensions followed by deafening silence. Disciplinary action may be necessary, but Pakistan’s hospitals have perfected the art of punishing individuals while leaving systems almost untouched. Punjab needs more than a single inquiry at one hospital. It needs a province-wide audit of infection-control committees, theatre protocols, sterilisation chains, lab reporting, blood banks, biomedical waste handling and emergency surgery procedures.
There is another danger here. The public conversation must not turn the HIV-positive patient into the problem. People living with HIV have a right to treatment, that too with confidentiality and dignity. Every patient entering an operating theatre should pass through the same safety protocol, because infection control cannot depend on whether a report is seen in time. Sterile instruments, safe injections, protective gear, proper waste disposal, confidential reporting and staff protection are not special precautions for HIV. They are the ground floor of competent medical care.
Pakistan’s HIV crisis has already moved beyond the old comforting fiction that it is confined to a few high-risk groups. WHO and UNAIDS estimate that around 350,000 people are living with HIV in Pakistan, with about 80 per cent unaware of their status, and new infections have risen by 200 per cent over the last 15 years.
Unsafe medical care sits at the heart of this danger. Reports have repeatedly pointed to poor infection control, syringe reuse, unsafe blood management and unregulated clinics as routes through which HIV (along with other bloodborne diseases) is reaching women and children with no known exposure risks. It should not have taken an investigation by a foreign broadcaster to expose the horrors in Taunsa, where hundreds of children were reportedly infected through reused syringes and contaminated multi-dose vials. Pakistan banned the reuse of 2.5cc and 3cc syringes in 2021, yet 10cc syringes remained outside the ban until recent outrage forced wider action.
The health sector’s decay is visible far beyond HIV. Pakistan loses hundreds of newborns and dozens of mothers every day to avoidable causes, while unsafe water, hepatitis, drug-resistant infections and medicine shortages keep exposing the same truth: public health is being managed as a crisis response, briefly awakened from its deep slumber whenever a tragedy becomes too visible to ignore. *