The WHO Representative/Head of Mission, Pakistan, Dr. Palitha Mahipala, has written a letter to Director General, Health Services, Sindh, in response to his letter dated 03rd June, about HIV outbreak in Larkana district and WHO support for outbreak response in Sindh. Dr. Palitha said in his letter they were waiting for suitable candidates to be identified by Sindh AIDS Control Program (SACP) for Human Resource Support for a physician, Counselor and Data Entry Operator. He said consignment of Pediatric ARVs, donated from MOH Ethiopia, will be available in the country by end June 2019 for HIV positive clients. He said WHO has placed orders for procurement of 50,000 HIV Rapid Diagnostics Kits (RDTs), and consignment will be available by 15th July, 2019. He said in his letter that WHO has negotiated with Common Management Unit (CMU) of Global Fund for provision of one CD4 Machine, which will be shifted shortly to Taluka Headquarter Hospital for proposed ART Clinics at Ratodero. Finally he said that WHO has already incorporated training of Department of Health staff on HIV treatment, Infection Control & Prevention and Hospital Waste Management. This shows that Sindh Government & Health Department has done nothing on their part for their own voters to control the dreaded viral disease but only relying on WHO and other international donor agencies which indeed is very astonishing and terrifying. Up to Friday, as many as 831 HIV positive cases were detected in Ratodero out of which 685 are children aged between 1 to 10 years and 146 are adults. So far 29,158 people among the general population have been screened since April 25, 2019 when SACP launched its screening camps in and around Ratodero taluka of Larkana district from where PPP Chairman Bilawal Bhutto Zardari has been elected as MNA and Faryal Talpur as MPA. Dialysis machines out of order-Six out of 14 dialysis machines are out of order since over a week at the Dialysis Center established in the Chandka Medical College Hospital (CMCH) for lot of kidney-failure patients of Larkana and other nearby districts. In this connection, Dr. Zahid Ali Shaikh, Assistant Professor and Incharge Nephrology Department, sent An SOS to the Medical Superintendent Dr. Abdul Sattar Shaikh informing him about the prevailing pathetic situation and dysfunctional RO System but the MS ignored his letter showing his sheer negligence due to which patients are suffering very badly. The poor patients and their attendants finding no other way came out on roads and held large protest in front of the Center and also shut the main gate of Casualty Department demanding repair of the machines so that their & their lived ones’ lives could be saved. Dr. Zahid further wrote that apart from this, shortage of A.V.Fistula has also taken place since over 10 days and patients are purchasing the same from their own sources. Out of eight working dialysis machines six are fixed for Hepatitis negative patients, one for Hepatitis C patients and another for HIV positive cases. Dr. Shaikh told this scribe on Saturday that machine reserved for HIV positive cases is also used for Hepatitis negative cases after getting advise from the Centre of Disease Control, USA. He said patients should not be panicked because the machine is properly sterilized before use on other patients due to heavy burden of negative patients. He said that patients get dialysis here in three shifts hence machines are also working round the clock which reduce their age. Each patient is to get 4 hours dialysis but due to rush 3 hour dialysis is carried out. Over 60 kidney-failure patients are attending the Center daily. In yet another letter, Dr. Zahid Shaikh wrote to MS that 12 new Hemodialysis machines and one RO system is lying idle at CMCH main medical store since over a year for which it has been repeatedly requested to get them installed without any positive response so far. He said the number of patients is rising day by day for which insufficient machines have been installed which cannot cope up with the ever increasing situation. Even RO systems are unable to provide sufficient water and become out of order frequently as the same are very old. Dr. Shaikh requested the MS to get the new machines installed on urgent basis to deal with the existing number of patients to save precious human lives. Copies of the letter have also been sent to District & Sessions Judge, SMBBMU Registrar, Chandka Medical College Principal and Larkana Deputy Commissioner for information & further action. Meanwhile, CMCH MS Dr. Sattar Shaikh, did not attend any call despite repeated phone calls to him to have his comments.