Every year we come across the budget exercises at the federal and provincial levels with the hope that the budget of that year may improve the living standards than the preceding years. Unfortunately, hopes are yet to be translated into reality. Situation is no different in Sindh. Every year on the one hand, budget statistics keep increasing, on the other, we have not seen significant improvements in the socio-economic situation of the residents of Sindh. We have witnessed tall claims of poverty reduction programmes, increased budgetary allocations for health and education, the government taking credit for passing huge number of important laws, etc. Unfortunately, the ground realities are contrary to the claims made by the government. To put in perspective health department, as per reports so far 851 persons have tested positive in Talka Ratodero near Larkana. Of them, 52% are male and 48% female and most of the affectees are children between the ages two to five years. A total of 62 children under one years old, 480 children between two and five years of age and 158 children between six and 15 years of age have tested positive. It put the number of HIV positive individuals aged 15-45 at 128, and that of 46 years and older at 22. The World Health Organization (WHO) has declared an HIV outbreak in Ratodero a “Grade 2 Emergency” and noted “an inadequate stock of antiretroviral therapy (ART) medicines has emerged as the major challenge”. The Chief Minister Syed Murad Ali Shah has announced endowment fund of Rs. 1 billion for the welfare of HIV/AIDS infected persons during financial year 2019-20. Nonetheless, the root cause of bulk of the problems in Sindh lies in taking action after the incident has occurred as the CM has announced one billion for the infected persons, once the situation has turned scary. The same amount could have been utilized for preventing such a deadly disease, it would definitely have saved thousands of families whose loved ones are suffering from such a serious illness. To put in perspective health department, as per reports so far 851 persons have tested positive in Talka Ratodero near Larkana. Of them, 52% are male and 48% female and most of the affectees are children between the ages two to five years Besides, the Provincial Assembly passed the Sindh HIV and AIDS Control Treatment and Protection Act in 2013 whose preamble says “to control the transmission of HIV and AIDs and to undertake measures for the treatment, care and support of people living with HIV and AIDS”. Under section 4 of this Act, Sindh AIDS Commission was to be established within fifteen days of the promulgation of the Act whose functions include to hold AIDS awareness campaigns, recommend inclusion of relevant information in the curriculum, help frame a policy for dispensation of funds for AIDS treatment and also help end discriminatory practices against HIV patients etc. It is worth-mentioning here that the Governor of Sindh assented this Act on 30th October, 2013. Even to this day, we do not know whether this Commission has been notified or not. In case it has been notified than the performance of the said commission is questionable? If it has not yet been established then why six years have been wasted which has cost the citizens of their lives? If the said commission had been functional, it must have been a game changer against the HIV/AIDS. Further, when I visited the Sindh Bureau of Statistics website, I found out the report of the Multiple Indicator Cluster Survey (MICS) report 2014 which measured 48% stunting in Sindh and the highest in Umerkot and Tharparkar with 66% and 63% respectively. The CM in his last budget speech claimed to “reduce stunting from 48% to 30% by 2021 and then 15% by 2026.” Ironically, when I turned over the pages of the budget speech of fiscal year 2017-18, I found the similar claims “to reduce stunting rate from existing 48% to 30% in next five years”. That means stunting rate has remained stagnant since 2014 then how can this daunting task of reducing stunting to 30% be achieved within two years? It seems stunting statistics will remain static. Shockingly, When I glanced over the Bureau’s website, heart-breaking statistics awaited me. According to the “Health Profile of Sindh 2016”, doctor to population ratio in Sindh is 3,159, population served by per nurse ratio is 12,411, and one bed is available in Sindh for 1,455 persons. In Dadu, doctor to population ratio is 1:7,414 and nurse to population ratio is 1:221,500. In Kamber Shahdadkot, doctor to population ratio is 1:14,655, and nurse to population 1:146,545. On the other side, the World Health Organization recommended doctor to population ratio is 1: 1,000. That means, the Sindh province is far behind the standard doctor, nurse and bed to population ratios. To further add insult to injury, the Sindh Healthcare Commission Act, 2013 empowers the commission to improve the quality of healthcare services and clinical governance and to ban quackery. Nevertheless, quackery is prevalent in every nook and corner that has added to the already bleeding population of Sindh. Recently, Dr Ghafoor Shoro of the Pakistan Medical Association (PMA) while speaking at a seminar “Quackery in Sindh” revealed the shocking statistics that there are around 150,000 to 200,000 quacks operating in Sindh, of whom 80,000 are based in Karachi. That is a very serious problem and also a cause of recent HIV/AIDS epidemic in the province. Poor segments are exploited by these quacks which instead of improving their health further worsens adding multitude problems in their list of issues. Hence, I urge the powers that be to take timely action for preventing looming large disasters before their occurrence and shun the usual practice of coming into active mood after disasters have occurred. It is time to translate tall claims into actions made in the budget-making exercise. Plugging the gap between the laws formulation and their implementation is need of hour as prevention is better than cure. The sooner do we realize this reality, the better it is as “a stich in time saves nine”. It is time to act ! The writer is a development sector practitioner