Sindh AIDS Control: Governance Failure Fuel HIV Surge

By Our Correspondent

KARACHI: (09 February 2026) A performance audit by the Directorate General Audit Sindh has uncovered serious governance and operational weaknesses in the Sindh AIDS Control Programme (SACP), raising alarms over its ability to curb HIV/AIDS spread in the province.

The Performance Audit Report was presented before the Sindh Assembly on Monday. According to the report the AIDS Control Programme – established in 1995 to prevent new infections through awareness, interventions, and treatment — failed to meet key targets outlined in its PC-I document. Service Delivery Packages for prevention, awareness, and treatment were not properly implemented, while treatment centres operated ineffectively.
Key shortcomings included weak institutional framework and governance structures, irregular procurement practices, such as purchasing materials before centres were fully established, payments made in violation of Monitoring Committee recommendations, critical lack of follow-up for 1,629 HIV-positive patients, heightening risks of further transmission.

The report warned that these lapses contributed to an observed increase in HIV cases during the review period and undermined efficient use of resources from the provincial government and National AIDS Control Programme.
The issues persist years later: The 2019 Ratodero outbreak in Larkana — where hundreds of children were infected mainly through unsafe injections and poor infection control — exposed similar systemic failures in regulating private clinics, blood banks, and healthcare practices. Despite that tragedy, recent reports indicate ongoing problems.

In 2025–2026, Sindh has seen a sharp rise in HIV cases, including among children. The Pakistan Medical Association (PMA) raised a “high-level alert” over the increase, with nearly 4,000 HIV-positive children registered in the province and over 100 new paediatric cases reported in Karachi in 2025 alone. Many infections are linked to unregulated medical practices, quackery, unlicensed facilities, and persistent gaps in infection control.

Critics, including medical bodies, have questioned SACP’s competence, funding management, and enforcement efforts, calling for transparent investigations, stricter regulations, and urgent reforms.

While the programme has expanded to include around 34 ART centres and some screening initiatives, experts stress that longstanding weaknesses in governance, regulatory oversight, resource utilization, patient follow-up, and healthcare safety continue to hinder effective HIV control.

Health authorities face mounting pressure to implement the audit’s recommendations and address root causes to prevent further preventable transmissions in Sindh.