Pakistan reports 84,000 registered HIV cases, but UN estimates far higher burden

Pakistan has officially registered 84,421 people living with HIV, according to figures presented in parliament by Health Minister Syed Mustafa Kamal, but international agencies say the true number of infections may be significantly higher.

Data from the National AIDS Control Program shows that about 60,785 patients — roughly 72% of registered cases — are receiving free antiretroviral therapy (ART) through a network of 98 treatment centers nationwide.

Provincial data indicates the epidemic is concentrated in the country’s most populous regions. Punjab carries the highest burden, followed by Sindh, Khyber Pakhtunkhwa, Balochistan and the Islamabad Capital Territory.

City-level figures show large urban clusters. Lahore has more than 10,000 registered cases, Faisalabad over 7,300, and Multan nearly 5,800. Sheikhupura and Okara each report more than 1,100 cases.

In Sindh, Karachi records several thousand cases across major hospitals. Hyderabad has 2,619 cases, Larkana reports over 3,000 combined cases, and Nawabshah has 1,286.

Peshawar in Khyber Pakhtunkhwa reports nearly 3,750 cases, while Quetta in Balochistan has 2,269. The Islamabad Capital Territory has around 4,459 registered patients.

Smaller numbers have been reported from Pakistan-administered Kashmir with 78 cases and Gilgit-Baltistan with 34.

A widening gap between detection and reality

However, estimates from the World Health Organization and UNAIDS suggest a much larger epidemic.

In a joint statement released on World AIDS Day 2025, the agencies said around 350,000 people are living with HIV in Pakistan, with nearly 80% unaware of their status.

“New infections have risen by 200% over the last 15 years,” the agencies said, noting an increase from 16,000 cases in 2010 to 48,000 in 2024. Pakistan is now considered to have one of the fastest-growing HIV epidemics in the WHO’s Eastern Mediterranean region.

The gap between official figures and international estimates reflects the difference between diagnosed cases and total infections, experts say.

While authorities say no formal reservations have been raised by UNAIDS over official reporting, they acknowledge efforts to improve surveillance and align with international standards.

According to WHO data, only 21% of people living with HIV in Pakistan were aware of their status in 2024. Of those, 16% were receiving treatment, and just 7% had achieved viral suppression.

Spread beyond high-risk groups

Once concentrated among high-risk groups, HIV transmission is increasingly spreading to the broader population, according to WHO and UNAIDS.

The agencies cite unsafe medical practices — including reuse of syringes, poorly regulated blood transfusions, low screening during pregnancy, and unprotected sexual activity — along with stigma limiting access to testing and care.

Children have been affected in outbreaks linked to unsafe healthcare practices. Reported pediatric cases rose from 530 in 2010 to 1,800 in 2023, with multiple outbreaks in Sindh and southern Punjab where more than 80% of detected cases involved children.

Government response and challenges

The government says it has adopted a multi-sectoral strategy to control HIV, including expanding testing, providing free ART, strengthening surveillance, improving blood safety and infection control, and running awareness campaigns.

The number of ART centers has increased from 13 in 2010 to about 95 to 98 in 2025, with treatment coverage expanding nearly eightfold over the past decade.

Despite this, gaps remain. Only 14% of pregnant women needing treatment to prevent mother-to-child transmission receive it, and just 38% of children living with HIV are on therapy.

WHO estimates that more than 14,000 people died of AIDS-related illnesses in Pakistan in 2024, including over 1,100 children the year before.

“Together, we can still end AIDS as a public health threat by 2030,” UNAIDS said, calling for increased domestic and international support.

Officials and international partners say addressing the epidemic will require expanded testing, stronger regulation of healthcare practices, and increased funding.