ISLAMABAD: The United Nations Development Programme (UNDP) has asked the governments of Punjab and Sindh to provide over $2.3 million (approximately Rs651 million) for the procurement of life-saving antiretroviral (ARV) medicines and the continuation of HIV prevention services.
The request, however, has drawn reservations from provincial authorities, who are reluctant to route funds through an international agency due to associated overhead charges.
Official letters written by UNDP to the health departments of Punjab and Sindh reveal that the agency has sought financial support exceeding Rs651 million to ensure uninterrupted HIV treatment and sustain prevention programmes under the Global Fund-supported national response.
In its correspondence with the Punjab government, UNDP requested at least $1.5 million to procure ARVs for patients in 2027. Similarly, in a letter addressed to the Sindh health secretary, the agency sought $828,140 to continue the procurement of ARVs for the province. The UN agency emphasized the urgency of the matter, noting that procurement orders for medicines required for the January–June 2027 period must be placed by June 1, 2026, due to a lead time of approximately six months.
Officials in the Punjab and Sindh health departments, however, said they would prefer to procure the medicines directly or through national mechanisms such as the Common Management Unit (CMU) or the National AIDS Control Programme. They maintained that the provinces are not willing to pay any “overhead charges” to international agencies. “We can procure the medicines ourselves or through national mechanisms such as the CMU and the National AIDS Control Programme. There is no justification for paying overhead charges to any international agency,” a senior provincial health official said on condition of anonymity.
In its response, UNDP maintained that it serves as the Principal Recipient of the Global Fund HIV grant and plays a critical role in HIV prevention and treatment services in Pakistan. The agency stated that it ensures the procurement of WHO-prequalified and Global Fund quality-assured ARVs through international competitive bidding to secure the best possible prices.
“As the Principal Recipient under the Global Fund HIV grant, UNDP is responsible for HIV prevention programming through community-based organizations, as well as the procurement of essential medicines and commodities for the national HIV response,” the agency said in its communication.
UNDP highlighted that it maintains close collaboration with provincial AIDS control programmes and supports outreach services to key populations through community-based organizations. The agency further stated that it ensures a steady supply of ARVs manufactured by WHO-prequalified companies at competitive rates. According to the letters, the medicines are currently procured at approximately $41–$42 per patient per year, ensuring both affordability and quality.
UNDP also pointed out that ARVs are not manufactured locally in Pakistan and that procurement largely depends on imports from India. Given existing trade constraints between Pakistan and India, the agency cautioned that provincial governments may face challenges in directly procuring these medicines.
“UNDP is willing to continue facilitating procurement on behalf of provincial governments to ensure continuity of supply,” the letters stated.
The organization added that it charges a reduced overhead of around 3 percent, applied in addition to procurement costs. It assured provincial authorities that this rate is minimal and intended to support operational and logistical requirements.
The correspondence also noted that UNDP’s Global Fund allocation covers only the 2026 fiscal year.
Without alternative financial arrangements, the agency would be unable to initiate procurement for 2027, potentially jeopardizing the uninterrupted provision of HIV treatment services.
In addition to ARV procurement, UNDP urged provincial governments to consider domestic funding to support community-based organizations addressing gaps created by recent reductions in the prevention component of the Global Fund grant. Such measures, it said, would help sustain HIV prevention efforts and gradually reduce reliance on donor funding.
