Islamabad: More than 25,000 peop1le, including hundreds of children, have officially died of HIV infection and Aids-related illnesses in Pakistan since the country’s first Aids case was reported in Lahore in 1987, data compiled by the federal and provincial health departments reveal.
Globally, HIV/Aids remains one of the world’s most severe public health challenges, having claimed an estimated 44.2 million lives worldwide since the start of the epidemic.
Officials in the provincial health departments and the Ministry of National Health Services, Regulations and Coordination told The News that the official figure did not represent the actual number of deaths caused by HIV and Aids in the country, as the infection was often not recorded as the underlying cause of death due to stigma, lack of diagnosis and weak reporting systems.
Worldwide, despite significant advancements in treatment accessibility, approximately 570,000 people still die annually from Aids-related illnesses, largely due to under-diagnosis and delayed treatment access in low- and middle-income health systems.
Pakistani health authorities say many HIV-positive patients die of tuberculosis, severe pneumonia, meningitis, cancers, chronic diarrhoea or other opportunistic infections after their immune systems become severely compromised. In several hospitals, the immediate cause of death is recorded as “cardiopulmonary arrest”, meaning the heart and breathing stopped, without mentioning the disease that led to the fatal condition.
Punjab has recorded the highest number of reported HIV/Aids deaths in the country, with more than 15,000 people having died since the first case was identified nearly four decades ago.
Sindh is second, where 6,373 HIV/Aids-related deaths have been officially recorded. Officials said these include several hundred children who lost their lives, as the province has the highest number of HIV-infected children in Pakistan.
Khyber Pakhtunkhwa has reported 1,950 deaths, while Islamabad Capital Territory has recorded 1,132 deaths, making the federal capital a major contributor to the country’s documented HIV mortality burden.
Balochistan has reported 656 HIV/Aids-related deaths, Azad Jammu and Kashmir (AJK) 13 deaths and Gilgit-Baltistan one death, according to the federal health ministry’s data. The cumulative figure from Sindh, KP, Islamabad Capital Territory, Balochistan, AJK and Gilgit-Baltistan alone stands at 10,125 deaths.
Health officials said the actual toll was likely much higher, especially in areas where HIV testing remains limited and patients reach health facilities only after developing life-threatening infections. They said deaths were also missed when a person never underwent an HIV test or when families and health facilities avoided disclosing the infection because of fear of discrimination.
“The reported deaths are only those which entered the health system and were documented as HIV- or Aids-related. A large number of people die without an HIV diagnosis, while in other cases the underlying infection is omitted from medical records,” an official said.
Pakistan is estimated to have around 370,000 people living with HIV, although rights activists, infectious diseases specialists and public health experts believe the actual number could be considerably higher because a large proportion of people infected with the virus remain undiagnosed.
Despite the large estimated burden, only around 62,000 people are currently receiving antiretroviral therapy across the country. These include around 7,500 children living with HIV who are registered at treatment centres.
Officials said Punjab has the highest burden of HIV patients as well as the largest number of reported deaths, followed by Sindh and other provinces. However, the rising number of paediatric cases, particularly in Sindh, has become a major concern for health authorities and child health experts.
Hundreds of children have acquired HIV during the last six to seven years in outbreaks linked to unsafe injections, reuse of syringes, poor infection-control practices, unsafe blood transfusions and unregulated healthcare providers. Large outbreaks in Larkana, Ratodero, parts of southern Sindh and, more recently, Karachi have exposed the vulnerability of children to preventable HIV transmission.
The mortality burden has become more visible since 2024, when reported HIV infections began increasing sharply in several parts of the country. Experts believe that many people are being diagnosed late, after the virus has already severely damaged their immunity and made them vulnerable to tuberculosis and other serious infections.
Infectious diseases specialists say HIV is no longer an automatic death sentence, as people diagnosed early and kept on uninterrupted antiretroviral treatment can live long and have productive lives. But delayed diagnosis, fear of testing, stigma and treatment interruptions continue to cost lives.
According to them, public awareness remains extremely poor, with many people still believing that HIV is untreatable or that a diagnosis would permanently isolate them from society. Such fears discourage people from seeking testing, disclosing their status and starting treatment in time.
Public health experts have urged the government to expand voluntary HIV testing, strengthen surveillance, ensure uninterrupted supplies of antiretroviral medicines and make treatment services available closer to communities. They also called for strict enforcement of safe injection practices, regulation of informal healthcare providers and mandatory screening of blood before transfusion.
They warn that Pakistan could continue to lose people to a disease that is now medically manageable unless it confronts the stigma and gaps that keep thousands of infected people outside diagnosis and treatment services.
