KARACHI: A federal health ministry investigation has concluded that the HIV outbreak linked to Karachi's Kulsum Bai Valika SESSI Hospital was caused by the repeated use of a single syringe on multiple newborns, describing the incident as a case of "criminal negligence" and recommending strict legal action against those responsible.
The findings have intensified concerns about infection prevention practices in healthcare facilities and raised fresh questions about patient safety standards in Pakistan's public health system.
According to the inquiry report, hospital staff repeatedly used the same 10cc syringe to administer injections to different newborns instead of discarding it after a single use. Investigators identified the unsafe injection practice as the primary cause of the outbreak.
Cases climbed from 91 to 104
The report revealed that the World Health Organization (WHO) first issued an alert regarding the outbreak in November 2025.
At that time, authorities had identified 91 HIV cases linked to the incident. However, the number of confirmed cases has since risen to 104, including 95 children and nine adults.
The figures make the incident one of the most alarming healthcare-associated HIV outbreaks reported in recent years and have renewed concerns over the dangers of unsafe injection practices.
Parents raised concerns over syringe reuse
According to the investigation, parents of affected children alleged that nursing staff routinely reused syringes on multiple patients rather than using a new disposable syringe for each child.
The report noted that the hospital administration did not deny the allegations raised by the parents. However, hospital officials informed investigators that infection prevention measures had since been strengthened.
The inquiry found that the outbreak may have remained undetected for some time before the cases began emerging among children and families associated with the hospital.
Federal team inspected hospital practices
A federal investigation team comprising the Director General of Health and the Deputy National Manager of the National AIDS Control Program visited Valika Hospital and surrounding localities, including Pathan Colony, to assess the situation.
The team inspected the hospital's vaccination centre, evaluated staff compliance with infection prevention and control protocols and provided guidance on the safe handling and single use of disposable syringes.
Investigators also held meetings with local officials, community representatives and parents of affected children to better understand the circumstances surrounding the outbreak.
Another public health risk identified
The inquiry identified an additional concern that could complicate disease control efforts.
According to the report, many residents of Pathan Colony seek medical treatment from unqualified healthcare providers and unlicensed practitioners, commonly referred to as quacks.
The investigation warned that unsafe medical practices outside formal healthcare settings could further increase the risk of transmitting blood-borne infections such as HIV and hepatitis B and C.
'Criminal negligence'
Calling the outbreak a result of "criminal negligence," the federal investigation team recommended an independent inquiry into the incident and urged the government to initiate strict legal proceedings against hospital administration and nursing staff found responsible.
The report also recommended an immediate crackdown on unlicensed medical practitioners operating in Pathan Colony and neighbouring areas to prevent similar outbreaks in the future.
Why this matters
Pakistan has experienced several healthcare-associated HIV outbreaks over the past decade, including the major outbreak in Ratodero, Sindh, in 2019, where hundreds of children were infected and investigations later highlighted unsafe injection practices as a key contributing factor.
Public health experts have repeatedly warned that the reuse of disposable syringes represents one of the most preventable causes of blood-borne infections.
The latest findings at Valika Hospital have renewed calls for stronger infection prevention systems, routine healthcare inspections, better staff training, strict enforcement of safe injection practices and greater accountability within healthcare institutions.
As authorities consider legal action and further investigations, the outbreak serves as a stark reminder that lapses in basic patient safety measures can have devastating and lifelong consequences, particularly for newborns and children.
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