Hospitals in Karachi (Pakistan's largest city) have registered a dramatic surge in paediatric HIV cases, with three facilities collectively admitting 159 infected children so far this year, according to medical sources. Doctors say the majority of cases are linked to unsafe healthcare practices — including the reuse of syringes and unscreened blood transfusions — rather than mother-to-child transmission, echoing a 2019 outbreak in Ratodero that became one of the largest recorded among children globally. The crisis is compounded by a shortage of antiretroviral and tuberculosis drugs following the suspension of USAID funding, raising fears of drug-resistant infections and preventable deaths.