According to an estimation/survey recently conducted by the National HIV Control Programme, there were approximately 133,299 HIV positive people in the country – a number that has grown exponentially in the last decades since the turn of the millennium. But more problematic than the number of HIV positive people is the paltry number receiving treatment.

In a written reply to a question asked by MNA Begum Tahira Bukhari in the National Assembly, the Ministry of National Health Services (NHS) said that “according to data received from 23 HIV treatment, 12 prevention of parents-to-child transmission and 20 community home-based centres, the total number of registered people living with HIV till December 2016 was 18,440. Around 8,888 of them were getting treatment.” That is only 6.6% of the total people being treated – a worrying metric that needs the government's immediate attention.

A separate study findings of the meta-analysis coordinated by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle concludes that the number of new HIV infections (majority through infected needles and drug use) in Pakistan grew at an average of 17.6 percent per year between 2005 and 2015 – from to 8,360 per year to 45,990 per year - making it the highest increase in the world. And unless the government adopts new preventive measures this number is expected to grow.

But the answer by the NHS betrays a broken and fragmented system. The ministry official said that after the 18th amendment, the health sector has been devolved to provinces and a combined strategy has to be adopted to resolve health issues, which indicates that not only no policy has been adopted yet, but that the federation was content passing the responsibility of stopping this epidemic to the provinces.

Critics have derided the efficacy of governments’ policies to control the disease as “flawed, donor-driven and intermittent” – and there seems to be no sign of a central policy emerging.