ISLAMABAD: As Pakistan grapples with a rapidly worsening HIV epidemic, concerns are mounting over the regulatory gaps that continue to allow the use of non-auto-disable syringes, even as authorities scramble to contain a surge in new infections.
Speaking to the media, Dr. Obaidullah Khan, head of the Drug Regulatory Authority of Pakistan (DRAP), confirmed that while 1ml, 2ml, and 5ml syringes in the country are now auto-disposable, the 10ml variant remains an exception to safety standards.
Dr. Khan stated that the authority has prepared a preliminary report on the matter and is awaiting a directive from the Ministry of Health. “If the Ministry of Health bans it, we will take immediate action,” he said, emphasizing that the authority is ready to enforce stricter standards if formally ordered.
While the regulator acknowledged the scale of the issue—noting that Pakistan remains one of the world’s highest users of therapeutic injections, with an estimated 1.5 to 2 billion syringes consumed annually—he maintained that it has not yet been “formally proven” that the spread of HIV in the country is directly linked to these syringes.
The government’s cautious stance comes amid an alarming escalation in HIV prevalence. Pakistan is currently battling one of the fastest-growing HIV epidemics in the World Health Organisation’s (WHO) Eastern Mediterranean Region.
Data indicates that new HIV infections have tripled over the last 15 years, climbing from approximately 16,000 in 2010 to roughly 48,000 in 2024.
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Health experts estimate that 350,000 people are currently living with the virus in Pakistan. Perhaps most concerning is the lack of awareness: nearly 80 percent of those infected do not know their status, and only a fraction of the total patient population is currently undergoing treatment with viral suppression.
The Taunsa outbreak and the ‘syringe factor’
The potential link between unsafe injections and the spread of HIV was starkly highlighted by a high-profile outbreak in Taunsa, Punjab. Between November 2024 and October 2025, approximately 331 children tested positive for HIV.
A subsequent investigation pointed toward the alleged reuse of syringes and the use of multi-dose vials at a government hospital—a practice that health-watch groups and affected families argue is a primary driver of the nationwide crisis.
While national authorities maintain that the direct role of syringes in the nationwide spread has not been “conclusively proven,” independent experts and advocacy groups argue that the sheer volume of medically unnecessary injections, combined with the continued presence of reusable or substandard devices, creates a perfect storm for the transmission of blood-borne pathogens, including HIV and Hepatitis.
The regulatory landscape is further complicated by the circulation of illicit medical devices. The Healthcare Devices Association of Pakistan has warned that banned, reusable syringes, as well as products falsely labelled as “auto-disable,” continue to flood the market, undermining the government’s efforts to enforce safety protocols.
In response to the mounting pressure, DRAP has initiated a nationwide crackdown, conducting market surveys and enforcement drives to identify and remove defective or non-auto-disable products from circulation.
However, until the 10cc “loophole” is closed and standardized safety measures are strictly applied to all injection devices, public health advocates warn that the risk of transmission through medical procedures will remain a critical vulnerability in Pakistan’s fight against the HIV epidemic.
