Thirty Thalassemia children infected with HIV virus between 2028-2026 in Balochistan, while their parents tested negative. Investigation reveals unsafe blood transfusion infecting children across the province.
June 15, 2026
By Nadeem Khan
QUETTA
At peak afternoon heat in Quetta, the corridors of the Bolan Medical Complex offer relative cool but little comfort. The province’s largest tertiary care hospital is packed — patients crowd steel benches waiting for checkups, while others clutch prescriptions in long lines for free medicine.
A foul smell trails the corridor leading to what is known as Balochistan’s largest HIV treatment center — three small rooms that belie the weight of what happens inside. In the first, shelves buckle under patient files while paramedics run rapid tests. Down the hall, a dimly lit room holds a woman and her child, waiting on results while her husband has already tested positive. A doctor emerges smiling: “Congratulations, your test is negative.” A wave of relief passes.
Next door, another patient pulls a scarf across his face during his examination — HIV still carries enough stigma here that even a hospital visit demands disguise.
Auto rickshaw driver Nizam-ud-Din is in a hurry — his son is waiting at school during the break. Bearded and wearing a traditional cap, has just collected HIV medicines for his twelve-year-old, Tayab Shah, who has been fighting thalassemia since he was six months old and contracted HIV by the age of five. The boy now carries both diseases. His parents carry neither.
“My child is HIV positive and living with thalassemia too — despite this, my wife and I are both negative,” Nizam-ud-Din says, moving towards the door.
“We receive blood from both private and government centers in Quetta,” Nizam says. “If blood screening was done properly, my child might not have been infected,” he says.
Medical records confirm that Nizam and his wife are HIV negative — only Tayab is positive. The question his case raises is larger than one family. Thalassemia patients depend on frequent transfusions, sometimes every few weeks, because their bodies cannot produce enough hemoglobin to carry oxygen to cells. When that blood is not screened properly, the treatment itself becomes the threat.
Balochistan already battles steep development challenges and a weak health system, where patients from remote districts travel hours to reach Quetta — and some travel even further outside the province for care they cannot find at home. Data from the HIV treatment center shows that between 2018 and 2026, thirty thalassemia patients contracted HIV despite both their parents testing negative — a pattern that points directly at unsafe transfusions.
The investigation found that substandard testing practices in both government and private hospitals — poor lab standards, inadequate screening — are driving HIV infections among children already weakened by thalassemia.
What is HIV and how does it affects the body?
HIV attacks the body’s immune system. Without treatment, it can progress within eight to ten years to AIDS — acquired immunodeficiency syndrome — the advanced stage where the immune system becomes severely weakened and weight loss sets in. Early infection often brings flu-like symptoms, though not everyone experiences them; some carry the virus for years with no signs at all. The only way to know is to get tested.
For those who do test positive, lifelong antiretroviral tablets can control the virus. HIV spreads through unsafe blood transfusions, unprotected sexual intercourse, shared contaminated syringes, and from mother to child during pregnancy.
Dr. Khudaidad Usmani, a senior physician at Quetta’s HIV treatment center, has watched the epidemic up close since the center opened in 2005. Today it carries 3,000 registered patients. He points to clear failures in the health system driving the spread — particularly among children with thalassemia. Mandatory lab screening before every blood donation must be enforced, he says; unsafe blood remains one of the primary transmission routes. Because HIV weakens the immune system, patients also become easy targets for common illnesses, making awareness and early intervention critical.
“Don’t wait for symptoms — get screened on time,” Dr. Usmani says. “With proper treatment, AIDS can be brought back to HIV, and patients can live a healthy life.”
Unregistered labs, no data
Data obtained from the Balochistan Healthcare Commission (BHCC), the autonomous body responsible for patient safety and licensing, shows 1,176 healthcare facilities are registered with it — yet only 17 hold even a provisional license. Not one facility in the province, including its tertiary hospitals, has received a final standardized license. The body has been functional for over a year and a half, but its standards remain largely unmet — a gap that may be contributing to rising HIV cases.
When asked how many labs, blood banks and private hospitals operate in the province, BHCC’s Chief Executive Officer Dr. Noor Qazi admits, “We don’t know the exact numbers. In every street there are substandard labs.” On licensing, he is firm. “We issue licenses only when healthcare facilities meet our standards — we never compromise.”
The numbers tell a different story. In Quetta alone, 138 labs operate across government and private sectors — 72 of them without even basic registration. In remote areas, the situation is worse. Conflict has kept entire districts off the radar of both the BHCC and the health ministry.
“We have insufficient funds — we would like to extend our network to the divisions as well,” Qazi says. “We are imposing fines where standards are not met.” Yet to date, the BHCC has not been able to bring even government-owned hospitals up to the standards it has set.
Balochistan Health Care Commission has imposed strict ban on random kit test which sometimes can produce false positive or negative result, and issued guidelines for ELISA (Enzyme-Linked Immunosorbent Assay) an advance level of diagnosis. Our investigation found that some private laboratories and blood banks in Quetta upgraded themselves to advance ELISA testing method but the government hospitals still lack the protocols and standards issued by BHCC and no ELISA testing method was found in the Bolan Medical Complex Hospital, Sandman Hospital—two of the mostly visited tertiary health care providing hospitals. Health experts warn poor testing can cause more spread of HIV in near future.
Substandard tests causing HIV
The gap between standards and practice has real consequences. A test conducted at BMC — the province’s largest tertiary care hospital — falsely returned a positive HIV result, later confirmed negative. When asked why government hospitals do not follow BHCC guidelines, Qazi was candid: “If we show strictness, poor patients would suffer.” He added that the commission has written to health officials urging hospitals to upgrade from rapid kits to the more accurate ELISA diagnostic method.
That shift is long overdue. Pakistan’s National Blood Transfusion & Blood Products Policy 2025-30 states that most blood banks across the country are still relying on rapid screening kits — and that this lack of standardized screening is the second largest cause of HIV transmission in Pakistan, accounting for 12 percent of infections, citing the World Health Organization, 2022.
The only blood center faces burden
Afzal Zarkoon, director of the Balochistan Blood Transfusion Authority (BBTA) — the official body responsible for safe blood transfusion — says 6,000 thalassemia patients are registered with the RBC center in Quetta. He acknowledges the crisis plainly: substandard testing is infecting young children with HIV, and the situation is alarming. “We are providing safe blood through ELISA testing and expanding our centers to Turbat, Khuzdar and Loralai,” he says.
But many thalassemia patients across Balochistan’s districts depend on private blood centers, and some can barely manage the journey to Quetta for safer blood.
For blood, Muqadas relies on her hometown. But for HIV treatment, every two to three months she makes the 215-kilometer journey to Quetta with her father. “It’s very difficult to travel,” she says. “I wish I could be treated in my own city.”
There are four HIV treatment centers across Balochistan, including one in Loralai — but her father Usman doesn’t trust it. Poor facilities at the local center are why he makes the trip. And having learned the hard way what unsafe blood costs, he now pays privately for ELISA screening before every transfusion. “I am concerned about my daughter’s health,” he says. “She is already infected because of unsafe blood — I will not take that risk again.”
HIV’s worrying rise among children
Balochistan’s AIDS control program has 3,490 HIV patients registered across the province, among them 149 below the age of sixteen. Officials say the true number is far higher — stigma is keeping people from coming forward.
Globally, UNAIDS data for 2024 puts the scale of the epidemic in stark relief: 40.8 million people living with HIV, 1.3 million newly infected, and 630,000 deaths from AIDS-related illnesses in a single year.
In the Balochistan Assembly, the opposition is losing patience. “The health situation is dire, especially in remote areas,” says Leader of the Opposition Younus Aziz Zehri. “The government keeps asking for more time. We have given enough. If the health situation does not improve by June, the opposition will announce its next course of action.”
Health Minister Bakht Muhammad Kakar acknowledges the scale of the problem but says solutions take time. “It is very difficult to cover all of Balochistan given its vast geography,” he says. “We are outsourcing, which will improve the healthcare system and the diagnosis process — but we cannot ban rapid kits entirely right now.” He was referring to the BHCC’s directive against HIV and AIDS rapid kits. On blood safety, he says the government is establishing regional blood centers in Loralai, Khuzdar and Turbat, where all screening will be conducted using the ELISA method to ensure thalassemia patients receive safe blood.
The promises offer little comfort to families already living with the consequences. Muqadas needs lifelong HIV treatment and regular blood transfusions — a double burden that her father carries quietly, worrying not only about her health but about the stigma she will face as she grows older. For thousands like her, the suffering did not have to begin. The question now is whether it will ever end.