Pakistan hospital at centre of child HIV outbreak caught reusing syringes in BBC film.

Warning: This story contains details that readers may find distressing.

Mohammed Amin was eight when he died shortly after testing positive for HIV. His fevers were so severe that he insisted on sleeping in the rain, and he writhed in pain "like he’d been thrown in hot oil," his mother, Sughra, recounted. "He used to fight with me, but he also loved me," 10-year-old Asma says, kneeling at her younger brother’s graveside. Not long after her brother contracted the virus, Asma was also diagnosed with HIV. Their family believes both children contracted it from injections with contaminated needles during routine medical treatment at a government hospital in Taunsa, in the Punjab province of Pakistan. They are two of the 331 children that BBC Eye has identified as testing positive for HIV in the city between November 2024 and October 2025.

Following a doctor at a private clinic linking the outbreak to the hospital, named THQ Taunsa, in late 2024, local authorities promised a "massive crackdown" and suspended the hospital’s medical superintendent in March 2025. However, a BBC Eye investigation has now revealed that dangerous injection practices continued for months thereafter. Over 32 hours of undercover filming at THQ Taunsa in late 2025, the BBC witnessed syringes being reused on multi-dose vials of medicine on 10 separate occasions, potentially contaminating the drugs within. In four of these instances, medicine from the same vial was administered to a different child. While it is unknown if any of these children were HIV-positive, this practice creates a clear risk of viral transmission.

"Even if they have attached a new needle, the back part, which we call the syringe body, has the virus in it, so it will transfer even with a new needle," stated Dr. Altaf Ahmed, a consultant microbiologist and one of Pakistan’s leading infectious disease experts, after reviewing the undercover footage. Despite clear signs displayed on the hospital walls illustrating safe injection practices, the BBC filmed staff, including a doctor, injecting patients without sterile gloves on 66 occasions. A different expert, after viewing the footage, highlighted broader weaknesses in infection control training across Pakistan. The investigation also observed a nurse rummaging through a medical waste disposal box without sterile gloves. "She is violating every principle of injecting medicine," remarked Dr. Ahmed.

When presented with the footage, the hospital’s new medical superintendent, Dr. Qasim Buzdar, refused to acknowledge its authenticity. He claimed it could have been recorded before his tenure or that "this footage could also be staged," asserting that his hospital was safe for children.

Dr. Gul Qaisrani, a doctor at a local private clinic, was the first to identify the escalating outbreak in late 2024, noting a significant rise in the number of children presenting with HIV diagnoses at his clinic. He reported that almost all of the 65 to 70 children he diagnosed had received treatment at THQ Taunsa. Dr. Qaisrani recalled one mother stating that her daughter was injected with the same syringe as a cousin living with HIV, and that the syringe was subsequently used on several other children. He also mentioned a father who reportedly challenged syringe reuse at THQ Taunsa but was dismissed by nurses.

BBC Eye has meticulously compiled data from the Punjab provincial Aids screening programme, private clinics, and a dataset leaked by police to identify 331 children who tested positive for HIV in the city of Taunsa between November 2024 and October 2025. Analysis of a sample of 97 children with HIV, whose families also underwent testing, revealed that only four of their mothers tested positive. This strongly suggests that mother-to-child transmission was not the primary cause of these infections. Sughra, the mother of Mohammed Amin and Asma, tested negative for HIV; her husband had died two years prior in a road traffic accident. The provincial Aids screening programme data explicitly lists "contaminated needle" as the mode of transmission in over half of these 331 cases, including Asma’s. For the remaining cases, the mode of transmission is not specified.

The Punjab government intervened in March 2025, when the reported number of cases stood at 106. THQ Taunsa Hospital’s medical superintendent at the time, Dr. Tayyab Farooq Chandio, was suspended. However, BBC Eye has discovered that within three months, he was working with children again as a senior medical officer at a rural health centre on the outskirts of Taunsa. Dr. Chandio stated in an interview with BBC Eye that he took "immediate" action upon being notified of an HIV-positive case at THQ Taunsa, but he maintained that the hospital was not the source of the outbreak.

Dr. Chandio was succeeded by Dr. Buzdar, who informed the BBC that HIV was his "main focus" upon assuming the role in March 2025 and that he had a "zero tolerance" policy for unsafe infection control. "We conducted training programmes for the paramedics and staff nurses on how to prevent and defeat HIV. The most important part is our section on infection prevention control. They have been properly trained in this," he asserted. BBC Eye’s evidence, however, demonstrates that unsafe practices persisted eight months later.

Footage captured in November and December 2025, filmed over several weeks, revealed syringes and vials frequently left open alongside discarded needles on countertops that should have been maintained as sterile environments. Most children observed receiving treatment at THQ Taunsa were given injections via a cannula – a tube inserted into a vein – which further elevates the risk of infection. By entering directly into the bloodstream, contaminated medicine can bypass the body’s natural defence mechanisms. The investigation also filmed one nurse retrieving a used syringe from under a counter, with liquid for the last patient still inside. Instead of discarding it, she handed it to a colleague, seemingly preparing it for reuse on another child. When confronted with this undercover footage, Dr. Buzdar insisted it had been filmed before his tenure or had been staged. Responding to what he would say to local parents watching this footage, he declared, "I can say to them with certainty, with confidence, that you should get your treatment done at THQ Taunsa."

In a formal statement, the local government asserted that "no validated epidemiological evidence" had "conclusively established THQ as a source" of the outbreak. The statement further added that a joint mission involving the children’s charity Unicef, the World Health Organization, and the regional healthcare department had highlighted "the role of unregulated private practices" and "the contribution of unscreened blood transfusions." However, BBC Eye has obtained the joint mission’s April 2025 inspection report into the city’s outbreak, which identified many of the same critical issues observed during the investigation into THQ Taunsa. "Conditions were especially concerning in the paediatric emergency room," the report noted, an area where BBC Eye had conducted filming. "Essential paediatric medications were missing, and unsafe injection practices were common. IV [intravenous] fluids were being reused, cannulas were unlabelled, and used IV sets were left hanging on stands. Hand hygiene was neglected – basins were blocked, and no sanitizers were available."

Dr. Fatima Mir, a professor of paediatric medicine at the Aga Khan University Hospital in Karachi, commented that the BBC’s footage underscores significant weaknesses in infection control training across Pakistan. "We must warn our injectors: ‘You have become an active instrument for passing disease,’" she stated. The investigation suggests that unsafe practices are partly fueled by systemic pressures, including a prevalent reliance on, and a cultural preference for, injections as a form of treatment. Pakistan exhibits one of the highest rates of therapeutic injections globally, with many being medically unnecessary. Dr. Mir explained that members of the public frequently request injections, even for their children, and doctors readily comply. "They should keep the threshold for injection practice very high. Only give injections for life-threatening illnesses. For mild to moderate illnesses, use oral medication."

A scarcity of medicines and supplies also contributes to unsafe practices. The demand for injections can strain resources, which are allocated in government hospitals through quota systems overseen by their superintendents. "They have a set number of supplies and are told they must make them last for the whole month," Dr. Mir noted. "Are they seeing where corner-cutting is dangerous? And where the money should be spent?" During the undercover filming, it was observed that supplies were often missing on the wards, and patients who could afford liquid paracetamol were instructed to procure their own. "They make us account for every little bit of medicine," one nurse remarked.

The practices documented at THQ Taunsa are sadly not isolated incidents, mirroring those seen in previous outbreaks elsewhere in Pakistan. In 2019, hundreds of children in the town of Ratodero, in the Sindh province, tested positive for HIV, with most having parents who tested negative. Local paediatrician Dr. Imran Arbani told the BBC that he found repeated clinic visits and multiple injections in their medical histories, concluding, "so it must have been transmitted in one or other of these medical settings." By 2021, the number of HIV-positive children in the area had risen to 1,500, and new infections continue to occur even now.

While filming in Taunsa, a cluster of cases was also reported in Karachi. In the SITE Town area, children treated at a local government hospital, Kulsoom Bai Valika Hospital, subsequently tested positive for HIV. Among them was two-year-old Mikasha. A family member told BBC Eye that hospital staff used the same syringe on multiple children: "They filled the same syringe and gave it to one child, then filled it again and gave it to another." The hospital’s medical superintendent, Dr. Mumtaz Shaikh, stated in an interview that "qualified doctors will never reuse" syringes, adding, "so we have no concept of such things happening in government hospitals." However, the federal health minister has publicly confirmed that the outbreak of 84 cases was triggered by the reuse of contaminated syringes at the hospital.

When presented with the findings of this investigation, a spokesperson for the national government stated that it had "acted promptly within its mandate to investigate concerns [and] implement infection prevention control measures," with guidelines disseminated to health facilities in March 2025.

Back in Taunsa, Asma’s family reports that she is losing weight and faces a lifetime of treatment for a virus she should never have been exposed to. The stigma associated with HIV often leads to neighbours preventing their children from playing with Asma, leaving her isolated as well as ill, her family says. She asks her mother, "What is wrong with me?" Standing at her brother’s grave, Asma expresses her love and misses him, saying, "He’s with God now." She tells BBC Eye that she works hard at school. "When I grow up," she says with determination, "I want to become a doctor."