HIV, prescription drug misuse, and institutional neglect are putting the country’s next generation in danger.
In recent years, at least 331 children in Punjab’s Taunsa district tested positive for HIV after unsafe medical practices, including the reuse of syringes at a government hospital. This outbreak exposed serious weaknesses in infection control and shows how preventable failures in healthcare can devastate families and communities.
Pakistan now faces two serious and related challenges that threaten its future: a rising HIV epidemic and increasing substance misuse among young people. Both reflect systemic weaknesses in public health, education, and enforcement, and both demand urgent action from government, healthcare authorities, schools, and society.
According to official data, Pakistan has more than 84,000 registered cases of HIV, with about 61,000 people receiving treatment in public facilities as of April 2026. Health authorities estimate that the actual number of people living with HIV could exceed 369,000, indicating many undiagnosed and untreated cases. Despite these numbers, only about 21 per cent of people with HIV know their status, and just 16 per cent receive treatment, leaving large gaps in the response.
At the same time, substance misuse is widespread. A national survey found that around 6.7 million people in Pakistan, nearly six per cent of those aged 15 to 64, have used illicit substances in the past year. While illegal drugs remain a problem, non-medical use of prescription medicines such as opioids, benzodiazepines, and steroids is also increasing, particularly among young people.
These twin crises share a common cause: failures in systems meant to protect the public. Unsafe practices in healthcare facilities can lead to preventable infections. Weak regulation of pharmacies and medical outlets allows powerful prescription medications to be sold without proper checks, making them easily accessible. Many pharmacies operate with untrained staff and limited supervision, and enforcement of existing laws on controlled substances is weak.
The misuse of prescription medicines often begins with self-medication to deal with stress, anxiety, or academic pressure and can quickly lead to dependency. Easy availability of these drugs without valid prescriptions creates a public health emergency that rivals more familiar issues like street narcotics.
Addressing these challenges requires a comprehensive and coordinated approach that spans health, education, law enforcement, and public awareness.
Pakistan must strengthen its public health systems. Universal access to HIV testing and antiretroviral therapy is critical. Treatment services should be expanded to rural and underserved areas, and confidentiality must be ensured to reduce stigma. Healthcare workers should receive training in infection control, and hospitals and clinics should adopt digital systems to track infections, monitor treatment, and flag irregularities.
Regulation of medications must be tightened. Pharmacies should be required to employ qualified pharmacists, maintain complete dispensing records, and verify prescriptions before dispensing controlled medicines. Routine inspections and penalties for noncompliance should be enforced. Informal and unlicensed medical outlets that sell addictive medications without oversight must be shut down or brought under proper supervision.
Schools and universities have a key role to play. Educational institutions should establish systems to identify students at risk of substance misuse or behavioural problems. Counselling services, behavioural monitoring, and academic support can help detect early warning signs. Clear codes of conduct and consistent enforcement will help restore discipline and cultivate personal responsibility.
Rehabilitation and reintegration programmes must be part of the public response. These services should include medical care, psychological support, and vocational training to help individuals recover from addiction and rebuild their lives. Equipping young people with skills and opportunities can reduce social exclusion and strengthen their engagement with their communities.
Public awareness is equally vital. Young people, parents, teachers, and community leaders need accurate information about the dangers of prescription misuse and the importance of early testing for HIV and other infections. Reducing stigma associated with HIV and addiction will encourage more people to seek help without fear of judgment.
The combined threat of HIV and substance misuse shows that Pakistan’s health, education, and regulatory systems must work in unison. Failure to act decisively weakens the nation’s ability to protect its young population and undermines its future prospects.
Pakistan’s youth are its greatest asset. They deserve healthcare systems that protect their well-being, educational environments that nurture their potential and regulatory frameworks that prevent exposure to harm. Immediate, coordinated, and compassionate efforts are vital to ensure that this generation can grow healthy, disciplined, and empowered.
Action cannot be postponed. Governments, institutions, and communities must act now to safeguard the health and future of Pakistan’s young people.
Copyright Business Recorder, 2026
The writer is an expert on institutional development, finance and governance