Express Tribune Editorials 8th August 2026

ART centres

HIV outbreaks in hospitals are almost always the result of sheer medical negligence and when such negligence is exercised against children - one of the most vulnerable members of society - there is no room for delayed action. After a recent HIV outbreak at the Kulsum Bai Valika Hospital in Karachi where 94 innocent children contracted the virus, the Sindh government's health department made the right call to decide to set up 44 Antiretroviral Therapy (ART) centres across the province.

These centres operate under Sindh's Communicable Disease Control (CDC) programme and are meant to assist in curbing the spread of HIV/AIDs by making it easier for citizens to access free and reliable treatment for the disease. The centres also have a responsibility to impart awareness and education to the general public which still finds itself steeped in decades-old myths and taboos regarding the spread of the virus.

Two things are important here: first, raising awareness regarding the HIV outbreak that occurred in Valika Hospital; and second, ensuring that these ART centres are functional and overseen by an independent body working in collaboration with the internal administration. The Sindh government's healthcare landscape largely suffers from a failure to address both of these issues: lack of awareness and accountability. While widespread awareness may initially breed fear among citizens already hesitant to visit hospitals in the country, it remains the sole mechanism capable of driving a collective demand for systemic accountability.

Citizens will demand protection only when they understand the threat they face. These ART centres must be insulated from polarising narratives, generate timely progress reports and accept strict oversight. Surveillance is indeed a monster - except when it serves as the ultimate shield against the careless destruction of young lives.

Broken law, broken lives

At least 1,914 cases of child abuse were reported across the country during the first six months of 2026 alone, a staggering number that should be seen as the nation's shame. The numbers are also getting worse. More than nine children were abused daily on average in 2025, and the number of cases rose by 8% compared to the previous year. The data compiled by the NGO Sahil also shows that 45% of incidents took place at the victims' own residences, while abusers in 43% of the cases were known to the victims. Girls make up a majority of the victims - 58% - but boys in the 11-15 age bracket are also considered highly vulnerable.

What is really riling up critics is the fact that Pakistan already has strong laws on the books regarding child protection, but we refuse to fully implement or enforce them. The Zainab Alert Act, the Juvenile Justice System Act and provincial child protection policies all exist on paper, but their implementation remains fragmented and reactive. Laws are useless if not evenly invoked. The Islamabad High Court recently noted that key provisions of the Zainab Alert Act remain lifeless due to shoddy implementation. A surfeit of laws means nothing when enforcement is absent. While 89% of cases were registered with police, registration is not justice. The conviction rate remains pitiful, and societal stigma often silences survivors and forces families to withdraw cases.

The crisis demands an overhaul of the criminal justice system, with specialised child protection units, fast-track courts and mandatory child safety education in schools. Law enforcement must be trained to handle cases with sensitivity, and survivors must receive psychological and legal support. Most of all, the government and civil society must eradicate taboos that breed a culture of silence that protects perpetrators and treats abuse as a private matter, rather than a societal failure.