Global Fund audit report: New HIV in Pakistan surge by 64pc in 5 years
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A medical practitioner holding a test tube for HIV test. — AFP/File
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Islamabad: HIV deaths in Pakistan have increased by 400 % and new infections have increased by 64 % in just five years – a devastating failure that is linked to the overall mismanagement, chronic delay, and the elimination of surveillance under Pakistan’s national health response, the global fund’s audit has been revealed.
Despite receiving more than US $ 1.1 billion in the global grant cycle, including only half a billion dollars, Pakistan’s efforts to tackle HIV, tuberculosis, and malaria have been disabled by inactive governance, weak shopping system, and poor financial accountability.
Covering the period between January 2021 and December 2023, the audit has described Pakistan’s grant governance as “ineffective”, which has exposed a broken system where political instability, lack of strategic direction, and repeated leadership changes have led to life -saving programs.
The new HIV infection increased from 7,741 to 12,731 in 2018, while AIDS mortality increased from 2,200 to 11,000 in the same period. For tuberculosis, about 70 % of the drug aboard TB could not be detected in 2023. The report also identifies the stagnation in the TB cases-which has 277 cases per 100,000, which are the highest since 2010-yet the World Fund has injected US $ 165 million in TB control efforts during the last grant cycle. Shopping and supply chain systems, which hold about 60 % of the grant budget, are scattered and weak.
The audit highlights the widespread stockout of HIV test kits at 64 % of the sites, the HIV diagnostic products sent to the provinces have expired, and about 36 369,000 malaria beds are worth US $ 0.9 million.
Local purchases suffered an average delays of US $ 4.3 million, withdrawing diagnostic and treatment efforts and producing massive waste. Pakistan also failed to fulfill its financing responsibilities under the Global Fund contracts, which reduced US $ 116 million. In the audit note, only five percent of the people between 2022 and 2025 were used by federal funds allocated for HIV, TB, and malaria. The audit has been exposed to receiving a large -scale non -transparent services, which recruits about one -third of the staff without interview or proper shortlisting. Payroll and purchase irregularities have been flagged, and millions of people were wasted on non -competitive contracts, which cost US $ 3.7 million without market survey or tender. Despite these alarming revelations, the World Fund Secretariat refuses to formulate new reform measures for many results of the report, though it has promoted to improve governance, promote wholesale transport projects for TB, and review the monitoring procedures.
The HIV grant was managed by the World Fund’s additional Safe Guard Policy by two principal recipients – the United Nations Development Program (UNDP) and the Ni Livegi Trust. However, the Common Management Unit (CMU) established the Ministry of National Health Services, which hosted the National HIV program, maintained a vital role in setting up a strategic direction and connecting implementation with the provincial governments.
The audit also found that the CMU effectively noted the delay in the key HIV activities and a damaged outbreak by noting the permanent difference in leadership, planning, and accountability.
Experts say that the CMUHIV grant was not the recipient of the Grant Cycle 6 (2021-2023), the monitoring and harmony issues are still suffering from national HIV response.
