The floods claimed over a thousand lives, with 808 of these casualties reported in the two provinces alone. They displaced three million people and damaged nearly 230,000 houses.<\/p>\n\n\n\n
For people living with HIV and Aids, their illness was an added risk factor.<\/p>\n\n\n\n
During last year\u2019s floods, many people with HIV got sick because they were cut off from antiretroviral therapy centres and couldn\u2019t access drugs, Asma Nasim tells Dialogue Earth. Nasim is head of the Department of Infectious Diseases at the Sindh Institute for Urology and Transplantation.<\/p>\n\n\n\n
In Pakistan, antiretroviral treatment for HIV\/Aids is provided free of cost at dedicated centres. Such therapy enables persons with HIV \u201cto live healthy lives by suppressing the virus and preserving immune functions,\u201d explains Asghar Ilyas Satti, national coordinator for the Association of People Living with HIV-Pakistan.<\/p>\n\n\n\n
This year, as monsoon rolls in, Pakistan is on hight alert,<\/a> and has warned citizens of heavy rainfall, urban flooding and more weather-related risks.<\/p>\n\n\n\n On 1 July, the country\u2019s National Disaster Management Authority (NDMA) issued a glacier lake outburst flood alert in two valleys in Gilgit-Baltistan, a region bordering Khyber Pakhtunkhwa. Rising river water levels damaged roads and bridges across several parts of the region, media outlet Dawn reported<\/a>. Soon after, heavy rains lashed Pakistan, claiming at least 14 lives across the country, according to The Nation<\/a>.<\/p>\n\n\n\n These warnings and recurring floods coincide with Pakistan recording a dramatic increase in the incidence of HIV.<\/p>\n\n\n\n Waheed (name changed), a teacher living with HIV in Khyber Pakhtunkhwa\u2019s Swat district, worries about the impacts of this year\u2019s monsoon on his health due to his experience last year.<\/p>\n\n\n\n While guiding his elderly mother, wife and three children to safety during the floods, he had to return to the house, but struggled to explain why. \u201cDue to the stigma associated with the disease, I have kept my illness a secret from everyone, even from my spouse,\u201d Waheed tells Dialogue Earth. \u201cI had only nine tablets left and was worried about facing a gap in treatment due to [loss of] access to [the antiretroviral] centre,\u201d he recalls.<\/p>\n\n\n\n Eventually, he managed to rush back to his submerged house to extract his antiretroviral drugs from a hidden spot.<\/p>\n\n\n\n \u201cGaps in treatment have severe health consequences including viral rebound, immune system damage and progression to Aids,\u201d Satti tells Dialogue Earth.<\/p>\n\n\n\n \u201cFor HIV patients, who are already navigating stigma and fragile health systems, climate disasters are not only destroying their homes and livelihood, but also endangering access to essential medication, a disruption that could have life-threatening consequences,\u201d Satti notes.<\/p>\n\n\n\n On World Aids Day in December 2025, the World Health Organization (WHO) reported<\/a> that new infections in Pakistan had risen by 200% in 15 years \u00ad\u2013 from 16,000 in 2010 to 48,000 in 2024. Hospitals in Karachi recently reported<\/a> a \u201cdramatic increase\u201d in the number of paediatric HIV cases over the last nine months alone, noted Dawn.<\/p>\n\n\n\n \u201cDuring the last three months, I have seen more children who are HIV positive than I have seen in the last ten years,\u201d says Nasim. \u201cIt isn\u2019t just that more people are being tested. It is that there are more people being infected,\u201d she adds.<\/p>\n\n\n\n Unsafe medical practices appear to have been the main cause of these spikes, Samreen Sarfaraz, chair of infection control services and consultant infectious diseases at Indus Hospital, told Dawn.<\/p>\n\n\n\n In April, the BBC published<\/a> a story on how 331 children had tested positive for HIV between November 2024 and October 2025 in the city of Taunsa, Punjab. Their story, confirmed via undercover filming, linked the outbreak to a hospital where children were being injected with reused syringes.<\/p>\n\n\n\n Waheed believes he contracted the virus while getting dental treatment where non-sterile instruments were used.<\/p>\n\n\n\n After the 2019 HIV outbreak in Larkana<\/a>, auto-disable syringes were introduced, which lock or break the plunger after one use. But more recently, such syringes have been discovered to be fake or substandard<\/a> in some areas, she notes. \u201cThis virus has reached epidemic proportions in Pakistan,\u201d says Nasim.<\/p>\n\n\n\n These are troubling developments as the monsoon season and the potential for dangerous floods arise yet again. At a press conference in November, chairperson for Pakistan\u2019s NDMA Inam Haider Malik cautioned that the 2026 monsoon could result in 22-26%<\/a> more rainfall than last year\u2019s.<\/p>\n\n\n\n At the same event, Prime Minister Shehbaz Sharif endorsed a five-year plan<\/a> for flood preparedness. This is significant in a country where no relief fund has ever been legally secured, climate and water expert Ali Tauqeer Sheikh noted<\/a> in a recent Dawn op-ed.<\/p>\n\n\n\n In May, Sharif ordered authorities to strengthen<\/a> monsoon preparedness. He also issued a directive to ensure comprehensive screening<\/a> of all patients in public hospitals for hepatitis and HIV.<\/p>\n\n\n\n Memories of the catastrophic floods<\/a> of 2022 are still fresh for many, when Pakistan suffered damage worth USD 10 billion, with more than 33 million people affected. In Sindh, the floods cut people with HIV off from treatment centres. \u201cThe devastating floods in 2022 disrupted our contact with a large number of HIV patients,\u201d says Robina, the province\u2019s head of the Association of People Living with HIV-Pakistan (APLHIV).<\/p>\n\n\n\n When communication networks are disrupted due to climate-related disasters, treatment delays become more common, says Pulwasha (name changed), a person with HIV who has volunteered to deliver medicine to patients at their homes in Peshawar. Many patients prefer having medicines delivered to avoid being seen at antiretroviral therapy centres, she notes.<\/p>\n\n\n\n Robina, who goes by a single name, tells Dialogue Earth that after six months of sustained efforts tracking patients lost to follow-up (LTFU) \u2013 those who drop out of treatment before it is complete \u2013 many patients came back to the treatment network. These were individuals who had stopped attending scheduled appointments or seeking care due to mental trauma and financial losses including of property and livelihoods.<\/p>\n\n\n\n \u201cThe LTFU also indicated that several HIV patients were completely missing [and] presumed dead, either due to drowning or interruptions in treatment, as vast areas of interior Sindh remained submerged under floodwaters and [were] cut off from major cities for several months, severely restricting patients\u2019 access to treatment centres,\u201d she says.<\/p>\n\n\n\n Nearly 20,000 patients<\/a> who initiated treatment at antiretroviral therapy centres for HIV\/Aids were considered missing by Pakistan\u2019s health ministry as of May 2026. This finding raised serious questions about follow-up, counselling and patient retention, noted the Standing Committee on National Health Services, Regulations and Coordination in a press release.<\/p>\n\n\n\n Realising the health risks faced by HIV patients during the August 2025 floods, APLHIV activated an Emergency Response Cell to ensure<\/a> uninterrupted treatment for affected individuals in Buner, Swat and Mansehra districts of Khyber Pakhtunkhwa, Satti says. Using its national registry of 25,000 people with HIV, APLHIV identified about 1,000 individuals residing in these flood-affected areas, over a hundred of whom were confirmed as directly affected by climate-induced disasters. Immediate coordination with centres, case managers, provincial and national programs ensured urgent re-supply of medicines to the flood-affected patients, Satti adds.<\/p>\n\n\n\n Sobo Malik, an activist working closely with people living with HIV at the NGO Khawaja Sira Society<\/a> in Lahore since 2015, says that while the government provides treatment, crucial follow-ups such as voluntary confidential counselling and testing are carried out by community-based organisations.<\/p>\n\n\n\n \u201cThere are no special programs for HIV-positive persons in case of disasters. Last year during floods, [people] living in or near the cities received nutritional packages plus treatment, but we are not so sure those in rural areas get the same facilities,\u201d she tells Dialogue Earth. \u201cGeneral aid in climate disasters, like medical camps and ration, is not specific to people with HIV. In flood relief camps, only verbal history is taken, and basics are checked like sugar [levels] and blood pressure. But no specific blood tests for HIV are conducted.\u201d<\/p>\n\n\n\n Confidentiality is also an issue with people with HIV, Malik says. \u201cBecause of the stigma, they usually don\u2019t want to tell anyone. And in mainstream society\u2026 testing is rare.\u201d<\/p>\n\n\n\n Diagnosis is important, but treatment, follow-up and counselling are just as important, she notes. \u201cTheir immunity is obviously compromised. The viral load needs to be brought down through medication, plus nutrition needs to be maintained to strengthen immunity. If that isn\u2019t done, then severe weather conditions\u2026 will impact their health more than an average person.\u201d<\/p>\n\n\n\n Sara Malik, deputy director of media at the NDMA, tells Dialogue Earth that the government body hopes to address the needs of people with HIV \u201cover time\u201d.<\/p>\n\n\n\n While there are no policies specific to these individuals, NDMA has partner NGOs that are active in the health sector, so they must be indirectly benefiting from their initiatives, she says.<\/p>\n\n\n\n NDMA, she says, \u201censures that vulnerable populations are supported during its post-disaster response\u201d, adding that it is now \u201cexpanding scope of its relief activities to reach maximum number of vulnerable people during emergencies\u201d.<\/p>\n\n\n\n Environmentalist and social activist Zulfikar Ali Bhutto Jr<\/a>, who advocates for the rights of people with HIV, says that access to medicines can make the condition quite manageable.<\/p>\n\n\n\n \u201cWhile in many countries the onus falls on the general population to remain safe, in Pakistan it is the government that must now act to ensure medical malpractice does not take any more lives,\u201d Bhutto tells Dialogue Earth. \u201cThankfully [antiretroviral] medication can be obtained for free in Pakistan. This is a good system that can work, it just needs to be utilised,\u201d he says.<\/p>\n\n\n\n \u201cSadly, erratic weather patterns, extreme heat and last year\u2019s flood have all impacted people\u2019s access to medication especially in rural areas.\u201d<\/p>\n\n\n\nHIV spikes amid floods<\/h2>\n\n\n\n
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<\/div>Who can help?<\/h2>\n\n\n\n
Sadly, erratic weather patterns, extreme heat and last year\u2019s flood have all impacted people\u2019s access to medication especially in rural areas<\/blockquote><\/cite><\/div><\/div>\n\n\n\n
Risk of other diseases<\/h2>\n\n\n\n