Warning: This article contains details that some readers may find disturbing.
Mohammed Amin was eight years old when he died shortly after testing positive for HIV.
He had such a fever that he insisted on sleeping in the rain and writhed in pain “as if he had been poured into boiling oil,” says his mother, Sughra.
“He used to fight with me, but he also loved me,” says Asma, 10, as she kneels next to her little brother’s grave.
Shortly after her brother contracted the virus, Asma was also diagnosed with HIV. His family believes that both children contracted it through injections with contaminated needles during routine medical treatment at a public hospital in Taunsa, Punjab province, Pakistan.
They are two of 331 children BBC Glimpse has identified who tested positive for HIV in the city between November 2024 and October 2025.
After a doctor at a private clinic linked the outbreak to the neatly being heart, known as THQ Taunsa, in late 2024, local authorities promised “drastic measures” and suspended the medical director of the neatly being heart in March 2025; However, a BBC Glimpse investigation now reveals that the dangerous injection practices continued months later.
During 32 hours of covert recording at THQ Taunsa in late 2025, we witnessed syringes being reused in multi-dose vials of medication on 10 separate occasions, potentially contaminating the drugs they contained.
In four of these cases, we saw medication from the same vial being administered to a different child. We do not know if any of the children were HIV positive, but this practice poses a clear risk of viral transmission.
“Even though they have put in a new needle, the back, what we call the body of the syringe, contains the virus, so the virus will be transmitted even with a new needle,” said Dr Altaf Ahmed, consultant microbiologist and one of Pakistan’s leading infectious disease experts, after viewing our covertly recorded footage.
Despite posters on the walls of Neatly Being Heart outlining safe injection practices, we filmed the deepest—including a doctor—injecting patients without sterile gloves on 66 occasions, and another expert told us that our footage highlighted broader deficiencies in infection control training in Pakistan.
We also saw a nurse rummaging through a medical waste container without sterile gloves. “It is violating all the principles of injectable drug administration,” Ahmed said.
But when we showed our images to Neatly Being Heart’s new medical director, Dr. Qasim Buzdar, he refused to acknowledge that they were authentic. He claimed that they could have been recorded before he took office or that “these images could also be staged,” and insisted that his neatly being heart was safe for children.
Dr. Gul Qaisrani, a doctor at a local private clinic, was the first to detect the outbreak in late 2024, after observing an increase in the number of children coming to his clinic and testing positive for HIV.
Almost all of the 65 or 70 children he diagnosed had been treated at THQ Taunsa, he says.
She remembers that a mother told her that her daughter had been injected with the same syringe as a cousin who was living with HIV, and that that syringe had later been used on several other children. Qaisrani says that a father told him that he had protested the reuse of syringes at THQ Taunsa, but that the nurses ignored him.
BBC Glimpse has collected data from the Punjab provincial AIDS screening programme, private clinics and a data set leaked by the police to identify 331 children who tested positive for HIV in the city of Taunsa between November 2024 and October 2025.
Of a sample of 97 children with HIV whose families were also tested, only four of their mothers tested positive. This suggests that very few of these cases were due to mother-to-child transmission. Mohammed Amin and Asma’s mother, Sughra, tested negative for HIV; Her husband died two years ago in a traffic accident.
Data from the provincial AIDS detection program indicate that the “contaminated needle” was the route of transmission in more than half of these 331 cases, including Asthma; In the others, the route is not specified.
The Punjab Government intervened in March 2025, when it claimed the number of cases was 106. The medical director of Taunsa’s THQ Wellbeing Facility, Dr Tayyab Farooq Chandio, was suspended, but BBC Glimpse can reveal that, within three months, he was back working with children as a senior doctor at a rural health center on the outskirts of Taunsa.
In an interview with BBC Glimpse, he said he took “immediate” action after being informed of a case of HIV at THQ Taunsa, but noted that neatly being heart was not the origin of the outbreak.
Chandio was replaced by Buzdar, who told the BBC that HIV was his “predominant priority” when he took office in March 2025 and that he applied a “zero tolerance” policy for any lack of security in the development of infections.
“We conduct training programs for paramedics and nursing staff on how to prevent and combat HIV. The most important part is our section on build watch over and infection prevention. They have received proper training in this regard,” he said.
However, BBC Glimpse evidence shows that unsafe practices continued eight months later.
Footage we recorded between November and December 2025, over several weeks, showed syringes and vials often left open alongside discarded needles on countertops that should be kept sterile.
Most of the children we saw receiving treatment at THQ Taunsa were given injections through a cannula – a tube inserted into a vein – further increasing the risk of infection. By entering directly into the bloodstream, contaminated medications can bypass the body’s natural defenses.
We also filmed a nurse removing a used syringe from under a counter that still contained fluid from the last patient. Instead of throwing it away, he hands it to his companion, apparently ready to be reused on another child.
When we showed Buzdar our covertly recorded footage, he insisted that it had been filmed before his appointment or had been staged.
When asked what he would say to parents in the area who were seeing these images, he said: “I can tell them with certainty, with confidence, that they should come to THQ Taunsa for treatment.”
In a statement, the local government stated that “no validated epidemiological test” had “conclusively established that THQ was the origin” of the outbreak.
He added that a joint mission between children’s charity Unicef, the World Health Organization and the regional health department had brought to light “the role of unregulated private clinics” and “the contribution of uncontrolled blood transfusions.”
However, BBC Glimpse has seen the April 2025 inspection report from the joint mission into the outbreak in the city, which found many of the same issues as our investigation into THQ Taunsa.
“Conditions were especially concerning in the pediatric emergency room,” the report notes; this is one of the apartments in which BBC Glimpse made its recordings.
“Essential pediatric medications were missing and unsafe injection practices were common. Intravenous fluids were reused, cannulas were not labeled, and used intravenous sets were left hanging on racks. Hand hygiene was neglected: sinks were clogged and disinfectants were not available.”
Dr. Fatima Mir, professor of pediatric medicine at the Aga Khan University Wellness Center in Karachi, says our images highlight the gaps in infection control training in Pakistan. “We must warn those who administer the injections: they have become an active vehicle for disease transmission.”
Our research suggests that unsafe practices are due, in part, to systemic pressures, including reliance on injections as a treatment and cultural preference for this method.
Pakistan has one of the highest rates of therapeutic injections in the world, many of them medically unnecessary. The population in no longer new requests them, even for their children, and doctors willingly administer them, says Mir.
“They should keep the threshold for injections very high. Injections should only be given for life-threatening illnesses. For mild or moderate illnesses, oral medications should be used.”
Shortages of medications and supplies also fuel unsafe practices. The demand for injections can put a strain on resources, which are allocated in public hospitals through quota systems overseen by their directors.
“They have a set amount of supplies and are told they have to make them last the entire month,” Mir says. “Do you realize where cutting costs is dangerous? And where the money should be spent?”
During our undercover filming we discovered that supplies were often missing from the wards and that patients who could afford liquid paracetamol were told to bring it at their own expense. “They hold us accountable for every drop of medicine,” said one nurse.
The practices documented at THQ Taunsa resemble those seen in previous outbreaks elsewhere in Pakistan.
In 2019, hundreds of children in the town of Ratodero in Sindh province tested positive for HIV, most of them with parents who tested negative.
Local pediatrician Dr. Imran Arbani told the BBC that he had detected repeated visits to the clinic and multiple injections in his medical records, “so transmission must have occurred in one of these medical settings.” In 2021, the number of HIV-positive local children had increased to 1,500, and new infections continue to occur today.
While we were shooting in Taunsa, an outbreak of cases was reported in Karachi. In the SITE Town area, several children treated at a local public health facility, the Kulsoom Bai Valika Wellbeing facility, subsequently tested positive for HIV.
Among them was two-year-old Mikasha.
An acquainted claimed that the neatest being heart used the same syringe on several children: “They filled the same syringe and gave it to one child, then they filled it again and gave it to another,” Glimpse told BBC.
Neatly Being Heart’s medical director, Dr. Mumtaz Shaikh, said in an interview that “qualified doctors never reuse” syringes, “so we don’t conceive of things like that happening in public hospitals.”
The federal health minister, however, has publicly confirmed that the outbreak of 84 cases was triggered by the reuse of contaminated syringes in the neatly being heart.
When we presented the findings of our investigation to the national government, a spokesperson stated that it had “acted promptly, within its mandate, to investigate concerns.” [y] apply build watch over and infection prevention measures”, with guidelines sent to healthcare centers in March 2025.
Back in Taunsa, Asma’s family says she is losing weight and now faces lifelong treatment for a virus she should never have been exposed to.
The stigma associated with HIV means neighbors often prevent their children from playing with her, leaving her isolated as well as sick, according to her family. She asks her mother: “What’s wrong with me?”
Standing at her brother’s grave, Asma says she misses him. “Now he is with God.”
He tells BBC Glimpse that he works hard at school.
“When I grow up,” she says, “I want to be a doctor.”
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