Hospital at centre of child HIV outbreak caught reusing syringes in Pakistan

Posted by flykespice 16 hours ago

Comments

Comment by satya71 15 hours ago

This is common practice in much of developed world. Long ago, they used to have re-usable glass syringes that could be sterilized. Unfortunately, people switched to disposable syringes. The unit costs are...high in the US, unreasonable in developing countries.

It's not just this hospital, it's widespread ([1] report 38%)

[1] https://www.emro.who.int/emhj-volume-26-2020/volume-26-issue...

Comment by Marsymars 15 hours ago

That article also makes it seem like patients in Pakistan are receiving what seems to me like a wildly high number of injections:

> An injection was provided during 53% of patient visits in Rawalpindi and 92% in Tando Allah Yar

> Patients from Tando Allah Yar reported a mean 3.8 visits to a healthcare provider by a member of their household during the previous month, compared to 2.5 by those from Rawalpindi (Table 2). During all such visits, an injection was given. Overall, 56% patients felt that an injection was necessary. Such perceptions were higher in Tando Allah Yar than in Rawalpindi (79% vs. 39%) (Table 2). Providers reciprocated such perceptions in that 44–56% of providers felt that an injection was required for common ailments such as fever, influenza, body aches or diarrhoea.

> Patients expect to receive injections for minor ailments such as fever or influenza-like symptoms and willingly pay for these, on the mistaken belief in the efficacy of injections to overcome common symptoms that eventually abate with time (10). Healthcare providers comply with such wishes and are convinced of the necessity of injections.

> We have previously demonstrated that the total national supply of syringes in Pakistan is sufficient to meet the demand for the ~1.1 billion syringes used annually for immunization, diabetes, laboratory testing and drug administration in clinics or hospitals

On the last point, I did a bit of a search to look for the total number of syringes used worldwide. I'm actually questioning whether that number is using similar methodology to arrive at the ~1.1 billion number, since I'm seeing numbers around 15 billion for the annual number of injections - meaning that Pakistan would be using over double the average per-capita number of syringes (and re-using many of them) while simultaneously having a population that's much younger (23 vs 31 median age) and poorer ($7k vs $26k median PPP/capita) than average.

If those numbers check out, the simple solution would just be to stop giving unnecessary injections, money would be saved, and there'd be no need to reuse syringes.

Comment by Aurornis 13 hours ago

> > Patients from Tando Allah Yar reported a mean 3.8 visits to a healthcare provider by a member of their household during the previous month,

This seems like an excessive number of doctor visits, too. I can’t imagine a household where someone is going to the doctor almost every week. 45 doctor visits a year and they’re getting injections (of what?) most of the time?

Comment by londons_explore 10 hours ago

I, as someone broadly healthy and who has barely used healthcare services, asked to see my health records recently.

I was shocked to see 500+ 'interactions' between me and the healthcare provider! However it turns out the majority of those interactions are very minor things - ie. "Patient received text message reminder about appointment". "Patient was sent letter with test results" etc.

When you count interactions like that, you can get a big number fast.

Comment by ceejayoz 15 hours ago

A similar thing happens in the US; people demand antibiotics for a cold. It’s easier to say yes than to explain the reason it won’t work.

Comment by Aurornis 13 hours ago

Antibiotic overprescribing was a problem in the past, but in my experience providers around me are very resistant to giving antibiotics at all.

My doctor’s office even has a big sign in the waiting room saying they don’t prescribe antibiotics for common infections.

The last time I got strep throat the urgent care clinic was resistant to testing me but finally gave in. When it came back positive the doctor acted oddly like he was reluctantly willing to prescribe antibiotics for it.

Comment by Marsymars 12 hours ago

> The last time I got strep throat the urgent care clinic was resistant to testing me but finally gave in. When it came back positive the doctor acted oddly like he was reluctantly willing to prescribe antibiotics for it.

For strep in particular, wiki indicates that not treating with antibiotics isn't unreasonable (presumably opinions will vary by doctor): https://en.wikipedia.org/wiki/Streptococcal_pharyngitis#Anti...

Comment by hgoel 12 hours ago

My dad in India gets prescribed antibiotics whenever he's sick. Despite my constant explanations, he insists that this is how it should be, because when you're sick your immunity is lowered.

On the other hand, the last time I got prescribed antibiotics was probably almost 10 years ago when I ended up in the hospital from an abscess.

Granted, my dad is old, but that part of the world still seems to expect doctors to do more for a common cold than just tell you to rest for a week and take an acetaminophen or phenylephrine if/when needed (even when that's really all you need).

Comment by Marsymars 12 hours ago

> Granted, my dad is old, but that part of the world still seems to expect doctors to do more for a common cold than just tell you to rest for a week and take an acetaminophen or phenylephrine if/when needed (even when that's really all you need).

FYI phenylephrine is effectively a placebo and the FDA has proposed ending its use in OTC drugs. (There've been HN threads on the subject, with many comments.)

Pseudoephedrine works great though.

Comment by devilbunny 4 hours ago

Phenylephrine is a placebo for nasal congestion, but it’s a solid drug for raising blood pressure. Used all the time in anesthesia (obviously not an OTC use).

Comment by ButlerianJihad 13 hours ago

I don’t know how widespread it is, but some people will beg for antibiotics when they definitely have a viral infection.

My friend who always used a naturopath would go on endlessly trying to diagnose herself with viral or bacterial to decide whether she should ask for antibiotics, but I definitely got the point.

I suppose many patients simply don’t know the difference.

Comment by fastasucan 6 hours ago

Why do you say oddly? Prescribing antibiotics just because is how you get resistance.

Comment by imtringued 8 hours ago

I know antibiotics are really popular because killing bacteria seems really effective, but have you considered asking your doctor for a probiotic treatment?

Oral probiotics tend to work really well (similar effect to getting rid of bad bacteria) because they don't have to survive the stomach acid.

Comment by throw0101a 5 hours ago

> A similar thing happens in the US; people demand antibiotics for a cold. It’s easier to say yes than to explain the reason it won’t work.

Are there placebos that could be given instead?

Comment by shigawire 15 hours ago

Is that true or just a rumor? All the family medicine people I know would not do that. Only in a case where it is 50/50 bacterial or viral like an ear infection in a young kid.

Comment by kube-system 14 hours ago

There is more effort today to avoid overprescribing antibiotics, but in cases where diagnosis is not certain, most providers will oblige

Comment by thayne 14 hours ago

More than that, it's often easier to just prescribe something than to figure out if it is bacterial or viral.

Comment by MassiveQuasar 13 hours ago

Could just prescribe sugar pills then instead of antibiotics for a cold.

Comment by thayne 9 hours ago

IME, most people (in the US) don't bother going to a doctor for a cold unless it lasts a long time or is especially bad, because you'll probably get better on your own and going to the doctor is expensive.

Comment by ButlerianJihad 9 hours ago

I was working in a church office when I came down with a runny nose and other cold symptoms.

My supervisor told me I could stay home for a day, but if longer than that, I would require a doctor’s excuse.

Now, that seemed fair from a labor perspective, but it is extremely unfair to someone like me. Because I do not own a vehicle, and seeing a doctor would involve boarding one or more buses and snorking the entire way there and back. Risking infection for everyone around me was exactly what I sought to avoid by staying home.

So what else could I do, but come into work and carry on? It is this sort of unreasonable requirement that fuels “presenteeism”.

Comment by Marsymars 1 hour ago

I see this as a dereliction of duty by doctors' associations; they should all have standing policies forbidding the provision of sick notes.

Comment by throw0101a 5 hours ago

> My supervisor told me I could stay home for a day, but if longer than that, I would require a doctor’s excuse.

You'd think the supervisor would realize it's in their own self-interest for you to not be around spreading infection (to them) by your mere presence.

There are of course people who abuse systems where doctors notes are not needed, and call in and then go have fun. It's not too hard to come across stories of people getting on short/long-term disability by know the correct doctor (I know of a situation where 3 members of the same family went to the same doctor and got a note for some condition).

Comment by loeg 12 hours ago

We don't give these hypochondriacs saline injections with dirty needles, though.

Comment by 15 hours ago

Comment by gib444 13 hours ago

In the UK, nothing is ever bacterial lol

I had a horrible tooth infection that anyone with a nose could tell was a bacterial infection yet I was massively gaslit and denied antibiotics until I went to the hospital at 11pm after a week of horrendous pain

Doctors very rarely do any kind of test in my experience (I would have thought oozing stinking green stuff would have been easy to test...)

Later

I am somewhat against antibiotics as I have a fragile/already destroyed gut. But there are times when I don't know what other solution there is after exhausting home remedies, other medication and waiting it out

Comment by 7 hours ago

Comment by dzhiurgis 13 hours ago

A friend passed away few months ago in London from kidney infection.

UK seems very to be very cautious of over diagnosis, while my experience in Eastern Europe was opposite - my infant received 3 different kinds of steroids (potentially what stunned his growth).

Comment by gib444 12 hours ago

I'm very sorry to read that

IMO there is a huge amount of denial of treatment to save costs. The gaslighting over symptoms, the refusal to refer you to specialist, the refusal to order tests etc is all part of it. And they never ever say it's about costs - just a tight lipped, "I know what's best" attitude

Comment by LorenPechtel 13 hours ago

Probably patient demand for *something*. The problem of antibiotics for viral infection is well known but the problem with needing to do something is far more widespread. I wouldn't be surprised if a lot of saline is getting injected.

Comment by loeg 15 hours ago

> This is common practice in much of developed world.

Do you mean "developing?" This is not common practice in rich Western countries.

Additionally, as sibling has already pointed out, sterile disposable syringes are extremely cheap.

Comment by Ferret7446 14 hours ago

The reason we switched is because it's cheaper (including the logistics overhead costs). Sterilization and transport isn't free

Comment by SoftTalker 13 hours ago

It's also not perfect. Sure you can throw instruments into an autoclave or even boiling water but they have to be kept sterile after they come out, which is probably harder to do especially in underdeveloped, resource-poor areas.

Comment by M95D 9 hours ago

> they have to be kept sterile after they come out, which is probably harder to do especially in underdeveloped, resource-poor areas

It's actually very easy. Sterilization takes place in a stainless steel container that has "windows" on it's sides. When the sterilization cycle ends, these "windows" are closed just as the container is taken out of the autoclave. The container will remain sterile inside until opened.

Also, simply opening the container to take one syringe from it doesn't make it dangerously contaminated. As demonstrated by the article, the biggest danger comes from other people's blood (HIV, HCV, HBV), not ordinary bacteria we have on our skin.

Comment by SanjayMehta 15 hours ago

A quick search found a pack of 100 disposable syringes in Pakistan for PKR 1100/- which is less than USD 4.

That's 4 cents per syringe. Seems quite reasonable to me. Seems they don't have economics as an excuse.

https://ailaaj.pk/products/apple-disposable-syringe-5ml-100s

Comment by leonidasrup 3 hours ago

There is strong correlation between life expectancy and GDP per capita.

https://ourworldindata.org/grapher/life-expectancy-vs-gdp-pe...

Been poor is your biggest health risk.

https://www.un.org/sustainabledevelopment/

Comment by CGMthrowaway 15 hours ago

A month's wage in Pakistan is about $125. So each syringe would feel like a cup of Dunkin does to many in the USA

Comment by bastawhiz 14 hours ago

I have orders of magnitude more cups of Dunkin each year than I get injections at a doctor

Comment by garbawarb 14 hours ago

But Pakistanis don't.

Comment by bastawhiz 13 hours ago

The point is that if the analogy of a $0.04 syringe is supposed to be as expensive as a cup of coffee, it's still not expensive even if you do it often. Maybe they have too many injections. Either way we have a bunch of kids with a disease that can kill because someone thought something as expensive as a cup of coffee was too expensive.

Comment by crazygringo 14 hours ago

Which would be entirely reasonable cost as part of a healthcare visit.

When people complain about healthcare costs, they're not complaining about things that cost the same as a cup of coffee locally.

Comment by kelnos 8 hours ago

I feel like spending the cost of a crappy cup of coffee to get a clean needle so you don't get HIV is money well spent.

Comment by wildzzz 12 hours ago

Median household income in US is $83k so 0.04/125 * 83k is about $26, much more than cup of coffee. If you're sticking like 15 kids a day with the same needle, that's like $400 a day saved.

Comment by MagnumOpus 11 hours ago

You are comparing monthly individual wages in Pakistan to annual household income in the US. That results in your numbers being nonsense.

Comment by mothballed 15 hours ago

[flagged]

Comment by Loughla 15 hours ago

That could have been said without the massive racism.

It's less about the money and more about the logistics of transporting and stocking these goods in a country that doesn't have decent basic infrastructure.

See?

Comment by mothballed 15 hours ago

[flagged]

Comment by alex43578 14 hours ago

You can't characterize a country where: - dozens of people just got HIV from syringe reuse - that ranks 168th out of 193 countries in HDI - ranked 136th out of 182 countries in corruption as backwards, underdeveloped, or corrupt. /s

Comment by i7l 15 hours ago

Do you know why they couldn't switch back to glass syringes?

Comment by ButlerianJihad 15 hours ago

Equipment that can be sterilized has been forced out of the market by these disposable things. It is far easier to push disposable product on medical providers and encourage rent-seeking and subscriptions to such things.

It’s exactly the same way with contact lenses. When I was in college in the ’90s, I could get a pair of permanent contact lenses. They would cost a few hundred bucks, but they would last me several years if the prescription didn’t change. They were the same as glasses. You would clean them everyday and disinfect them, and they would serve quite well permanently.

But the contact lens industry decided that wasn’t good enough, and decided that they could sell subscription services for contact lenses that you would need to discard every night.

And those daily wear contact lenses, the disposable kind, basically forced out of the market the permanent ones and now the optometrist regards me as a Martian when I request permanent lenses instead.

Comment by cromka 15 hours ago

You completely ignored human error aspect. Before the blood donation centers used one time use equipment, donors were getting infected with something nasty every now and then. You can sure as hell expect people to commonly forget to properly sanitize those syringes.

Comment by M95D 9 hours ago

Sterilization is* the most strictly controlled process in any hospital. Nobody can just "forget" to sterilize or pick up a used syringe thinking it's sterile.

* Or at least it should be. It seems that Pakistan is different.

Comment by cromka 1 hour ago

> Sterilization is* the most strictly controlled process in any hospital.

As aviation has shown—where human error has been studied for decades—reducing mistakes is difficult and expensive because it requires multiple layers of quality assurance. In countries where labor is costly, especially in healthcare, it has got to actually be cheaper to use single-use equipment, with the added benefit of reducing the risk of infection through that route to zero.

Comment by LorenPechtel 13 hours ago

There is also the reality that a sealed package is more of a guarantee of sterility than something that should be autoclaved. Even in the US there have been cases of nasties being passed by inadequate cleaning.

And we had a big scandal locally. Were they doing a shoddy job of colonoscopies? Probably. But genetics left no doubt that they were using one needle per jab, but one syringe per patient. And drawing up from multi-use vials. Stick the hep C patient, in pulling back a bit ends up in the syringe. Discard needle, syringe is still infected. New needle, old syringe, draw from the vial again, vial is now infected.

Comment by ButlerianJihad 7 hours ago

There is a secured room here where I've been assigned a PIN, but the room's door is unlocked between 6am-6pm. Nevertheless, I always enter my PIN on the pad, or at least try to recall it clearly. Because if you're in the habit of pulling that door open during the day, 8 months later will come a time it is locked, and you won't remember your PIN because you've never ever used it.

The same goes for sterilizing such things in a medical setting. I think HCPs are very accustomed to the disposable and pre-sterilized supplies that they don't even consider an item's sterile status or the need to sterilize it after use. So this is the pitfall that comes with all the disposable stuff: that routine sterilization is forgotten as a skill or as a necessity.

Comment by SoftTalker 13 hours ago

You can still get rigid gas-permeable lenses that last basically forever, I wear them every day. You have to take them out at night and clean them, but you only buy them once (unless you damage or lose them, or your prescription changes).

Comment by stratts 15 hours ago

Daily isn't the only option - you can still get monthly lenses.

Comment by ButlerianJihad 15 hours ago

Like I said, with proper care and disinfection, permanent lenses could last for years, not days or months!

Comment by kube-system 14 hours ago

Weren’t those the hard plastic ones with low oxygen permeability? They’re not as good for your eyes.

Comment by ButlerianJihad 14 hours ago

No, they were soft, “hydrophilic” or for astigmatism, toric. The hard ones were old, old technology, and largely superseded.

Comment by jonahx 15 hours ago

I share your hate of rent-seeking and subscription culture, but tbf disposable contact lenses are legitimately a nicer product to use. I've done it both ways.

Comment by nulld3v 15 hours ago

It's not like glass syringes are out of production though? They are still pretty cheap, I get them for $0.50 each from China.

Comment by technion 12 hours ago

Surely there is a cost to sterilising too.

Comment by faangguyindia 15 hours ago

If you forget to autoclave them or not done properly you end up with infected patients, risk is just too much

Comment by seb1204 15 hours ago

Sounds like the same risk as this situation of reusing them.

Comment by kube-system 14 hours ago

Well if you’re going to infect people, might as well save money while doing so :)

Comment by jjk166 14 hours ago

We sterilize plenty of other common tools like scalpels so that doesn't seem like a valid reason. Obviously the disposable design is not even an adequate solution to the risk of cross contamination. I would imagine if it were a real concern you could easily add something like a color changing strip that would indicate whether the needle has been autoclaved since its last use without rendering it useless.

Comment by NDlurker 15 hours ago

Prions aren't destroyed by autoclave

Comment by Marsymars 15 hours ago

They can "survive" autoclave cycles that render other pathogens dead/inactive, but there do exist autoclave cycles that seem to pretty reliably inactivate prions.

Comment by Loughla 15 hours ago

No but viruses and bacteria are. What's your point and how common is transmitting prions?

Comment by NDlurker 14 hours ago

My point is disposable is superior

Comment by kqgnkqgn 15 hours ago

If you can't trust them to follow the very easy directions of "throw away the single use syringe", how likely is it that they are going to follow the much more complicated process of properly sanitizing the glass syringe?

Comment by themafia 14 hours ago

> The unit costs are...high in the US

So many products are bundled into purchase agreements at hospitals that you can't, in general, sensibly talk about per-unit costs.

Comment by imtringued 8 hours ago

The unit costs per syringe are incredibly low even by Pakistani cost of living standards and the cost of reusing a syringe is extremely high.

You're coming up with an extremely complicated solution that would be a complete non-issue if the yearly salary of Pakistani citizens rose by even a single dollar.

Comment by heffert 13 hours ago

[flagged]

Comment by nameconflicts 15 hours ago

1. They're talking about the current situation, but you're bringing up history. 2. Given the lessons from the past, why would you still want to do something this dangerous?

Comment by seb1204 15 hours ago

Cost, or availability due to cost. Still a driver in developing countries.

Comment by SanjayMehta 15 hours ago

From the WHO article linked to by GP, the issue is that patients also insist on injections over oral meds.

That's driving the insistence on injections, and rural doctors/clinics cutting corners.

Comment by dwa3592 15 hours ago

I was in middle school when we were taught that used syringes were one of the causes of HIV. Can't believe a hospital would do this!!!

Comment by CGMthrowaway 15 hours ago

These are hospital volunteers reusing the syringes. There's no telling they even went to middle school.

Comment by cookiengineer 11 hours ago

[flagged]

Comment by Gud 11 hours ago

What do you mean, go wrong? God willed it.

Comment by 9 hours ago

Comment by chimineycricket 10 hours ago

Women are allowed full education in Pakistan.

Comment by cookiengineer 10 hours ago

> Women are allowed full education in Pakistan.

Malala Yousafzai might disagree with that statement. You know, because she was shot in the head for advocating education for girls/women.

Just sayin'

Comment by ffsm8 2 hours ago

Let's not get reality get in the way of their headfiction of how great Muslim rule is

Comment by geor9e 14 hours ago

There's obviously terrible procedures happening at this clinic, involving contamination, but that one video doesn't seem like the culprit. Notice he removes the needle, then injects medicine into a cannula tube, not flesh. He then re-attaches the needle, draws the second dose, and injects again. That was the problem. The narrator says he then used a brand new syringe for every child, but that initial procedure contaminated the vial. Cannula tubes are primed with saline, that's kind of a long gap for blood to travel to contaminate the vial. Yes he did it wrong, but I get why he thought it would be ok.

Comment by jaypatelani 15 hours ago

US should rather sanction Pakistan than getting IMF loan to it.

Comment by mlmonkey 15 hours ago

And what will Pakistan do with such an IMF loan? The Generals would siphon off most of it to buy their palatial Dubai houses and London condos. Until Pakistan cleans up its act, giving it more loans it throwing good money after bad.

Comment by themafia 14 hours ago

> The Generals would siphon off most of it to buy their palatial Dubai houses and London condos.

Next door to other world leaders doing the same? Is that truly our motivation for not transferring the money? Some generals might illicitly buy houses?

> Until Pakistan cleans up its act

I'm sure "The Generals" are going to help there.

> giving it more loans it throwing good money after bad.

Abandoning them entirely as hostages is not acceptable.

Comment by KetoManx64 10 hours ago

If you find it unacceptable why don't you go fly over there and do volunteet work and donate your money to fund schools and education?

Comment by themafia 10 hours ago

I had sort of hoped our Democracy would afford for a more effective approach. If you find those generals so onerous why don't you go fly over there and assassinate them?

Comment by KetoManx64 8 hours ago

[flagged]

Comment by ETH_start 15 hours ago

The parent comment is suggesting sanctioning them, not giving them IMF loans.

Comment by Dusseldorf 14 hours ago

It took me 5 rereads before I properly read "should" instead of "would", which totally flips the implication!

Comment by 15 hours ago

Comment by 13 hours ago

Comment by malfist 15 hours ago

How would sanctions help?

Comment by jaypatelani 5 hours ago

If you block loans they will try and act on trading with other countries which will be more helpful overall than just throwing money at the problem

Comment by malfist 2 hours ago

And that prevents hospitals from reusing needles, how?

Comment by halperter 15 hours ago

https://archive.is/a9p1X

Does anyone have alternative archival sites? I want to switch away from archive.today because of the uncivil behavior [1] but can't find any other archival sites that can unpaywall websites.

[1] https://arstechnica.com/tech-policy/2026/02/wikipedia-might-...

Comment by LeoPanthera 15 hours ago

Have you considered paying your way through the wall?

If you're not willing to do that, it's "uncivil" to pirate their content, wouldn't you say?

Comment by jjmarr 15 hours ago

Does the BBC even have a paywall that needs to be bypassed so people can pirate news?

Comment by LeoPanthera 15 hours ago

Currently only in the USA. You can read a few articles for free, then there is a $9/month or $50/year subscription.

It includes the website, the live streaming BBC News TV channel, and a library of documentaries.

Comment by ceejayoz 15 hours ago

I've been getting one intermittently in recent weeks on the BBC site from the US.

Comment by aussieguy1234 15 hours ago

One way to think of infection control best practice with needles like this.

The cost of a new needle, syringe or new gloves is quite cheap.

The cost of an infection is high.

The cost of a HIV infection is life altering.

So, its clear that whoever did this thought that whatever small savings they obtained from not using a fresh syringe was more important to them than the high likelihood their patients would get infections, including HIV.

Comment by kelnos 8 hours ago

Unfortunately, the person making the decision to save money on syringes isn't the one who has to bear the cost when something goes wrong.

Comment by seb1204 15 hours ago

Your cost claims need to be considered with the perspective of the country or location of the clinic.

Comment by hsbauauvhabzb 15 hours ago

And from the perspective of who pays the cost.

Comment by aussieguy1234 14 hours ago

Wherever you are, the cost of the said items is always much cheaper than the infection

Comment by calvinmorrison 15 hours ago

expect nothing less from a country that has the largest slave population in the world.

Comment by t1234s 16 hours ago

[flagged]

Comment by calmworm 15 hours ago

Or maybe better education?

Comment by ceejayoz 15 hours ago

> When we showed Buzdar our undercover footage, he insisted it had been filmed before his tenure or that it had been staged. When asked what he would say to local parents watching this footage, he said: "I can say to them with certainty, with confidence, that you should get your treatment done at THQ Taunsa."

Not gonna fix this with education if they won't admit to having a problem in the first place.

Comment by Gud 11 hours ago

It’s not going to fix this individual, but it certainly will fix the society.

Comment by plutomeetsyou 15 hours ago

or the lack of education is the cause of such denial of science.

Comment by ceejayoz 15 hours ago

If he lacked the education he wouldn’t be claiming it was fake footage.

Comment by jabedude 15 hours ago

Are you claiming that Pakistani nurses and doctors are not educated on the dangers of needle reuse?

Comment by kube-system 14 hours ago

Doctors and nurses are far from the only medical professionals who might be sticking you with a needle.

In the US your phlebotomist probably has a high school degree and a certification which required a few classes over one semester at a community college and passing an exam.

I doubt Pakistan has higher requirements than most US states do.

Comment by supjeff 15 hours ago

If they aren't educated, throw the whole thing away and start over. if they are educated, and decided to share HIV needles with children, throw the whole thing away, but put them all in prison.

Comment by esalman 15 hours ago

Someone like USAID needs to support such education with funding etc.- https://www.mtapsprogram.org/our-work/health-area/antimicrob...

Too bad Elon got rid of it.

Comment by 15 hours ago

Comment by OutOfHere 15 hours ago

If it were China, the death penalty would be guaranteed for it.

Comment by mothballed 15 hours ago

[flagged]

Comment by 15 hours ago

Comment by corndoge 15 hours ago

> They are highly distrustful in particular of people offering vaccines

FTA

> Our investigation suggests that unsafe practices are in part driven by systemic pressures including a reliance on, and cultural preference for, injections as treatment.

> Pakistan has one of the highest rates of therapeutic injections in the world, many of them medically unnecessary. Members of the general public ask for them, including for their children, and doctors happily oblige, says Mir.

Stop making shit up

Comment by mothballed 15 hours ago

[flagged]

Comment by corndoge 15 hours ago

Vax program is common knowledge, literally everyone knows about that, and it was an intelligence program not an execution campaign. Your conclusion is made up

Comment by SanjayMehta 15 hours ago

GP is using "executed" instead of "lynched."

This goes back to the polio vaccination campaign started in the 1990s. Bin Laden op happened in 2010-2011.

Polio workers were being chased away and lynched longer that. [1]

Still happening BTW [2]

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC2727330/ [2] https://www.rediff.com/news/report/polio-team-attacked-in-pa...

Comment by mothballed 15 hours ago

You're arguing against a straw man then. I didn't claim the "intelligence program" was an execution campaign against anyone but Bin Laden. The conclusion that it was a trojan horse, I think quite factual.

I did claim Pakistanis have executed vaccine workers ("circumspect people with needles").... because as I cited they have. In part because they have been used as CIA operations.

Comment by temptemptemp111 15 hours ago

[dead]