Major HIV/AIDS Survey in Pakistan Deemed Unreliable, Faces International Condemnation

ISLAMABAD (Nadeem Choudhary) A landmark national study on HIV/AIDS, which cost the national exchequer over one billion rupees, has been declared methodologically flawed and unreliable by international partners and government officials, casting a shadow over the country’s efforts to combat the epidemic.

The Integrated Biological and Behavioral Surveillance (IBBS) Round 6, intended to assess HIV prevalence among key populations, is now at the center of a storm of criticism from UNAIDS, The Global Fund, and the UNDP, its primary funder.

According to a critical review of the report, the survey, executed by the Health Services Academy (HSA), heavily relied on “estimations and aggregated data” instead of individual, linked HIV test results. This fundamental deviation from global standards has been described as a flaw that “significantly undermines the credibility and utility of the data collected.”

Serious questions have also been raised about the survey’s execution. The data collection process, which included over 20,000 interviews and HIV tests, was completed in a mere ten days—a timeframe experts call “unfeasible” for a study of this scale and complexity. Furthermore, the tools used for data collection were not piloted in the field, further compromising the reliability of the findings.

In a significant blow, The Global Fund has expressed that the survey “lacks clarity and transparency” and has declined to release further funding for a third-party validation. The organization’s support was channeled through the United Nations Development Programme (UNDP).

A senior official from the Ministry of National Health Services, Regulations and Coordination, speaking on condition of anonymity, confirmed that due to the survey’s failure to meet standard research criteria, the Ministry is unable to endorse its findings.

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“The complexity of the concerns warrants a more measured approach,” the official stated, referring to initial recommendations to resolve the issues within one month. The official also revealed a “lack of technically competent personnel” to rectify the process’s flaws internally.

Attempting to salvage the situation through an external audit presents its own challenges. Officials estimate that a third-party validation would take more than eight months and consume a significant portion of the project’s remaining funds, without any guarantee of a conclusive outcome.

“In light of the urgency, a detailed review has been conducted, including a meeting with Dr. Rahim from CMU,” an internal document notes. The findings are now open for corrections from relevant parties.

Faced with this impasse, some stakeholders are suggesting a middle path. Instead of a costly and time-consuming re-validation, there is a proposal for the Ministry to endorse the survey with clear, stated limitations, and to align its use with a consultative forum to discuss the concerns raised.

This controversy highlights a critical need for a comprehensive overhaul in how such vital public health data is collected. As one expert involved in the review noted, “Collaboration among stakeholders, transparency in data collection, and adherence to methodological standards are essential for ensuring the integrity of HIV-related data and its implications for public health programming.”
For a stance on the substandard nature of the HIV/AIDS survey, repeated attempts were made to contact the Vice Chancellor of the Health Services Academy, Dr. Shahzad Ali Khan. However, no response was received from him.

The email sent for a response was also copied to the Secretary of National Health Services, but no reply was received from his office either.