THIS is with reference to the article `Collapse and consequences` (Aug 7), which rightly diagnosed a healthcare system in freefall. Citing thousands of children infected with HIV through reused syringes alongside a staggering 10 million hepatitis C cases, the article highlighted a crisis of national proportions. However, by framing this solely as a political and structural failure requiring a top-down reset, it overlooked a far more uncomfortable truth: the moral and professional breakdown seen in our hospitals every single day.

Attributing the spread of blood-borne pathogens primarily to needle reuse is a dangerous oversimplification. Unsterilised surgical tools, contaminated IV sets, unsafe dental equipment, and unmonitored blood banks are actively transmitting disease. When an infant is incidentally found HCV-positive because her mother received unchecked routine injections during pregnancy, and is then wrongly advised against breastfeeding, we are not merely witnessing a funding shortfall.

We are seeing a complete collapse of clinical standards and basic patient care.

It is convenient to blame political appointees who often lack medical literacy.

But politicians do not run our wards or manage our clinics. The true custodians of this health system are the medical think tanks, senior professors, department heads and programme directors who have presided over decades of decay. Writing op-eds after retirement and falling from power does not absolve the technocratic elite who once held power, controlled budgets and failed to enforce accountability on their watch.

Systemic reforms and political consensusmean nothing if the culture within our medical institutions remains indifferent.

Real protection for our children will not come from legislative slogans or foreign aid. It will begin only when healthcare leaders enforce zero-tolerance infection control in their own units, hold negligent staff members accountable, and strictly restore professional ethics to the bedside.

Dr Suleman Daud Khan Peshawar