To give a broad overview of the ways in which inconsistent record-keeping and reporting have exacerbated the HIV epidemic in Pakistan. And how they are affecting our capacity to achieve the Sustainable Development Goals (SDGs). It is crucial to shed light on the efforts and challenges in this area because HIV is taboo in Pakistan. As the HIV rate rises and healthcare reporting in Pakistan weakens, evidence-based solutions must be developed and implemented. Disease reporting and epidemiological patterns are shifting quickly, and innovative approaches are needed to keep up. Although Pakistan is a low- and middle-income country, the SDGs would be difficult to achieve because of its financial woes and dysfunctional healthcare system. This has an overall negative impact on health care as a whole. In low- and middle-income nations like Pakistan, where there is a significant lack of data on the individuals impacted by the disease, attempting and sustaining HIV surveillance efforts requires the government’s and other donors’ engagement. Removing roadblocks to an evidence-based approach to HIV, measuring progress toward eradicating the virus, and allocating resources in light of this is an immediate necessity.