Hepatitis crisis

Pakistan is in the grip of a hepatitis crisis of staggering proportions. With an estimated 12 to 15 million people infected with hepatitis B or C, the country carries one of the heaviest hepatitis C burdens in the world. What makes it worse is that new infections could be cut significantly simply by following basic medical safety practices. As things stand, Pakistan ranks among the top five countries globally for hepatitis burden, with nearly 10 million people living with hepatitis C and approximately 4 million with hepatitis B. Each year brings an estimated 110,000 to 150,000 new infections, and complications from the disease claim over 37,000 lives annually. A Punjab-centric study last year found hepatitis C prevalence rates as high as 42.7% among certain risk groups.

The major causes of hepatitis transmission in Pakistan are all easily preventable. Unsafe medical injections account for 62% of new hepatitis C infections, with reuse of non-sterile syringes, improperly sterilised equipment and unscreened blood transfusions cited in studies. Barbershops using unsterilised razors and quacks operating without oversight are also cited, along with lax infection control at various levels in the formal healthcare system. Lack of public awareness is also a problem. Only 25% to 30% of carriers know they are infected, which is further compounded by the fact that many in the general population don't know how the diseases spread.

The government has launched an ambitious National Programme for the Elimination of Hepatitis C, which aims to screen over 164 million people and provide free treatment. The programme has already mobilised significant domestic funding, and the WHO has pledged full support. Health officials say that with full commitment, Pakistan could eliminate hepatitis C within a decade.

But ambition without execution is merely theatre. Previous hepatitis programmes have failed due to mismanagement, lack of transparency and dependence on costly imports. Eliminating hepatitis is not about crafting new plans. It demands rigorous enforcement of every aspect of the plan.