Approximately, 5 and 10 million people are affected with hepatitis B and C respectively in Pakistan. Thousands of new patients are added every year due to lack of prevention, testing and treatment resources as well as inadequately screened blood transfusion, improperly sterilized invasive medical devices and unsafe injections.
To curb the huge disease burden, the government has announced Prime Minister Imran Khan’s new ambitious plan to eliminate viral hepatitis B and C infections in the country by 2030. The programme aims to provide leadership and coordination to provincial programmes in scaling up hepatitis prevention, testing and treatment services.
The announcement was made at an event as part of the World Hepatitis Day 2019 global campaign, jointly organised by the Ministry of Health Services, Regulations and Coordination (NHSRC), Government of Pakistan, the Aga Khan University and the World Health Organization (WHO).
Despite challenges, Pakistan demonstrated high political commitment that led WHO to host this year’s global event in the country.
Dr Arif Alvi, Honourable President of Islamic Republic of Pakistan and the chief guest on the occasion lauded international partners and key national health policymakers for their commitment in this regard. “The Prime Minister’s plan is a step forward toward improving healthcare in the country and achieving the United Nations’ Sustainable Development Goals in the long run,” said President Alvi.
Unnecessary injections are widespread and shockingly high numbers of untrained healthcare professionals are delivering such injections to unsuspecting people in Pakistan.
People who inject drugs are highly affected but do not have access to prevention programmes that can help them stop onward transmission. As there is no vaccine to prevent hepatitis C, the risk factors leading to new infections need to be avoided at all levels. Hepatitis B can be fully prevented with vaccine.
In support of the Prime Minister’s initiative, NHSRC also announced new national plans for injection safety, safe blood transfusion, and national infection control guidelines. The implementation will be overseen by the newly created National Task Force of the Ministry.
“Every one of us has a role to play in eliminating hepatitis in Pakistan. We have political will and policy tools to stop hepatitis at its roots, particularly, by improving the state of poor injection safety through implementing the new policies launched today,” said Dr Zafar Mirza, Special Assistant to Prime Minister on Health. “Turning this into success will require partnerships and collaboration, and I hope our global, regional and local partners will join Pakistan in investing to eliminate hepatitis.”
Although Pakistan produces cheaper medicines to cure hepatitis C infection, with a very low cost of US$20 per cure within three months, very few people in the country know of their infection, and therefore, do not access testing and treatment services. The cost of cure for hepatitis C could be as high as US$15,000 in a country like the US.
Hepatitis B and C infections are transmitted primarily through blood and are key causes of liver cirrhosis and cancer.
The number of annual liver cancer cases reported at the Aga Khan University Hospital have increased three-fold over the past 20 years, informed Dr Adil Haider, dean of AKU Medical College. “We stand ready to support the government in its commendable efforts to eliminate hepatitis from Pakistan by offering our expertise and countrywide out-reach capabilities,” said Dr Haider.
As most people living with hepatitis remain unaware, they could require repeated hospitalisation, expensive medicines and liver transplants, causing major financial burdens on their families as well as health systems. In many cases, patients die within 1–3 years as they get the access to testing and treatment very late. According to WHO, 23,720 people died of hepatitis-related causes in Pakistan in 2016, which compares to a bus full of 64 people every day.
A new study released by WHO shows that investing in eliminating hepatitis can bring cost savings, because instead of paying for long-term care required for liver cirrhosis and cancer, people would access hepatitis testing, treatment or cure while they are healthy.
The WHO expressed its full support to the Government of Pakistan in implementing its plans to eliminate hepatitis B and C epidemics. WHO Director-General Dr Tedros Adhanom Ghebreyesus congratulated Pakistan’s high political leadership and the Prime Minister’s initiative, in his video message to the event.
The WHO Assistant Director-General for Universal health coverage for communicable and noncommunicable diseases, Dr Ren Minghui underlined the importance of using many existing opportunities and innovations that can support Pakistan achieve its ambitious but necessary goals.
The Regional Director of WHO EMRO Dr Ahmed Salim Saif Al-Mandhari also acknowledged Pakistan’s political leadership in responding to it hepatitis scourge, and said that Pakistan’s efforts could serve as a positive example for other countries in the region, which has the highest prevalence of hepatitis C in the world and ranked second for the size of hepatitis B hepatitis.
On the occasion, provincial health ministers and secretaries, provincial hepatitis control programme managers, members of National Technical Advisory Group, researchers, policy makers and civil society activists also pledged their support to the cause.