Approximately 5 million and 10 million people in Pakistan are affected with hepatitis B and C respectively, which are key causes of liver cirrhosis and cancer.
To curb the huge disease burden, the government has announced the Prime Minister's Programme for Hepatitis to eliminate viral hepatitis B and C infections from the country by 2030. 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, Regulatio
AKU's Professor Saeed Hamid shares statistics about the burden of the disease in the country. Photo: AKU.
ns and Coordination (NHSRC), government of Pakistan, Aga Khan University and the World Health Organization (WHO).
Thousands of people contract the disease every year due to lack of prevention, testing and treatment resources as well as inadequately screened blood transfusions, improperly sterilised invasive medical devices and unsafe injections. Aiming to provide leadership and coordination to provincial programmes, the Prime Minister's programme will include six key interventions, including free
"
"
screening of over 140 million people, and new national plans for injection safety and safe blood transfusion.
The implementation will be overseen by the newly created NHSRC national task force and the initiative falls in line with the University's commitment to achieving targets under the global sustainable development goals which call for the eradication of hepatitis by 2030.
Dr Arif Alvi, Honourable President of the 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 tipping point has come as the Prime Minister himself is concerned about these issues. Although there is a huge task before us, but it is doable," said President Alvi.
"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 interventions launched today," said Dr Zafar Mirza, minister of state for 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 curing a case of hepatitis C could be as high as US$ 15,000 in a country like the US.
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. Hepatitis B can be fully prevented with vaccine but since there is no vaccine to prevent hepatitis C, the risk factors leading to new infections need to be avoided at all levels. Despite these challenges, Pakistan was chosen as host of this year's global event in the country.
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 outreach capabilities."
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 to 3 years as they get access to testing and treatment very late. According to WHO, 23,720 people died of hepatitis-related causes in Pakistan in 2016, equivalent 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. In a video message for the event, WHO Director-General Dr Tedros Adhanom Ghebreyesus congratulated Pakistan's high political leadership on the Prime Minister's initiative.
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.
WHO EMRO Regional Director Dr Ahmed Al-Mandhari also acknowledged Pakistan's political leadership in responding to its hepatitis scourge, and said that Pakistan's efforts could serve as a positive example for other countries in the region.
On the occasion, provincial health ministers and secretaries, provincial hepatitis control programme managers, members of the National Technical Advisory Group, researchers, policymakers and civil society activists also pledged their support to the cause.
