Pakistan is now home to the world’s largest population of hepatitis C patients, with nearly 10 million people infected by the virus amid rampant use of unclean needles and unhygienic health services.
Around half a million new infections were detected in Pakistan between 2015 and 2021, according to the US Centre for Disease Analysis (CDA).
The findings are the result of a two-year research and analysis conducted jointly by the CDA and Pakistan’s provincial health departments, health officials said on Friday.
“Pakistan is now home to the world’s largest population of patients living with hepatitis C, surpassing even China, India and Nigeria,” Dr Homie Razavi, an epidemiologist, told reporters.
The growing burden of the virus, which transmits through blood-to-blood contract and can cause severe liver complications if untreated, is expected to further strain a public health system identified by the World Health Organization as one of the globe’s worst.
Health experts say the reuse of needles and syringes, unscreened blood transfusions, and sharing of razors by barbers and surgical instruments by dentists are the main reasons for the spread of hepatitis C in Pakistan.
The country also has one of the highest rates for therapeutic injections per capita in the world.
“Unfortunately, we have poor infection prevention control,” said Dr Amna Subhan of Aga Khan University Hospital. “Also, pregnant women are not vaccinated for hepatitis B, resulting in transmission of the virus from mother to child.”
Disease is a ‘ticking bomb’
The recent floods have exacerbated the situation by damaging nearly 900 health facilities across the country and exposing 75,000 pregnant women to infection, officials said.
Many pregnant women were forced to give birth in partially flooded and unhygienic homes, in cramped refugee camps or in makeshift tents – often without a midwife or doctor.
Even as the government has committed to eliminating all hepatitis viruses by 2030, the growing prevalence of the disease shows that Pakistan is sitting on a “ticking bomb”, one health official told The Telegraph.
Experts attribute the persistent rise in hepatitis C cases to the absence of a comprehensive, population-wide screening programme that can identify the “missing millions of people who require treatment”.
“There are several challenges that hinder the elimination of HCV from Pakistan including the lack of patient awareness about the causes and transmission of disease, lack of affordability for investigations and drug treatment and lack of experienced healthcare professionals,” said Dr Yasir Waheed, a leading Pakistani virologist.
The lack of effective drugs and robust epidemiological data are also major contributors to the growing prevalence of the disease, he added.
In Pakistan, the control of hepatitis has so far remained a low political priority, with poor implementation of health-related policies and government-sponsored treatment programmes by the devolved provincial health ministries.
However, the establishment of the National Blood Transfusion Authority in Pakistan has been a major development that addresses one of the biggest sources of infection in the country: contaminated blood units.
But Dr Waheed believes the elimination of hepatitis from Pakistan by 2030 will be impossible under current initiatives.
“It will be a significant development if the country succeeded in reducing the annual hepatitis deaths from 200,000 to less than 25,000. The control of hepatitis epidemics requires political will, financial investment and support from pharmaceutical, medical and civil societies around the globe,” he said.
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