Pakistan, a nation grappling with numerous public health challenges, has now found itself at the epicentre of a global hepatitis C crisis.
According to government officials, the country bears the highest number of hepatitis C cases in the world.
This staggering burden underscores systemic failures within the healthcare infrastructure, reflecting an urgent need for comprehensive reforms to address not only hepatitis C but also other public health crises, such as polio eradication.
Hepatitis C, a viral infection primarily affecting the liver, is preventable and treatable.
Yet, in Pakistan, an estimated 10 million people are infected with the virus, and thousands more are added to this number each year.
The high prevalence rate is fuelled by factors such as unsafe medical practices, reuse of syringes, poor screening protocols for blood transfusions, and a lack of public awareness.
Faisal Sultan, Pakistan’s Prime Minister’s aide on health, recently described the situation as a “national health emergency.”
This declaration is not surprising, given the virus’s potential to cause severe liver damage, cirrhosis, and liver cancer if left untreated.
Despite the availability of highly effective direct-acting antiviral (DAA) drugs, which can cure the infection in over 90% of cases, access remains a significant barrier for millions of Pakistanis.
Pakistan’s struggle against hepatitis C is reminiscent of its long-standing battle with polio.
Despite decades of efforts, the country remains one of only two in the world where polio remains endemic.
The common thread between these crises is the fragmented healthcare infrastructure, characterised by inadequate funding, lack of trained personnel, and insufficient coordination among health departments.
Both diseases also share a history of mistrust and misinformation.
In the case of polio, vaccine hesitancy fuelled by conspiracy theories has hindered immunisation campaigns.
Similarly, a lack of awareness about hepatitis C and misconceptions about its transmission perpetuate risky behaviours and delay treatment.
Pakistan’s healthcare system faces chronic issues that exacerbate the hepatitis C crisis.
Public health facilities are underfunded and overcrowded, forcing many patients to turn to private healthcare providers who often lack regulation.
This leads to unsafe medical practices, such as the reuse of syringes and improper sterilisation of surgical instruments, which are major contributors to the spread of hepatitis C.
Moreover, preventive measures, such as routine screening for blood donors and public health campaigns to educate communities, are either inadequate or absent.
The absence of a robust primary healthcare network means that early diagnosis and treatment are often delayed, allowing the disease to progress unchecked.
Economic disparities further compound the crisis.
The cost of treating the disease, which includes diagnostic tests, antiviral medications, and follow-up care, is beyond the reach of most Pakistanis.
A significant portion of the population lives below the poverty line and relies on public healthcare facilities that are already stretched thin.
This financial strain exacerbates inequality, as those who can afford private healthcare are more likely to receive timely and effective treatment.
Moreover, the economic burden extends to lost productivity. Hepatitis C often progresses to chronic liver disease, significantly impairing an individual’s ability to work.
This loss of productivity not only affects families but also hampers the country’s overall economic growth.
Although the government has initiated programmes to provide free or subsidised DAAs, the scale of these initiatives is insufficient to meet the demand.
Additionally, healthcare facilities in rural areas are scarce and poorly equipped, leaving millions of people without access to basic medical care.
Women and marginalised communities are particularly vulnerable, as cultural and logistical barriers often prevent them from seeking timely treatment.
The hepatitis C crisis in Pakistan has drawn attention from global health organizations, including the World Health Organization (WHO) and the United Nations.
These organizations have emphasised the importance of implementing comprehensive strategies to tackle the epidemic, such as improving infection control practices, expanding access to DAAs, and enhancing public awareness campaigns.
The international community has also recognised the potential spill-over effects of Pakistan’s health crisis.
With millions of Pakistanis living and working abroad, the unchecked spread of hepatitis C poses a global health risk.
Addressing the hepatitis C crisis requires a multifaceted approach that tackles the root causes of the problem while ensuring immediate relief for those affected.
Political will and leadership are also critical to addressing the hepatitis C crisis.
The Prime Minister’s acknowledgement of hepatitis C as a national emergency is a step in the right direction, but concrete actions must follow it. This includes setting measurable targets, monitoring progress, and involving all stakeholders, including civil society, healthcare professionals, and international partners.
Countries like Egypt have successfully tackled hepatitis C through comprehensive national programmes.
Egypt’s initiative included mass screening campaigns, subsidised treatments, and strong government commitment, resulting in a significant decline in hepatitis C cases.
Pakistan can adapt similar strategies to its unique context, leveraging its existing healthcare infrastructure and community networks.
The alarming prevalence of hepatitis C in Pakistan is a wake-up call that demands immediate and sustained action.
This crisis not only threatens the health and well-being of millions but also underscores the broader systemic failures within the country’s healthcare system.
As the nation grapples with this public health emergency, it is imperative to remember that hepatitis C is both preventable and treatable.
“Pakistan must adopt a proactive and sustained strategy to tackle this growing menace. This includes widespread public awareness campaigns, improved healthcare accessibility, and stringent regulation of medical practices to prevent unsafe injections and blood transfusions,” according to an editorial published in one of Pakistan’s leading English daily The Nation. “Ignoring these steps will only accelerate the decay of public health and further erode Pakistan’s standing in the global community,” it added.
