Pakistan is now home to the world’s largest population of hepatitis C patients, with nearly 10 million people infected with the virus, while rampant use of unclean needles and unsanitary health services leads to it.
According to the US Center for Disease Analysis (CDA), around half a million new infections were detected in Pakistan between 2015 and 2021.
The findings come as a result of two years of research and analysis conducted jointly by the CDA and Pakistan’s provincial health authorities, health officials said on Friday.
“Pakistan now hosts the world’s largest population of patients living with hepatitis C, surpassing even China, India and Nigeria,” said Dr. Homie Razavi, an epidemiologist, told reporters.
The growing burden of the virus, which is transmitted by blood-to-blood contract and can lead to serious liver complications if left untreated, is expected to further strain a public health system that has been rated by the World Health Organization as one of the worst in the world.
Health experts say reuse of needles and syringes, unproven blood transfusions and sharing of razors by barbers and surgical tools by dentists are the main reasons behind the spread of hepatitis C in Pakistan.
The country also has one of the highest per capita therapeutic injection rates in the world.
“Unfortunately, we have poor infection control,” said Dr. Amna Subhan from Aga Khan University Hospital. “Also, pregnant women are not vaccinated against hepatitis B, which results in transmission of the virus from mother to child.”
Illness is a “ticking bomb”
Recent flooding has exacerbated the situation, damaging nearly 900 health facilities across the country and exposing 75,000 pregnant women to infection, officials said.
Many pregnant women had to give birth in partly flooded and unsanitary houses, in cramped refugee camps or in makeshift tents – often without a midwife or doctor.
Even though the government has pledged to eliminate all hepatitis viruses by 2030, the disease’s growing prevalence shows Pakistan is sitting on a “ticking bombshell,” a health official told The Telegraph.
Experts attribute the continued rise in hepatitis C cases to the lack of a comprehensive, population-wide screening program that can identify the “missing millions of people in need of treatment.”
“There are several challenges hampering the elimination of HCV from Pakistan, including a lack of patient awareness of the causes and transmission of disease, lack of affordability for testing and drug treatment, and lack of experienced healthcare professionals,” said Dr. Yasir Waheed, one of the leading Pakistani virologists.
The lack of effective drugs and robust epidemiological data are also major contributors to the increasing prevalence of the disease, he added.
In Pakistan, hepatitis control has been a low political priority due to poor implementation of health policies and government-sponsored treatment programs by the provincial devolved health ministries.
However, the establishment of Pakistan’s National Blood Transfusion Authority was a major development that addresses one of the country’s biggest sources of infection: contaminated blood supplies.
But dr Waheed believes that eliminating hepatitis from Pakistan by 2030 will be impossible under current initiatives.
“It will be a significant development if the country manages to reduce annual hepatitis deaths from 200,000 to less than 25,000. Controlling hepatitis epidemics requires political will, financial investment and support from pharmaceutical, medical and civil society around the world,” he said.
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