A major public health threat

EDITORIAL: It is worrying enough that Pakistan remains one of the two countries where poliovirus is still prevalent, added to it is the World Health Organisation’s finding that after Egypt this country has the world’s second highest incidence of hepatitis B and C — a major public health threat. Between them the two countries share a staggering 80 percent of the global burden of hepatitis infections.

Now a report prepared by Punjab government’s Planning and Development Board (P&DB) on the Prevention and Control of Hepatitis Programme in Punjab has come up with disturbing information; in all probability, the situation in other provinces is not very different. It shows that so far mitigation strategies have made little progress.

According to the report, during the last four years (2017-2021), a total of 1,634,614 individuals were registered at various hepatitis clinics, established under the project across the province for the treatment of hepatitis B and C (HBV & HCV), family screening and HBV vaccination. Of them, 255,482 HCV and 22,826 HBV patients were treated, which is a desperately low number. Furthermore, notes the report, as per the project data, current annual average of treatment of HCV cases is around 64,000, which is only around 8 percent of the actual target, i.e., 812,900 cases per year. These are pretty astounding figures; the actual numbers though may be much higher.

At this rate the chances look bleak of Pakistan meeting the World Health Organisation’s target of eliminating viral hepatitis by reducing HCV incident by 80 percent and mortality by 65 percent in Pakistan by no later than 2030. Further complicating matters is a high percentage of patients who drop out of treatment. As per the P&DP report findings, only about 50 percent of HCV and 24 percent of the HBC patients received treatment after initial diagnosis.

The danger of massive transmissions has increased by the same proportion, putting millions of people at grave risk of contracting these lethal viruses. This menace to public health needs to be countered in all its manifestations on a priority basis. That may be a challenging task considering resource constraints and the huge allocations the project requires. Nonetheless, the government can, and should, try to countervail that demand with effective prevention and control measures. Experts suggest comprehensive screening in higher prevalence groups, such as people who inject drugs and those looking after patients in families.

A significant cause of these infections is also unscreened blood transfusions. Clinics and hospitals must be strictly checked for careless, unethical practices. Then there are unsuspecting individuals who catch these lethal viruses from barber shops and ear/nose piercing facilities as well as those living with infected marital partners. It is imperative therefore for all provincial governments to run public awareness campaign on a continual basis to deter risky behaviour. The time to act is now to rid this country of HCV and HBV.

Copyright Business Recorder, 2022