The government is launching a five-year programme for prevention and control of hepatitis with a total cost of Rs 2.590 billion. The first chunk of Rs 300 million will be spent in fiscal year 2005-06. But the programme has not provided enough relief to the chronic hepatitis B and C patients. These funds are not enough for diagnoses, and treatment of hepatitis B and C as per medical professionals. Under the prevention and control programme, health departments will provide vaccination facilities to 90 per cent infants and screening of 100 per cent expecting mothers for hepatitis B & C by the year 2010.
Diagnostic facilities for hepatitis B & C will be established at all district and tehsil hospitals where treatment will also be available to vulnerable and poor class.
A recent study conducted by a group of practitioners related to catastrophic disease and organ transplant revealed that more than 80 per cent of liver cancer reported is due to hepatitis C or hepatitis B.
And 18 per cent of our general medical ward admissions are due to liver disease. In Capital City two screening labs claimed that 5 to 8 per cent of hepatitis B and C results are positive.
Meanwhile, World Health Organisation (WHO) estimated that 5 to 10 per cent of the population is carrying hepatitis B virus in their blood here. It is very disappointing to note the only effective treatment (not available in Pakistan) for advance cases of liver problems is liver transplantation.
It cost about eight million rupees for the operation abroad and about 15 to 20 thousand rupees monthly as life long recurrent maintenance cost. The over all financial implications of treatment of liver diseases are astronomical. The cost of only one drug 'Pegyland Interferon' used for the treatment of hepatitis B and C is Rs 13000 per injection and a minimum of 24 injections are required for every patient.
The study supposes if 'Interferon' injection required for the treatment of estimated hepatitis B affected population of nine million, the government needs Rs 61875 million for the treatment of 25 per cent of these patients. The cost of other required medication and investigation is over and above this expenditure. Chronic hepatitis B and C affect 90 per cent both male and females of our population at their most prime productive age resulting in tremendous loss of human resource
The effect of chronic hepatitis B and C on women (particularly child bearing age) and children are more drastic. 95 per cent of children born of hepatitis B positive mothers carry the virus in their blood. These children have less than 10 per cent lifetime chance of spontaneous clearance of hepatitis virus from their body and are thus potential risk to themselves and others
The risk of transmission of hepatitis B through sexual contact is very high. More than 25 per cent of husbands according to a study may get the disease through this route. Hepatitis C is also transmitted through sexual route and vertical transmission but to a lower degree comparing to B. In addition many other genetic and acquired liver diseases are resulting in ever increasing mortality and morbidity in patients.
Unfortunately, there is no systematic effort to control this disease and to do indigenous research on this problem. Some NGOs and local governments are making individual efforts at present but there is lack of a national policy or strategy to combat this problem. There is even no national pool data or survey which could clearly and scientifically explain the magnitude of the problem, risk factors of the disease and other important relevant information.
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