Viral hepatitis (hepatitis B and C) is one of Pakistan’s most serious public-health threats—and also one of the most solvable. New data from global and regional agencies show that infections and deaths remain high worldwide, yet countries that scale up smart, simplified strategies are bending the curve. For Pakistan, the path to elimination runs through testing at scale, fast linkage to curative treatment (for HCV), lifelong care (for HBV), safe injections and blood, and newborn protection with the hepatitis B birth dose.
Pakistan carries a disproportionately high burden. Recent analyses estimate ~9.8–10 million people living with chronic hepatitis C (HCV)—placing Pakistan among the very highest-burden countries globally. Regional WHO materials further note that the Eastern Mediterranean Region has the highest global HCV prevalence, with Pakistan estimated around 4.1%—well above regional averages. Meanwhile, WHO’s country page for Pakistan has long sign-posted ~12 million people living with hepatitis B or C and ~150,000 new infections annually, much of it from unsafe health-care practices.
What “elimination” means (and why it matters)
The WHO 2030 elimination targets aim to reduce new infections by 90% and deaths by 65% versus 2015 baselines. The 2024 WHO report is blunt: even as vaccination and direct-acting antivirals (DAAs) expand, 1.3 million people still die every year—about 3,500 deaths daily—and only a fraction of those infected are diagnosed or treated. For Pakistan, elimination means fewer families losing loved ones to preventable liver failure and cancer, and fewer people infected in clinics due to unsafe procedures.
The good news: Pakistan’s momentum is real
1) A national plan with ambitious screening targets
In 2024, the federal government re-committed to HCV elimination, announcing national targets to screen half the eligible population by 2025 and the rest by 2030, with a step-wise “test-and-treat” approach across provinces. Recent national profiles summarize this Phase-1 (to 2025) and Phase-2 (to 2030) plan and emphasize rapid linkage to treatment.
2) Launch of the Prime Minister’s Hepatitis C Elimination Programme
A 2024 programme announcement set aside PKR 68.25 billion for nationwide screening and treatment (Phase-1 in 2024–27; follow-on through 2030), led by the Ministry of National Health Services with federal and provincial co-financing. This is a rare, large-scale investment in public health—and exactly the kind of financing WHO says is required to hit 2030 goals.
3) Affordable cures and new delivery models
Pakistan benefits from generic DAAs (e.g., sofosbuvir-based regimens), whose prices in LMICs have fallen dramatically—making mass treatment plausible when procurement and logistics are organized. New local initiatives (e.g., door-to-door or community-based screening pilots) show how to find undiagnosed infections outside hospitals.
“Get tested and treated quickly” → ACMC Laboratory Services (HCV antibody, HCV RNA/antigen)
“Specialist hepatitis care” → ACMC GI & Liver Clinic (staging, treatment, follow-up)
The hard part: what’s still holding us back
1) Unsafe injections and infection control
WHO and EMRO continue to spotlight unsafe therapeutic injections and blood practices as major drivers of Pakistan’s new hepatitis infections. One 2025 update estimates ~110,000 new HCV infections per year in Pakistan—~62% linked to unsafe medical injections (including transfusion practices) and 38% to injection drug use. Ending syringe/needle reuse and improving sterilization in clinics, dental settings, dialysis, and barber shops remain non-negotiable.
2) Hepatitis B birth dose is not yet universal
Pakistan’s EPI schedule provides hepatitis B as part of the pentavalent series at 6, 10, and 14 weeks, not a universal birth-dose (within 24 hours)—leaving a critical 6-week window of vulnerability to perinatal/early-life infection. WHO and partners continue to call for HepB-BD introduction; Pakistan-based studies suggest adding a birth dose is feasible and immunogenic. Gavi’s 2024 programme now offers funding support to countries that apply.
3) Diagnosis and treatment gaps
Globally, most countries still miss the 60% diagnosis and 50% treatment coverage targets. Pakistan’s challenge is scaling up confirmatory testing (RNA/core antigen), same-day treatment starts, and tracking outcomes in a robust registry so that procurement matches need.
4) Health-system friction
Experts highlight financing continuity, supply chains, lab quality assurance, workforce training, and data systems as barriers. Without harm-reduction services for people who inject drugs and screening in antenatal care, elimination will lag.
What will accelerate elimination (practical playbook)
A) Make testing routine—and simple
- Screen once, act fast: Use HCV antibody with reflex RNA or core antigen so patients avoid multiple visits.
- Point-of-care where possible: Mobile/community testing to reach rural women, youth, and men who avoid hospitals.
- Integrate testing into TB, HIV, dialysis, antenatal, surgical, and diabetes clinics.
B) Treat at scale with a “public health” model
- Pangenotypic DAAs (e.g., sofosbuvir + daclatasvir or velpatasvir) enable simplified regimens with minimal monitoring—vital for rural Pakistan.
- Decentralize prescription authority to trained primary-care clinicians; send only complex cases to tertiary centers.
- One-visit start (test-treat the same day) reduces loss to follow-up.
C) Protect every newborn with HepB-BD
- Introduce universal HepB birth dose within 24 hours alongside existing EPI pentavalent doses. This is among the highest-impact HBV interventions to reach 2030 targets.
D) Safer care, everywhere
- Zero reuse of syringes/needles; enforce single-use auto-disable devices; train and audit clinics and dental practices.
- Blood safety: scale nucleic acid testing (NAT) where feasible; tighten regulation of private blood banks; standardize donor screening.
- Harm reduction: needle-syringe programmes and opioid-substitution therapy for PWID.
E) Data that drives delivery
- National hepatitis registry to follow patients from screening → confirmation → treatment → cure (SVR) and to forecast drug/lab supplies.
- Dashboards shared with provinces to track coverage, stockouts, outcomes.
“Screen today, don’t wait” → ACMC Laboratory Services
If you need “Personalized follow-up” → ACMC Preventive Health Programs (adherence, side-effect support, family testing)
What this means for families in Pakistan
- Hepatitis C is curable in 8–12 weeks for most patients with modern DAAs. Early treatment prevents cirrhosis and liver cancer.
- Hepatitis B is preventable and controllable: newborn birth-dose, full infant vaccination, and lifelong antiviral therapy when indicated.
- Most new infections are avoidable: choose clinics that use new, sealed syringes, insist on single-use instruments or proper sterilization, and avoid unnecessary injections.
At ACMC, our hepatology team offers same-day testing, fast linkage to therapy, and specialist follow-up (including FibroScan for liver stiffness when needed). If you or a family member has ever received injections in informal settings, had a blood transfusion, is pregnant, or has abnormal liver tests—get screened.
Frequently Asked Questions (FAQs)
1) Is Pakistan on track to eliminate hepatitis by 2030?
Pakistan has major momentum—a funded national HCV programme and ambitious screening targets to 2025/2030—but must close gaps in confirmatory testing, treatment coverage, HepB birth-dose introduction, and injection/blood safety. The direction is right; the pace must quicken.
2) How many people in Pakistan live with hepatitis B or C?
WHO and regional materials indicate ~12 million people in Pakistan live with HBV or HCV combined; HCV alone is commonly estimated near 9.8–10 million, among the largest burdens globally.
3) Why do new infections keep happening?
Unsafe medical injections and transfusion practices remain dominant drivers of new HCV infections in Pakistan, alongside injecting drug use. Eliminating syringe reuse, enforcing sterilization, and improving blood-bank screening are essential.
4) What about the hepatitis B birth dose—does Pakistan give it?
Not yet universally. Pakistan’s EPI delivers hepatitis B within pentavalent vaccines at 6, 10, 14 weeks, but no universal dose at birth—the WHO-recommended shield within 24 hours. Introducing HepB-BD would close a critical prevention gap.
5) Are hepatitis C medicines affordable in Pakistan?
Yes—generic DAAs are available and costs in LMICs have fallen sharply, enabling large-scale treatment when procurement/logistics are organized. Your ACMC clinician will advise the right regimen and monitoring plan.
6) What should my family do today?
- Get tested at a reliable center (HCV antibody with reflex RNA/core antigen; HBsAg for HBV).
- Treat immediately if HCV is confirmed—cure prevents complications and stops transmission.
- Vaccinate newborns and unvaccinated family for HBV; ask your maternity facility about birth-dose readiness.
- Demand safe care: always ask for new, sealed syringes and proper sterilization.
Bottom line
Pakistan can beat hepatitis—the tools exist, and the commitment is visible. To finish the job, the country must normalize testing, start treatment the same day, introduce the HBV birth dose, and end unsafe injections. For individuals and families, the message is simple: test early, treat fast, and choose safe care. ACMC is here to help you do exactly that—today.
Key sources for figures and policy statements include WHO’s 2024 Global Hepatitis Report and 2025 updates; EMRO/WHO Pakistan materials on burden, unsafe injections, and the HepB birth dose; and national elimination profiles summarizing Pakistan’s 2024 recommitment and targets.
