ISLAMABAD - World Hepatitis Day is being observed today across the world to highlight the seriousness of the disease but in Pakistan, currently facing an epidemic of Viral Hepatitis, the government has no time to make operational its Hepatitis Control Programme that has been virtually halted.

“Currently the National Hepatitis Control Programme stands nowhere. The programme at the federal level has been stopped as the government has failed to place the programme under any ministry,” informed an official requesting not to be named. Initially, after the devolution the programme was attached with the Ministry of Inter-Provincial Coordination and Ministry of Capital Administration and Development for few months, but now bureaucratic hurdles and tug of war between the various ministries over the control of the programme has made the programme completely non-functional at the federal level, he added. According to officials, since June 2011 there has been no activity at the federal level and, though, the provinces have been getting their funds from the federal government and through NFC Award as well and officials of the programme have also been drawing their salaries but factually the programme is not operational at the provincial level too and the ultimate sufferers are the patients.

In the fiscal year 2011-12 the national programme was allocated Rs. 10 million that could not be spent in the pretext of devolution. This fiscal year 2012-13 the programme has been earmarked Rs.684 million but the officials remain unclear about the distribution of funds among the provincial and the federal programme. There is no national focal point or organization at the federal level as well where data from all the provinces can be gathered and used for adequate surveillance systems to take evidence-based policy decisions.

Since 2011, World Hepatitis Day has been celebrated annually on 28 July. This year, the slogan of World Hepatitis Day is ‘Hepatitis, it’s closer than you think. Know it. Confront it’. The key message of the second World Hepatitis Day is that hepatitis is a preventable disease. Everyone can get this disease, yet it rarely affects those who consciously guard against it.

According to World Health Organization (WHO) Pakistan is currently facing an epidemic of Viral Hepatitis in the country and national prevalence of Hepatitis B is 2.4%, national prevalence of Hepatitis C is 4.9 % and currently there are 12 million persons infected with this disease in the country.

Main reasons for the spread of this disease are frequent use of therapeutic injections, re-use of syringes, inappropriate sterilization practices and hospital waste management. It is caused by a group of viruses that infect the liver through either consumption of contaminated food and water or exposure to unsafe blood and infected body fluids.

According to Dr. Waseem Khawaja, spokesperson of Pakistan Institute of Medical Sciences (PIMS), Department of Gastroenterology of the hospital daily treats 350 to 400 hepatitis patients. As many as 60% of the OPD patients are of hepatitis patients in its various stages.

About 3500 patients of hepatitis C at PIMS have been receiving free interferon therapy from zakat and Pakistan Baitul Mal funds and 2100 endoscopies are done to treat the complications of hepatitis patients, Dr. khawaja said. And 2300 patients have been admitted and treated in gastro ward with complications of hepatitis like bleeding, drowsiness, infections and coma, since January1, 2012.  

According to him 5%of emergency in the hospital is occupied by hepatitis C patients with complications. Prof. Dr. Tashfeen Adam, Head Department of Gastroenterology, said strict laws should be made to end quackery in Pakistan so that the patients can be treated by qualified specialists. He said hepatitis C and B can lead to liver cancer if not treated properly and 25% more patients of hepatitis care reporting this year as compared to the previous year due to increasing awareness among people. Viral hepatitis is a global public health problem affecting millions of people every year, causing disability and death. The group of viruses (hepatitis A, B, C, D and E) that cause acute or chronic infection and inflammation of the liver give rise to a major global public health problem.

Viral hepatitis affects 1 in every 12 people worldwide. It affects those close to them too. Around 500 million people worldwide are chronically infected with two types of blood-borne hepatitis: hepatitis B and C. Approximately 1 million people die each year from related complications, most commonly from liver diseases including liver cancer, according to WHO.

Health experts say ‘We are experiencing a silent epidemic today. Affordable measures, such as vaccination, safe blood supply, safe injections, and safe food, can reduce the transmission of viral hepatitis infections’.

Dr Ala Alwan, WHO Regional Director for the Eastern Mediterranean, stressed that the chronic nature of hepatitis B and C infection calls for strong focus on screening, care and treatment. With early detection and appropriate management, it is possible to change the quality of life of millions of people who are living with this disease.

‘The good news is that there is an effective vaccine for preventing hepatitis B. As of 2011, 17 out of 23 countries in the Region have included the hepatitis B vaccine in their immunization programmes. Over 80% of infants in these countries have received 3 doses of the vaccine, which will provide them with lifelong protection from hepatitis B infection. We are working with the remaining countries in the Region to help protect their people in the near future,” said Dr Alwan.