Dr Bilawal Kamran
Every year, World Hepatitis Day offers governments an opportunity to reflect on their progress against one of the world’s most preventable and treatable public health threats. In Pakistan, however, this year’s observance has once again exposed a disturbing reality. The latest figures released by the Pakistan Medical Association (PMA) paint a bleak picture of a country struggling to contain an epidemic that has already reached alarming proportions. These numbers should not be viewed as routine health statistics. They represent millions of lives affected, thousands of families devastated, and an enormous economic burden that continues to grow because of official neglect and weak governance.
Pakistan now ranks among the countries carrying the heaviest burden of viral hepatitis in the world. Even more troubling is its position as the largest reservoir of Hepatitis C infections globally. Nearly 13.8 million Pakistanis are living with chronic Hepatitis B or Hepatitis C, while more than 37,000 people lose their lives every year to complications such as liver cirrhosis and liver cancer. These are not unavoidable deaths. Modern medicine has already provided the means to prevent, diagnose, and, in the case of Hepatitis C, cure the disease. The persistence of such staggering numbers reflects a failure of policy implementation rather than a lack of medical knowledge.
The tragedy lies in the fact that hepatitis is largely preventable. Hepatitis B can be effectively controlled through timely vaccination, especially when administered at birth, while Hepatitis C can now be cured with highly effective antiviral medicines. Many countries have significantly reduced infection rates through strong vaccination programmes, strict infection-control standards, and widespread public awareness. Pakistan, unfortunately, continues to witness approximately 110,000 new Hepatitis C infections every year, demonstrating that preventive measures remain inadequate and poorly enforced.
The principal reason behind the continuing spread of hepatitis is not the absence of treatment but the unsafe practices that have become deeply embedded within the healthcare system. The repeated use of disposable syringes, poor sterilization of surgical and dental instruments, unsafe injection practices, and inadequately screened blood transfusions continue to expose millions of Pakistanis to infection. These are failures of regulation, supervision, and accountability rather than limitations of medical science. A healthcare system that permits such practices to persist cannot claim to be protecting public health.
The problem extends well beyond hospitals and clinics. Across the country, countless dental clinics, barber shops, beauty salons, and cosmetic treatment centres operate without proper hygiene standards. Reused blades, unsterilized instruments, and unsafe cosmetic procedures have become common sources of infection. Meanwhile, thousands of unqualified medical practitioners continue to operate openly despite repeated promises by governments to eliminate quackery. Weak enforcement allows these illegal practices to flourish, placing public safety at constant risk.
Pakistan’s regulatory institutions have failed to exercise effective oversight over both public and private healthcare facilities. Licensing authorities often lack the capacity or the political backing needed to enforce safety standards consistently. Inspections are irregular, penalties are rarely imposed, and violations frequently go unpunished. As a result, unsafe medical practices become routine rather than exceptional. Until regulatory agencies are empowered, adequately staffed, and held accountable for performance, the cycle of infection will continue.
The economic consequences of viral hepatitis deserve equal attention. Chronic liver disease imposes enormous costs on families already struggling with inflation and limited access to healthcare. Long-term treatment, repeated hospital admissions, loss of productivity, and premature deaths collectively reduce national economic output. Many patients are diagnosed only after severe complications have developed, making treatment significantly more expensive and less effective. Investing in prevention is therefore not only a public health necessity but also a sound economic strategy.
Public awareness remains another weak link in Pakistan’s response. Many citizens remain unaware of the ways hepatitis spreads or mistakenly believe that only high-risk groups are vulnerable. In reality, ordinary medical procedures, dental treatments, blood transfusions, ear piercing, tattooing, and even a shave at an unhygienic barber shop can transmit the virus if proper precautions are not observed. Misconceptions, combined with social stigma, discourage many individuals from seeking early diagnosis or informing family members after infection. Public education campaigns should therefore become continuous national programmes rather than symbolic activities confined to World Hepatitis Day.
A successful response requires more than public messaging. Pakistan needs a comprehensive national hepatitis elimination strategy with measurable goals, adequate funding, and clear institutional responsibilities. Infection-control protocols must be enforced rigorously across every healthcare facility, whether public or private. Blood banks should undergo regular independent audits, and violations of safety regulations should result in swift legal action. Healthcare workers require continuous training on infection prevention, while medical waste management systems must be modernized to eliminate unnecessary risks.
Expanding vaccination coverage is equally critical. Every newborn should receive the Hepatitis B birth-dose vaccine within the recommended timeframe, while high-risk populations must have easy access to screening and affordable treatment services. Modern antiviral medicines have transformed Hepatitis C into a curable disease, yet many patients remain undiagnosed or unable to afford treatment. The government should work closely with provincial health departments, international partners, pharmaceutical companies, and civil society organizations to expand access to affordable medicines and diagnostic facilities throughout the country.
Digital health technologies can also strengthen Pakistan’s response. Electronic disease surveillance systems, integrated patient registries, and real-time reporting mechanisms would enable health authorities to identify outbreaks quickly, monitor treatment outcomes, and allocate resources more efficiently. Reliable data should guide policymaking instead of fragmented estimates and irregular reporting. Better coordination between federal and provincial governments is essential to ensure that hepatitis control remains a national priority rather than a series of disconnected provincial initiatives.
Ultimately, the fight against hepatitis is not simply a medical challenge; it is a test of governance. Countries that have made meaningful progress have done so through political commitment, regulatory discipline, sustained investment, and public participation. Pakistan possesses the medical knowledge, vaccines, diagnostic tools, and effective treatments needed to dramatically reduce the burden of viral hepatitis. What has been missing is the determination to implement these solutions consistently and at scale.
World Hepatitis Day should therefore become more than an annual reminder of missed opportunities. It should mark the beginning of a determined national campaign to eliminate a disease that continues to claim tens of thousands of lives unnecessarily every year. Pakistan cannot afford to treat hepatitis as a routine health issue when it has already evolved into a national public health emergency. A country that aspires to improve its human development indicators, strengthen its healthcare system, and accelerate economic progress must confront this epidemic with urgency, resolve, and unwavering political commitment. Only then can future generations inherit a healthier and more secure Pakistan.
