The Ministry of Health and the World Health Organisation have launched a Rs 67 billion Prime Minister’s Hepatitis C Elimination Programme, whose first phase will screen 1.6 million people and treat those who test positive. On paper, the ambition is historic. Pakistan carries the heaviest hepatitis C burden in the world, with roughly 10 million infections out of 50 million globally. Someone in this country dies from related complications every twenty minutes, and fewer than one-third of patients even know they carry the virus.
Sadly, ambition alone has never cured anyone. Pakistan has had a National Hepatitis Strategic Framework, provincial action plans, donor-supported pilots and micro-elimination experiments before. Some of them worked in limited settings. Free therapy was delivered to thousands in low-income settlements.
However, none of this has stopped the country from producing new infections through the same disgracefully familiar channels, which thrive because of unsafe blood transfusions, reused syringes, poorly regulated private blood banks, informal dental practices, barber-shop razors and quack clinics.
The hepatitis epidemic is also inseparable from another public health calamity that Pakistan has preferred to discuss in whispers. According to official figures, roughly 9,700 new HIV cases were reported in the first nine months of 2024. This failure matters because hepatitis C and HIV travel through many of the same broken routes.
Pakistan does not need to reinvent the wheel. It only needs to enforce what it already knows by making infection control a non-negotiable obligation across not just hospitals and blood banks but every informal corner of the healthcare economy where a reused needle or unsterilised blade can still decide the fate of a life.
There is also a privacy question that must not be dismissed in the enthusiasm for mass screening. NADRA-linked systems may help track patients, prevent duplication and improve follow-up, yet Pakistan has a poor record of protecting vulnerable citizens from stigma once their private information enters public systems. Hepatitis and HIV testing must be integrated into antenatal care, primary healthcare and community outreach. Still, confidentiality needs to be treated as a public health tool. People will not come forward for testing if they fear humiliation, job loss, family violence or social exclusion.
The government’s hepatitis C drive can become one of the most consequential public health interventions in Pakistan’s history. It can spare families the slow ruin of liver disease, reduce catastrophic medical costs and prove that the state can still act at scale when it chooses to. Needless to say, none of this will matter if the programme becomes another ceremonial exercise while the same unsafe practices continue in the lanes where many first seek care. *