November 04, 2008	Tuesday	Ziqa'ad 5, 1429

KARACHI, Nov 3: The Sindh government has planned to vaccinate 1.4 million newborns and 245,000 adults against hepatitis B and provide treatment to about 16,600 patients of hepatitis C during this fiscal year under the ‘Chief Minister’s Initiative for hepatitis-free Sindh’.

Sources in the health department said the government had finally approved the release of Rs2.35 billion in three-year instalments for the hepatitis prevention and control programme, which would initially be run in five districts. The government in June last had announced that it would allocate Rs5 billion to fight hepatitis for the entire Sindh, where hepatitis has become a leading cause of morbidity and mortality over the recent years.

The expanded programme of immunization that’s addressing hepatitis B in infants only was found not feasible’ for it did not prevent mothers from transferring the viral disease to their children, according to experts. It is estimated that 1.5 million patients of hepatitis B and 1.7 million patients of hepatitis C existed in the province.

Most affected districts were Larkana, Kamber-Shahdadkot, Dadu, Matiari, Nawabshah and Hyderabad, while the adjoining districts of Shikarpur, Jamshoro, Tando Mohammad Khan and Sanghar were on the verge of outbreak of the diseases too, said an official report.

The problem has largely remained unaddressed due to non-availability of adequate screening service against hepatitis at a taluka level. Besides, a lack of up-to-mark molecular biology labs and inadequate supply of costly medicines to treat the eligible patients of hepatitis B and C at health establishments remained major challenges in the public sector.

The sources said during the last three years the federal government through its ‘ambitious and fund consuming’ hepatitis programme could only provide the prescribed treatment to 40 per cent of about 10,000 hepatitis C patients registered across the province. The hepatitis C medicine supply remained meagre and highly interrupted during the last one year in Sindh.

The sources said the authorities approved the hepatitis-free programme for launch in Larkana, Khairpur, Nawabshah, Kamber and Badin districts. A project director and some key officials had already been appointed, while the process for procurement of vaccines, machineries and equipment would begin within a week, said the health department source, adding that if things went in the right direction the hepatitis-free Sindh project would go operational by December’s first week.

Under the three-year project, 50,000 patients of viral hepatitis C and 6,000 patients of hepatitis B will be provided treatment, while about 4.2 million newborns, 675 general population, 45,000 high risk population and 15,000 jail inmates will be vaccinated.

Project manger Dr Abdul Majeed Chhutto told Dawn that the government had already released Rs200 million for the project, while the proceedings for release of Rs802 million had been initiated on a war-footing basis as the chief minister wanted an immediate implementation of the programme.

Dr Majeed said PCR laboratories would be established in Larkana and Sukkur during the next few months, while cold chain will be established and maintained at Kotri, Sukkur and Larkana. Another PCR laboratory would be set up in Mirpurkhas at a later stage, he added.

In addition to vaccination and provision of treatment, measures would be taken to increase the capacity of medial and technical staffs at various health centres, he said, while awareness campaigns and seminars on promotion of safe blood transfusion, injection safety and behaviour changes would also be held in the coming months.

In reply to a question, he said provision of the free of charge treatment to patients of hepatitis B and C from December onwards would not be a problem as a list of registered patients who were still awaiting the treatment under the prime minister’s programme on hepatitis was being acquired to be incorporated in the new project.

He said the programme would be extended to the population of other district of the province as well.