THE extent of the damage caused by the hepatitis C virus is beginning to be revealed as a public health disaster that is impossible to reverse but that can be halted. Given that Pakistan has the world’s second-highest prevalence rate for hepatitis C after Egypt, it is clear that the national health services ministry has yet to demonstrate solid commitment to tackling this crisis. On Monday, a news report revealed 50,000 patients had been diagnosed with hepatitis C in Punjab over six months. Dubbed the slow, silent killer, hepatitis C can cause chronic liver disease that proceeds insidiously and can go unnoticed for decades. Because there is a cure for the virus, abandoning thousands to potential death due to poor diagnosis by untrained medical practitioners is not an option. If prices for drugs prevent large-scale provision of treatment, the government should approach global health donors — though a fairer pricing framework for drugs must be encouraged. The paucity of resources has meant that other national disease-prevention programmes are buttressed with donor funding. Similarly, public-private partnerships are needed for hepatitis. Meanwhile, because poverty fuels economic vulnerability, regulating healthcare providers will curb malpractice. And though the Punjab Hepatitis Ordinance, 2017, stipulates the enforcement of preventive measures (safe blood transfusions and dialysis etc), the overall lack of quality medical services is at the core of the crisis.

Investing resources and expertise for prevention and treatment is critical for hepatitis C. Eliminating risk factors implies ensuring implementation of health and safety mechanisms — including curtailing the use of dirty syringes, enforcing safe blood transfusions and improving the hospital-waste disposal infrastructure. Moreover, the health ministry must note that its long-standing failure to consolidate preventive strategies has left the exchequer with a hefty burden. However, certain projects spearheaded by Punjab’s health ministry are worth emulating. First, Punjab has reportedly replaced 50pc of syringes in hospitals with single-use syringes. Improving waste-control projects in Punjab, including by building 39 incinerators in health facilities, is also on the checklist. So, with the Supreme Court’s alarm at Sindh’s lax attitude towards social-service provision, including waste-disposal mechanisms, it makes good sense for the province to follow Punjab. Only when countries like ours, with few resources and high prevalence of disease, demonstrate strong political and financial commitment, can governments eliminate life-threatening illnesses. Otherwise, a potential death sentence awaits swathes of poor communities.

Published in Dawn, December 19th, 2017