LAHORE, Sept 9: Instead of a change for the better, the managers of a health programme have decided to provide free vaccines and medicines to only 500 hepatitis B and C patients across Punjab as against the previous figure of 5,000 annually.

Under the Prime Minister’s National Programme for Prevention and Control of Hepatitis, free injection of interferon and ribavarin for Hepatitis C and vaccine and tablet lamvidne for Hepatitis B were being provided to over 5,000 patients annually through the teaching hospitals and district headquarters hospitals (DHQs) since 2005.

A source in the health ministry informed Dawn on Tuesday that the architects of the programme primarily wanted to focus on awareness about the disease. “Now each teaching and DHQ hospital will be given vaccine and medicine to facilitate 15 patients,” he said.

On the other hand, the PM’s programme manager, Dr Sharif Khan said it had asked the provinces to develop a mechanism to provide free vaccine and medicine to the poor patients as it could not continue to do so. He said it had provided a large quantity of vaccine to the provinces for hepatitis B patients.

“We are going by the PC-I of the programme and during this phase the more emphasis is on awareness,” he said, and added that it was also providing training to the hospital staff regarding sterilisation and hospital waste management.

Dr Khan said they had ensured the cost of the whole treatment of hepatitis C patient at a public hospital at Rs13,500. Besides, they were providing full support to all provinces in this regard.

The objective of the programme (2005-10) is to improve the health status of the people by decreasing the disease burden due to hepatitis viral infections, and reduce the vulnerability through awareness among the people regarding hepatitis viral infections through the implementation of scientifically sound preventive and control strategies. The federal government had also asked the district governments to allocate separate funds for prevention and control of hepatitis B and C.

It is pertinent to mention that free vaccines and medicines to even 5,000 patients in Punjab annually were not enough to cater to the need of such a large number of hepatitis B and C patients.

According to a physician, hepatitis C is on the rise in the province and the disease can be fought only with a joint effort of the federal, provincial and district governments. He said the NGOs and donors also should come forward for the cause.

At present, around 16 million Pakistanis are reportedly suffering from hepatitis B and C. Hepatitis B is caused by hepadnavirus, which can cause both acute and chronic hepatitis. Chronic hepatitis develops in the 15 per cent patients who are unable to eliminate the virus after an initial infection. Identified methods of transmission include blood transfusion, tattoos and sex.

In about half of the cases the source of infection can’t be determined. Blood contact can occur by sharing syringes in intravenous drug use, shaving accessories such as razor blades or touching wounds of infected persons.

Hepatitis C is caused by a flavivirus that can be transmitted through contact with blood (including through sexual contact where the two parties’ blood is mixed). Hepatitis C may lead to a chronic form of hepatitis culminating in cirrhosis. It can remain asymptomatic for 10 to 20 years. No vaccine is available for hepatitis C.