July 28 is marked as World Hepatitis Day and the WHO’s theme for this year is ‘One Life, One Liver’, highlighting how hepatitis leads to potentially fatal health problems. This specific date was chosen for the day as it is the birthday of Dr Baruch Blumberg, the man who discovered the hepatitis B virus and developed a vaccine against it. Despite this achievement, hepatitis still causes over one million deaths annually. Experts claim that Pakistan has the world’s highest burden of hepatitis C, with 10 million cases nationwide, and around five million people in the country suffer from hepatitis B. These are the most concerning strains of the virus and together are the leading cause of liver cancer and cirrhosis and viral hepatitis-related deaths. According to experts, hepatitis B and C are mostly spread by the blood and body fluids of an infected person.
There are certain features of hepatitis B and C which make a country like Pakistan particularly vulnerable to them. Most new infections from these strains go undetected since symptoms are often mild or do not show up altogether. Hence, a person might be infected with hepatitis but be unaware of their condition, facilitating the spread of the virus through practices like unscreened blood transfusions, the reusing or sharing of contaminated needles in hospitals or among drug abusers. Experts claim that lack of awareness is the main cause for the spread of hepatitis in Pakistan and that better treatment would not be possible without early diagnosis. Pakistan lacks widespread access to many crucial health services, with hundreds of thousands missing out on even routine services like immunization. The healthcare system has also become notorious for unsafe practices, including the use of unsterilized or contaminated needles and ineffective regulation. For example, in 2019, there was a mass outbreak of HIV in Sindh, reportedly involving 1500 patients, after the reuse of dirty needles, allegedly by a doctor. According to a 2017 report by the International Journal of Health Policy and Management, up to 40 per cent of transfused blood in Pakistan is not screened for communicable diseases and around half of all blood transfusions are not screened for hepatitis C, B or HIV.
Cracking down on the spread of hepatitis will thus require tighter supervision and monitoring of the healthcare system itself, especially concerning the use of needles and blood banks. World Hepatitis Day provides us an opportunity to reflect on how it is one thing that health services do not reach people and another that the services themselves can endanger people due to a lack of standards. It must also be stated that it is the poor who bear the brunt of this problem, often having no choice but to rely on the most poorly maintained and run healthcare centres. This has to change if we are to stop hepatitis and other communicable diseases and it can only change if hospitals and doctors have to pay the consequences when they get things wrong. It is also necessary to increase access to testing services and boost immunization efforts. That so many still miss out on such crucial services points to a lack of resources and access to basic health care not being a top priority among those in charge.
Published at The News on 28th July 2023