The grim statistics released by the Pakistan Medical Association (PMA) on World Hepatitis Day should serve as a wake-up call for policymakers. Pakistan’s position among the countries carrying the heaviest burden of viral hepatitis is not merely a matter for the health ministry. It is a national development challenge that affects families, productivity, healthcare spending and, ultimately, the country’s human capital.
Pakistan is ranked among the world’s highest-burden countries for viral hepatitis and has emerged as the largest reservoir of Hepatitis C infections globally. Nearly 13.8 million Pakistanis are estimated to be living with chronic Hepatitis B or C, while more than 37,000 people die every year from complications including liver cirrhosis and liver cancer.
Behind these figures are thousands of families dealing with prolonged illness, expensive treatment and the loss of breadwinners. The scale of the crisis also raises an uncomfortable question: how has Pakistan allowed a largely preventable and, in the case of Hepatitis C, curable disease to reach such alarming proportions?
The answer lies partly in the weaknesses of the country’s healthcare system. Hepatitis is not an unavoidable consequence of poverty or geography. Hepatitis C can be cured with effective antiviral treatment, while Hepatitis B can be prevented through vaccination and managed with appropriate medical care. Yet the country continues to record around 110,000 new Hepatitis C infections every year.
The overwhelming contribution of unsafe medical practices makes this situation particularly disturbing. Reuse of syringes, inadequate sterilisation of medical equipment, unsafe injections and unscreened blood transfusions continue to expose people to infection. What should be basic infection-control practice is too often treated as an optional precaution.
This is not simply a problem of individual negligence. It reflects systemic failures in regulation, monitoring, training and enforcement. Healthcare facilities, whether public or private, cannot be allowed to compromise basic safety standards without consequences. A patient seeking treatment should not have to worry that the very procedure intended to make them healthier could expose them to a potentially life-threatening infection.
The risks also extend well beyond hospitals and major medical centres. Dental clinics, barber shops and beauty salons can become sources of transmission when instruments are not properly sterilised. The continued presence of unlicensed practitioners and quacks adds another dangerous dimension to the problem.
Pakistan has announced crackdowns on quackery repeatedly, but the persistence of unqualified medical practice suggests that enforcement remains inconsistent. Laws have little value if violations are not detected, prosecuted and punished. Periodic campaigns may generate headlines, but they cannot substitute for permanent regulatory systems capable of identifying unsafe practitioners and preventing them from operating.
The official messages issued around World Hepatitis Day have rightly focused on prevention, early diagnosis and equitable access to treatment. But Pakistan has heard similar messages for years. What is missing is not awareness at the policy level but sustained implementation.
The country needs a national hepatitis elimination programme based on measurable objectives rather than broad declarations. Authorities should establish clear targets for screening, vaccination, treatment and reductions in new infections, with regular public reporting on progress. Funding must be adequate and sustained, while responsibilities should be clearly assigned to federal, provincial and local institutions.
Infection control should be treated as a non-negotiable requirement throughout the healthcare system. Medical facilities need regular inspections and audits, while blood banks should be subjected to strict and transparent quality controls. Safety violations should result in meaningful penalties rather than warnings that are easily ignored.
Universal Hepatitis B birth-dose vaccination should also receive much greater attention. Expanding vaccination coverage is among the most effective ways of preventing future infections and reducing the long-term burden on the healthcare system. At the same time, Pakistan needs to expand affordable screening so that infected people can be diagnosed before the disease progresses to severe liver damage.
Treatment must be accessible as well. Diagnosis without affordable treatment does little to address the problem. Patients who discover that they have Hepatitis C should be able to obtain effective treatment without being pushed into financial distress. Similarly, those living with Hepatitis B need long-term monitoring and medical support.
Public awareness is another critical part of the response. Many Pakistanis remain unaware that everyday medical and personal-care practices can carry risks if basic hygiene standards are ignored. Unsafe injections, improperly screened blood and inadequately sterilised instruments can transmit infection. People need to know how hepatitis spreads, where they can get tested and what treatment options are available.
Awareness campaigns, however, should not be limited to a single day every year. Health education needs to be continuous, evidence-based and designed for different communities and literacy levels. Television, radio, social media, schools, workplaces and local healthcare networks can all play a role.
Reducing stigma is equally important. People diagnosed with hepatitis may avoid testing because of fear, misinformation or social embarrassment. Such reluctance allows infections to remain hidden and increases the likelihood of transmission. Early diagnosis should be presented as an act of responsibility rather than a source of shame.
Pakistan cannot afford to treat hepatitis as another health problem that can be managed through occasional campaigns and official statements. The economic consequences of the epidemic are considerable. Patients who become seriously ill may lose their ability to work, families may face high treatment costs and the healthcare system must eventually bear the expense of treating complications that could have been prevented or detected earlier.
The country already possesses many of the tools required to change this trajectory. The challenge is to deploy them systematically and consistently.
World Hepatitis Day should therefore be more than an annual reminder of alarming statistics. It should become an opportunity to measure what has actually been achieved since the previous year—and what remains undone.
Pakistan does not need another declaration of concern. It needs political commitment, effective regulation, reliable financing, vaccination, widespread screening, accessible treatment and strict enforcement of basic healthcare standards.
Thousands of deaths from hepatitis every year are not an inevitable reality. They are, to a significant extent, preventable. The real test of public policy is whether Pakistan finally acts with the urgency that this preventable health emergency demands.