$3.9b could eliminate Hepatitis C in Pakistan, save lives: study
Statesman Report
PESHAWAR: The $3.9 billion the WHO says is needed to eliminate Hepatitis C in Pakistan could save lives and reduce poor health, according to a research paper published in the Lancet Global Health.
Pakistan has one of the highest rates of Hepatitis C infection in the world and makes up for 10% of total infections, according to the research. New direct-acting antivirals are highly effective at curing infections, resulting in the WHO recently developing a Global Health Strategy to eliminate Hepatitis C by 2030.
Targets have also been set to reduce global incidence by 80% and mortality by 65% but there is still a lack of guidance on how to achieve these targets in low and middle-income countries, and there are no estimates on how much it could cost, according to a press release issued by the Aga Khan University.
The study, a collaboration between the University of Bristol, Médecins Sans Frontières, the Pakistan HCV Task Force, the US Centres for Disease Control and Prevention, AKU, and Pakistan Kidney and Liver Institute, used mathematical modelling to provide the first country-level estimates of the screening and treatment needed to achieve the WHO elimination targets as well as the possible costs of doing so.
The study found that to achieve elimination by 2030, around 36 million people will need to be screened or re-screened annually, and around 660,000 need to be treated each year. Regular re-screenings will also be needed to identify new infections or re-infections, and efforts will need to be made to reengage individuals lost to follow-up. Success will also depend on achieving high referral rates to ensure that at least 90% of those diagnosed receive treatment.
Achieving this target could mean preventing 5.8 million new infections and 390,000 Hepatitis C-associated deaths that would have otherwise occurred by 2030. The estimated cost is dependent on using the cheapest drugs and tests, and using a simplified testing and treatment algorithm.
“Our modelling suggests that Pakistan’s Hepatitis C epidemic is on the rise, with around 700,000 new infections occurring each year, rapidly adding to the current 7.5 million people, or about 4% of the population, who are infected with Hepatitis C. The situation is expected to get worse if interventions are not scaled up,” said Dr Aaron Lim, infectious disease mathematical modeller and lead author from the University of Bristol.
“The amount of investment needed to reduce new infections to WHO elimination levels will be substantial, but equally so are the benefits to patients and the community,” said AKU’s Professor Saeed Hamid. “Improving access to direct-acting antivirals along with reductions in costs means that now is the time to push for Hepatitis C. This will require cooperation across both public and private sectors to ensure the best pathways of care which will bring the biggest impact.”
Dr Huma Qureshi, national lead for the prevention and control of hepatitis in Pakistan, believes public awareness is equally important. “These prevention efforts can help speed up our elimination efforts.”