LAHORE: An alarming report from the World Hea­lth Organisa­tion (WHO) indicates that Pakistan had the highest number of viral hepatitis C infections in the world, around 8.8 million, and accounts for 44 per cent of all new hepatitis C infections attributed to unsafe medical injections.

In previous years, Egypt repor­ted the largest number of hepatitis C and B cases, followed by Pakistan.

The data from 187 countries shows the estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, 83pc were caused by hepatitis B and 17pc by hepatitis C, according to the report.

If the number of hepatitis B and hepatitis C cases are combined, then Pakis­tan ranks fifth in the world, only trailing behind China, India, Indonesia and Nige­ria, with around 12.6 million cases reported in 2022.

WHO’s Global Hepatitis Report 2024 reveals country accounts for 44pc of new infections from unsafe injections

The WHO’s Global Hepa­titis Report 2024 notes that ten countries account for nearly two thirds of the global burden of viral hepatitis B and C, with Ethio­pia, Bang­la­desh, Vietnam, Philippines and the Rus­sian Federation rounding off the top ten.

For hepatitis C, six countries — China, India, Indo­nesia, Pakistan, Russian Federation and US — represent 50pc of the global burden However, the report states that Egypt has become the first country to achieve gold tier status on the path to elimination of hepatitis C, based on fulfilling WHO criteria that will set the country up to ach­ieve the reduced incidence and mortality targets of full elimination before 2030.

In addition, as of Dec 2023, 16 countries have been validated for eliminating either one or more among HIV, syphilis and HBV, the report noted.

Commenting on the report, senior medical experts say most of the patients in Pakistan are either diagnosed incidentally or get symptomatic when their illness advances years after getting the infection.

Dr Masood Sheikh from the Lahore General Hospital told Dawn that Pakistan has been bearing the second-largest burden of hepatitis C globally, with a nationwide prevalence of 4.8 per cent.

“From 2015 to 2019, there was a 5pc increase in hepatitis C-related deaths and an 8pc increase in hepatitis B-related deaths,” he said.

The transmission of the virus increased manifold in Pakistan due to ignorance of sterilisation techniques, sharing personal items, and unsafe healthcare practices. He lamen­ted that the burden of liver cancers and transplants has risen three-fold all over the country over the past 20 years.

“Hepatitis is an inflammation of the liver that can cause a range of health problems and can be fatal,” Dr Sheikh said.

The latest WHO report also contains information on access to health products from 38 countries for the viral hepatitis response, which together account for about 80pc of the global disease burden of viral hepatitis B and C.

Updated WHO estimates indicate that 254 million people live with hepatitis B and 50 million with hepatitis C in 2022 all over the world.

“Half the burden of chronic hepatitis B and C infections was diagnosed in 30–54 age group, 12pc among children under 18 years of age,” reads the report. Men account for 58pc of all the cases.

However, drug pricing data offers a silver lining; the lowest reported price of daclatasvir/sofosbuvir — a two drug combo for the treatment of hepatitis C — for a 12-week course of treatment was from Pakistan at about $33 for a generic course of treatment. The highest reported price was from China, at about $10,000.

Published in Dawn, April 17th, 2024