KARACHI         -        A large investment of at least US $3.9 billion is needed to meet the World Health Organization’s (WHO) target for the elimination of Hepatitis C virus (HCV) in Pakistan, with major focus on saving of lives, says a University of Bristol led research published in The Lancet Global Health.

Pakistan is registered to have one of the highest rates of Hepatitis C infection in the world, accounting for over 10 percent of global HCV infections, hence reducing new infections to meet the WHO target is a public health priority, said the researchers belonging to the University of Bristol, Medicins Sans Frontiers, Pakistan HCV Task Force, the US Centers for Disease Control and Prevention, Aga Khan University and the Pakistan Kidney and Liver Institute.

 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 ought to be treated each year. Regular re-screening was also registered to be required so as to  identify new infections or re-infections coupled with efforts to re-engage individuals lost to follow-up.

Success of the exercise was cited to depend on achieving high referral rates to ensure that at least 90 per cent of those diagnosed receive treatment whereas achieving the WHO elimination target could mean preventing 5.8 million new infections and 390,000 HCV-associated deaths that would have otherwise occurred by 2030.

The estimated US$3.9 billion cost, the equivalent of around 9.0 per cent of the current health expenditure of Pakistan or an investment of US$ 1.50 per person per year, was mentioned to be dependent on using the low cost drugs and tests besides application of a simplified testing and treatment algorithm.

Professor Saeed Hamid of Aga Khan University was of the opinion that the amount of investment needed to reduce new HCV infections to WHO elimination levels will be substantial, but equally so are the benefits to patients and the community.

“Improving access to DAAs along with reductions in costs means that now is the time to push for HCV elimination. This will require cooperation across both public and private sectors to ensure the best pathways of care which will bring the biggest impact,” he added.

Dr Huma Qureshi, national lead for the prevention and control of viral hepatitis in Pakistan and former executive director of the Pakistan Health Research Council emphasized that along with screening and treatment country must also raise public awareness on viral hepatitis and educate people on the risk factors and how hepatitis can be spread.

“These prevention efforts can help speed up our elimination efforts,” she said.

Professor Peter Vickerman, Professor of Infectious Disease Modelling at the University of Bristol and principal investigator of the study maintained that achieving HCV elimination is not just about reducing the number of people who are infected but is also about improving quality of life and population health through averting new infections and preventing cases of advanced liver disease, liver cancer, and liver-related deaths due to the isssue