The World Health Organisation’s of target eliminating hepatitis B and C by 2030 appears to be a pipe dream for Pakistan, where more than 10 million people infected with viral hepatitis are still undiagnosed, and hundreds of them are dying due to complications of the infection, including liver cancer, end-stage liver disease and liver failure, said national and international experts on Friday.
They said Pakistan was among one of the most affected countries where hepatitis B and C was fast spreading among those who injected drugs, were given injections through reused syringes, received unscreened blood and were exposed to unsterilised razors at barber shops. They called for mass screening throughout the country to ascertain the actual data of disease burden and to plan treatment of infected people.
They were speaking at a joint symposium of the World Gastroenterology Organisation (WGO) and the Pakistan Society for the Study of Liver Diseases (PSSLD) at the 12th annual meeting of the PSSLD at a local hotel on Friday.
WGO President Prof Cihan Yusdaydin from Turkey, eminent Turkish transplant surgeon Prof Kamil Yalcin Polat, Norah A Terrault from the United States, Aaron Lim from United Kingdom, Sheikh Muhammad Fazle Akbar from Japan and several other experts from regional countries made their presentations and discussed strategies to wipe out the disease from the world.
Prof Polat offered his services to train Pakistani surgeons in live donor liver transplants (LDLT), saying Turkey was the second leading the country in performing liver transplants, followed by the US, and that over 38 centres were performing liver transplants there.
He said other Turkish experts were also willing to share their knowledge with Pakistani counterparts, which was evident from the presence of many Turkish experts at this conference. He said he was not only ready to do liver transplants in Pakistan but could also invite Pakistani surgeons to his centre for training.
“Turkey and Pakistan are already cooperating in the fields of gastroenterology, radiology and cardiology, and this cooperation would increase in the coming days. “ Prof Polat added that Pakistani experts were already acquiring training at different medical centres and universities in Turkey, which was beneficial to them and their countrymen.
Eminent gastroenterologist and WGO Training Centre Karachi director Prof Wasim Jaffri said that despite the poor situation with regard to hepatitis B and C in Pakistan, this menace could be eliminated through concentrated efforts. He called for joint efforts by the federal and provincial governments and the private sector to screen, diagnose and treat viral hepatitis patients in Pakistan.
“Unfortunately, despite the availability of huge resources, our efforts are not concentrated and collaborative, and in this way, we are not making any impact. All the stakeholders, including the federal and provincial governments, the private sector and NGOs need to work together to eliminate this menace, which is very much doable.”
Commenting on the availability of liver transplant facilities in Sindh, he said the Dow University of Health Sciences (DUHS), the Sindh Institute of Urology and Transplantation (SIUT) and the Gambat Institute of Medical Sciences were busy in performing liver transplants with some problems, but those issues were quite natural and could be resolved over the time.
Another leading gastroenterologist and PSSLD vice president, Prof Zaigham Abbas, said that at the moment there was no hope of hepatitis B and C elimination from Pakistan by 2030 as there were millions of patients who were still undiagnosed and they were silently spreading these infections to other people. He added that this situation could lead to serious consequences for Pakistan.
“Pakistan could face travel restrictions like polio where people could be asked to provide proof they are hepatitis B and C negative to enter other countries of the world,” he warned and asked for creating mass awareness about these diseases so that the people could get themselves screened and treated.
Former PSSLD president and AKU expert Prof Saeed Hamid discussed the role of community-based screening and treatment in the elimination of hepatitis and deplored that due to a variety of reasons, a large number of people were not opting for treatment despite getting diagnosed with hepatitis B and C.
“In the Malir district of Karachi, the prevalence of hepatitis B and C is around 24 per cent, which is very alarming. We have worked with community and screened many patients, but the majority of them did not turn up for the treatment due to a variety of reasons,” he said and called for creating awareness among the people about hepatitis.