Pakistan bears the world’s heaviest hepatitis C burden with nine million cases, as WHO marks World Hepatitis Day by urging accelerated action toward the 2030 elimination goal through national screening and free treatment.
On World Hepatitis Day, the World Health Organisation renewed its call for urgent, science-based action as Pakistan confronts one of the planet’s most severe viral hepatitis crises. An estimated 12.9 million people in the country live with chronic viral hepatitis – 9 million with hepatitis C and 3.8 million with hepatitis B – making Pakistan the nation with the single largest hepatitis C burden worldwide. Only about three in ten of those infected know their status, leaving millions untreated and at risk of progressive liver damage, cirrhosis, cancer and death.
Every year more than 48,000 Pakistanis die from preventable and curable hepatitis infections – the equivalent of one death every 11 minutes. In 2024 alone, over 88,000 people newly contracted hepatitis C, while annual new infections are estimated at around 110,000. Globally, hepatitis B and C claimed 1.34 million lives in 2024, according to the WHO Global Hepatitis Report 2026, with more than 4,900 new infections occurring daily.
Historical Transmission Fuelled by Unsafe Practices
The scale of Pakistan’s epidemic is rooted largely in historical healthcare-associated transmission. Widespread reuse of needles and syringes for medical injections, unregulated private blood banks, incomplete blood screening, and unsafe surgical, dental, piercing, tattooing and barbering practices have driven the spread for decades. Current estimates attribute roughly 62 per cent of new hepatitis C infections to unsafe medical injections and blood transfusions, and 38 per cent to injection drug use.
Prevalence varies sharply by province. Punjab records the highest rates, followed by Khyber Pakhtunkhwa, Sindh and Balochistan. Rural populations face higher exposure than urban ones, reflecting deeper gaps in infection control and access to safe care. Hepatitis B and C together account for the vast majority of hepatitis-related deaths worldwide; left untreated they progress silently to life-threatening complications.
WHO Backs National Elimination Drive
Under the international theme “Hepatitis: Let’s break it down,” WHO Representative in Pakistan, Dr Luo Dapeng, reaffirmed the organisation’s full partnership with the government. “WHO will continue to partner with Pakistan to promote medical science to protect and save lives and adapt the best practices and lessons learned from around the world to the national context,” he said. “WHO stands with Pakistan to accelerate research and innovation, integrate hepatitis services into universal health coverage, enhance prevention – including vaccination – and ensure equitable access to quality hepatitis testing and treatment for every family, regardless of social or economic status.”
Central to these efforts is the Prime Minister’s National Programme for the Elimination of Hepatitis C Infection. Launched with WHO technical support, the initiative aims to test tens of millions of people and provide free life-saving treatment. Early phases have focused on Islamabad Capital Territory, targeting 1.6 million people, before expanding nationwide to reach more than 164 million across subsequent stages. The programme seeks to screen half the eligible population (approximately 82.5 million people aged 12 and above) and treat 5 million by 2027, advancing toward the World Health Assembly goal of eliminating hepatitis as a public health threat by 2030.
Federal funding, including allocations reported in the range of tens of billions of rupees and hundreds of millions of dollars in partnership with WHO, underpins free screening, diagnosis and a three-to-six-month course of direct-acting antiviral therapy. Locally manufactured medicines keep costs low – around US$25 for a full course in some reports – removing a major barrier to access. Modelling suggests the programme could avert 850,000 deaths and 1.1 million new infections by 2050, prevent tens of thousands of cases of liver cancer and cirrhosis, and generate substantial savings in treatment and hospitalisation costs over the coming years.
Prevention, Testing and Treatment as Cornerstones
Hepatitis B is preventable through vaccination, with WHO emphasising the critical importance of administering the birth dose within 24 hours of delivery. Hepatitis C is curable in the great majority of cases with short courses of oral antivirals. Yet diagnosis remains the weakest link: low awareness and limited testing mean most infected people remain unaware until advanced disease develops.
WHO stresses the need to integrate hepatitis services into primary healthcare and universal health coverage, expand harm-reduction measures for people who inject drugs, enforce safe-injection practices and blood safety standards, and regulate unqualified practitioners. Strengthening laboratory capacity, electronic medical records and community-based screening – drawing lessons from successful pilots and Egypt’s mass-screening model – are also priorities under Pakistan’s National Hepatitis Strategic Framework 2024–2030.
Global Context and the Path Ahead
Pakistan accounts for a disproportionate share of the global hepatitis C burden. Together with India and China it represents a large fraction of worldwide cases, and it ranks among the ten countries responsible for a majority of hepatitis C-related deaths. The Eastern Mediterranean Region, of which Pakistan is a major part, remains the only WHO region where more than 1 per cent of the general population is chronically infected with hepatitis C.
Despite progress since 2015, the world remains off track to meet 2030 targets of a 90 per cent reduction in incidence and 65 per cent reduction in mortality without rapid scale-up. Pakistan’s response – combining political commitment at the highest level, free treatment, domestic manufacturing and international partnership – positions the country as both a high-burden test case and a potential model for elimination. Success would not only save hundreds of thousands of Pakistani lives but also make a decisive contribution to global targets.
The tools exist: vaccines that protect more than 95 per cent of recipients against hepatitis B, curative therapies for hepatitis C, and proven public-health strategies for safe healthcare and harm reduction. What remains is the sustained will to break down barriers of stigma, cost, access and weak infection control.
