HEPATITIS B and C remain significant public health challenges in Pakistan, affecting thousands across the country. However, history seems to repeat itself, as past failures in Hepatitis Eradication programs indicate that state representatives have not effectively learned from previous shortcomings to address this pressing issue.
The 2011-12 program, which turned out to be a failure due to mismanagement and poor planning, left a lesson for everyone, as the Former Chief Minister of Sindh, Qaim Ali Shah, said, “The hepatitis program lacked vision and coordination. Funds were allocated, but implementation never matched the promises”. Now, with renewed enthusiasm and a massive fund of Rs. 70 billion, another program has been launched. Pakistan now faces the same critical question once again: “Will it succumb to the same pitfalls as before?
The ongoing program, in its initial phase, promises to screen, test and treat approximately 50% of the population. However, significant concerns have emerged, particularly regarding the quality and availability of the diagnostic equipment and treatment methods to be employed. Although the program entails the utilization of local medicines for treatment which, unquestionably, is a welcome development for the local pharmaceutical sector, the government is still not contemplating local diagnostic test kits which, undoubtedly, is a major issue. During the COVID-19 pandemic, the local pharmaceutical sectors demonstrated their ability to produce credible diagnostic kits at a fraction of the price of foreign suppliers. In spite of this, the state continues to insist on employing diagnostic equipment from multinational companies, resulting in unnecessarily high costs.
Dr. Sania Nishtar, one of the leading public health professionals, has already shown alarm at government reliance on multinationals, stating: “The government’s reliance on foreign diagnostic tools neglects the potential of local manufacturers, who can offer high-quality, affordable alternatives. It is a lost chance to save costs and build the local economy”. Selecting multinational diagnostic tools while resorting to local medicines for treatment is paradoxical. It questions the government’s resolve for local industry and reflects the disconnect in its strategy to address the hepatitis crisis. Punjab Planning and Development Board’s 2023 report found that previous Hepatitis programs were a failure because of a lack of transparency and dependence on high-cost foreign imports. Neglecting local diagnostic solutions, the Government would be wasting tax money and weakening attempts to make the program less expensive.
The lack of an overarching technical advisory board, pointed out by experts such as Dr. Nishtar, is also contributing to the worry. “A program of this magnitude needs a clear roadmap, expert advice and public-private partnership. Without these, are we learning from past mistakes?” she said. The omission of local test kits from the plan of the program is a testament to the absence of expert advice and thought given to sustainable, local options. Economist Ha-Joon Chang contends, “Building local capabilities is essential for resilience.” If Pakistan wants to make its healthcare system stronger and less dependent on foreign sources, it has to adopt local manufacturing in every facet of Hepatitis eradication program—treatment and diagnostic equipment as well. The dependence on foreign diagnostic kits continues to drive up the cost and also denies local manufacturers the chance to develop and innovate.
—The writer is contributing columnist.
