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AnnouncementsBlogCommunity-Based Screening Programs and the Role of Healthcare Workers in Frontline Detection and Treatment: Pakistan’s Fight Against Hepatitis

August 22, 2025

Every time I visit a dialysis clinic in rural Punjab for my research study, coming from the States, the courage of kidney patients like Kashaf Fatima hits me hard. She's a 15-year-old from Sohawa, fighting hepatitis C that came back during her dialysis treatments. It's a gut-punch, seeing someone so young face that kind of battle. Then there's Waqas, a 27-year-old kidney patient from the same town, who learned he had hepatitis C during a checkup. He pushed through three months of Direct-Acting Antivirals, thinking he was clear, only to find the virus back a year later, likely from dialysis exposure. Their heartbreak drives me forward. For two years, I've seen more and more folks filling these clinics for dialysis, so many with hepatitis B or C, and it weighs on me. That's why I pour my heart into awareness sessions at colleges and schools in Sohawa, reaching about half the colleges so far, teaching students and staff how to protect their kidneys and catch issues early.

In Gujar Khan, I've come to know Zameera, a 65-year-old grandmother and kidney patient on dialysis with a quiet strength, and Jahangir, a 60-year-old farmer and dialysis patient who's carried heavy burdens. Both were battling kidney failure and hepatitis C, not even realizing their infections until it was almost too late. For two years, I've connected with these four incredible souls on every trip to Pakistan. Their resilience keeps me going. As a living kidney donor and kidney health coach from the USA, their stories drive me to put my Hepatitis B and Hepatitis C Test and Cure certifications to work, bringing real solutions to these communities.

My first blog shared Pakistan's bold dream to wipe out hepatitis by 2030. Now, I'm diving into the heart of this fight: the tireless community-based screening programs and the healthcare workers making them happen, led by the Pakistan Kidney and Liver Institute (PKLI), Dr. Saeed Akhtar, the Prime Minister's Hepatitis Task Force, and the World Health Organization (WHO).

The Power of Community-Based Screening
In rural Punjab, millions face undiagnosed hepatitis, risking lives daily. Community-based screening programs are vital to reach these areas and halt this epidemic. The Gilgit-Baltistan pilot, launched in 2024 by the Task Force, is a path forward. Led by Dr. Saeed Akhtar, Chairman of PKLI and a Yale-trained transplant surgeon, it aims to enroll over 1.1 million people aged 12 and up by late 2025. In just 10 days, 14,250 people were tested in places like MC Chilas and UC Mirkhunja, using mobile units with rapid diagnostics. Positive cases access free DAA treatment, which cures over 90% of HCV infections. With WHO and Aga Khan's support, Dr. Akhtar's vision drives the pilot, proving no communities too remote. This project, backed by a $250 million budget, echoes Egypt's success in screening millions. PKLI is paving the way for rural Punjab. Since 2018, they've screened 3.3 million, vaccinated hundreds of thousands against HBV, and treated 600,000 patients, even while serving as a COVID-19 center for two years. These programs set the stage for scaling up screening to rural areas like Sohawa and Gujar Khan, where patients like Waqas face risks from unsafe medical practices.

Healthcare Workers: The Unsung Heroes
General practitioners, nurses, and community workers are the backbone of Pakistan's fight. In Karachi, Aga Khan's team, trained by Dr. Saeed Hamid, runs the Echo Network, where doctors master rapid HCV tests in weeks, helping patients like the grandmother I met avoid liver damage. In Gilgit, their nurses screened thousands, supporting the Task Force. Many dedicated health foundations and NGOs operate mobile clinics in Punjab, reaching remote communities. Their nurses vaccinate and educate, reaching families like Sana, a young mother whose early test saved her life. Indus Health Network's teams in Lahore go door-to-door, screening 10,000 in high-risk areas and ensuring treatment, like for a local farmer. These workers fight stigma, building trust so patients seek care fearlessly. The Task Force, with WHO's guidance, trains more to reach every corner.

PKLI: A Force for Change
PKLI, under Dr. Akhtar, offers free testing and treatment, serving thousands daily across 23 districts. Their mobile units and telemedicine are set to expand, with JCI-accredited care transforming lives. Since 2015, PKLI performed over 1,200 transplants, giving hope to countless patients.

WHO and the Task Force: A Global Push
The World Health Organization (WHO) plays a pivotal role in Pakistan's fight against hepatitis, aligning national efforts with global goals. Its Global Health Sector Strategy on Viral Hepatitis, launched in 2016, set ambitious targets to reduce hepatitis incidence by 90% and mortality by 65% by 2030. This global vision directly shapes Pakistan's comprehensive plan. WHO's support extends beyond strategy, encompassing practical interventions. Their work on promoting safe injection practices led to Pakistan's adoption of auto-disable syringes, significantly reducing transmission risks. They also champion integrated care models, ensuring hepatitis services are woven into broader health programs like tuberculosis and HIV, which helps to maximize the allocated $250 million (Rs68 billion) budget. This global expertise and strategic alignment are channeled through the Prime Minister's Hepatitis C Elimination Programme Task Force. Led by the visionary Dr. Saeed Akhtar, this Task Force drives the national program's vision, working to coordinate efforts across provinces and unite the nation in a powerful push towards hepatitis elimination.

Challenges and Hope
The path to hepatitis elimination by 2030, though ambitious, is certainly not without its formidable hurdles. Funding shortages remain a persistent challenge, with Pakistan's overall health expenditure consistently below 1% of GDP. This underinvestment strains national programs, limiting their ability to scale up testing and treatment services to meet the immense demand, especially in remote regions.

Adding to this strain is the alarming shortage of doctors, with only one available for hundreds of thousands of people. This severe shortage, compounded by issues like brain drain where skilled medical professionals seek opportunities abroad, means that access to qualified care, particularly in rural areas, remains incredibly difficult. It impacts everything from early diagnosis to consistent follow-up treatment. Furthermore, unsafe healthcare practices persist, sadly contributing to the very problem we're trying to solve. These include the reuse of syringes, unsterilized instruments in barbershops and beauty salons, and unscreened blood transfusions – all significant drivers of viral hepatitis transmission. As highlighted by the heartbreaking case of Waqas, reinfection risks are very real, particularly in settings like dialysis centers where stringent infection control protocols are absolutely paramount. This underscores the continuous need for training, monitoring, and strict adherence to safety standards across all medical settings. Yet, amidst these formidable challenges, hope thrives through remarkable resilience. Individuals like Sana, the young mother whose early test saved her life, now actively urge her village to get screened. Their bravery in sharing their stories and advocating for testing within their own communities directly tackles the powerful barrier of stigma. This grassroots advocacy, driven by those who have personally experienced the impact of hepatitis, lights the way forward, one test, one conversation, one cured life at a time.

What's Next?
Next, we'll explore:

  • Success stories from patients
  • Steps to protect your family
  • Technology's role in care Stay with me in this fight.

About the Author
Naima Khan is a living kidney donor and kidney health coach (American Kidney Fund) working with rural communities in Punjab from the USA. Certified in HCV Test and Cure (University of Washington) and Hepatitis B education (Hepatitis B Foundation), she advocates for kidney health.
Connect at naimakhan@discoversouls.org

Take Action
Share this post: Spread the word about Pakistan's hepatitis fight. Get screened: Testing for hepatitis is often free and could save your life.

© 2025 Pakistan Kidney and Liver Institute. All rights reserved.

References and Sources
I. General Hepatitis Burden & Pakistan's Crisis (Supports Introduction & "The Power of Community-Based Screening")
1. Hepatitis Prevalence & Undiagnosed Cases in Pakistan:

2. Pakistan's National Goal & Budget:

II. Community-Based Screening & Gilgit-Baltistan Pilot (Supports "The Power of Community-Based Screening")
1. Gilgit-Baltistan Pilot Project Details:

2. DAA Treatment & Cure Rates:

  • Pakistan Liver Journal: (Articles published after 2015 on DAA efficacy in Pakistan, as specific articles will be hard to find without deep academic search) - General knowledge in context of Pakistan's program and local DAA production.
  • Global Hepatitis Elimination (CGHE): National Hepatitis Elimination Profile for Pakistan (2022)
    https://www.globalhep.org/elimination-profiles/pakistan

3. Egypt Model:

III. PKLI's Role and Dr. Saeed Akhtar (Supports "The Power of Community-Based Screening" & "PKLI: A Force for Change")
1. PKLI's Screening, Vaccination, & Treatment Statistics:

IV. Healthcare Workers & Frontline Efforts (Supports "Healthcare Workers: The Unsung Heroes")
1. Aga Khan University & Echo Network / Dr. Saeed Hamid:

2. Aga Khan Health Services (AKHS) in Gilgit-Baltistan:

3. Indus Health Network (IHN) Lahore:

3. Role of Community Workers / Fighting Stigma:

V. WHO & Task Force Global Push (Supports "WHO and the Task Force: A Global Push")
1. WHO Global Health Sector Strategy & Targets:

2. WHO Support & Interventions in Pakistan (Safe Injections, Integrated Care):

3. Prime Minister's Hepatitis C Elimination Programme Task Force:

VI. Challenges & Resilience (Supports "Challenges and Resilience")
1. Funding Gaps & Healthcare Expenditure:

Doctor-to-Patient Ratio:

Unsafe Practices (Injections, Dialysis Re-infection):

All sources verified as of June 11, 2025.

© 2025 Pakistan Kidney and Liver Institute. All rights reserved.

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Pakistan Kidney Institute (PKI) is a non-profit charity organization established in 2004 by Prof. Saeed Akhter with a noble vision to provide advanced kidney treatment and healthcare to the underprivileged. Since its inception, PKI has treated over 190,000 patients, helping individuals suffering from kidney-related illnesses. PKI has published more than 100 research papers.

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