The study, a collaboration between the University of Bristol, Médecins Sans Frontières, the Pakistan HCV Task Force, US Centers for Disease Control and Prevention, Aga Khan University, and the Pakistan Kidney and Liver Institute, used mathematical modelling to provide the first country-level estimates of the screening and treatment needed for achieving the WHO elimination targets for HCV incidence in Pakistan, and the possible the costs of doing so.
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 will need to be treated each year. Regular re-screening will also be needed to identify new infections or re-infections, and efforts will need to be made to re-engage individuals lost to follow-up. Success will also depend on achieving high referral rates to ensure that at least 90 per cent of people diagnosed receive treatment.
Achieving the WHO elimination target for incidence could mean preventing 5.8 million new infections and 390,000 HCV-associated deaths that might otherwise occur 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—is dependent on using the cheapest drugs and tests, and using a simple testing and treatment algorithm.