By Dr Usman Waheed
Associate Professor, Islamabad Medical & Dental College, Islamabad
As Pakistan marks World Hepatitis Day on July 28, the country continues to face the world’s largest hepatitis C burden, making safe blood transfusion one of the most important yet often overlooked pillars of hepatitis prevention. The global theme for 2026, “Hepatitis: Let’s Break It Down,” calls for removing the barriers that prevent people from accessing prevention, testing and treatment.
According to the World Health Organization (WHO), an estimated 287 million people are living with chronic hepatitis B or C worldwide, while these infections claim around 1.3 million lives every year. Pakistan alone is home to an estimated 9 to 10 million people living with hepatitis C and is also among the countries with the highest burden of chronic hepatitis B.
The Prime Minister’s Programme for the Elimination of Hepatitis C, backed by nearly Rs68 billion in federal and provincial funding, represents a major national effort to expand screening, confirmatory testing and treatment. However, Pakistan cannot eliminate hepatitis through treatment alone. Preventing new infections must remain an equally important priority, and ensuring the safety of every blood transfusion is central to that effort.
Blood transfusions save the lives of mothers with childbirth complications, children with severe anaemia, patients with thalassaemia and cancer, accident victims and those undergoing major surgery. But when blood is collected from unsafe donors or inadequately screened, it can transmit life-threatening infections, particularly hepatitis B and hepatitis C.
National evidence highlights the scale of the challenge. A systematic review covering more than 10 million blood donors found hepatitis B prevalence of approximately 1.1 percent, while another analysis of nearly 8.9 million blood donors estimated hepatitis C prevalence at 2.71 percent. Earlier studies among repeatedly transfused thalassaemia patients reported hepatitis C prevalence of almost 30 percent and hepatitis B prevalence of more than four percent. These findings underline why every donated unit of blood must undergo reliable, quality-assured screening before transfusion.
The first line of defence against transfusion-transmitted infections is a strong culture of regular, voluntary and unpaid blood donation. Such donors generally belong to lower-risk populations and are more likely to provide accurate information during donor screening. Yet only about 18 percent of Pakistan’s blood supply comes from voluntary unpaid donors, while the country remains heavily dependent on family and replacement donors. Transforming blood donation from an emergency family obligation into a routine civic responsibility requires sustained public awareness and institutional support.
Equally important is the quality of blood screening. Every donated unit should be tested for hepatitis B, hepatitis C, HIV, syphilis and malaria using validated technologies, trained personnel and rigorous quality-control systems. Weak laboratory practices, inadequate quality assurance and poor regulatory oversight can allow infected blood to enter the supply chain. Participation in external quality assessment programmes, regular inspections of blood centres and adoption of improved testing technologies can further minimise these risks.
Provincial and federal blood transfusion authorities also need adequate resources and stronger regulatory powers to license blood centres, conduct routine inspections, enforce uniform national standards and close facilities that repeatedly fail to comply with safety requirements. Effective haemovigilance systems should also be strengthened so that transfusion-related infections and adverse events can be detected, investigated and prevented from recurring.
Pakistan has already adopted the National Blood Transfusion and Blood Products Policy 2025-30, but policies alone cannot improve blood safety without effective implementation. An empowered National Blood Transfusion Council, or an equivalent national coordinating mechanism, should bring together federal and provincial health authorities, regulators, public and private blood services, professional organisations, thalassaemia centres and patient representatives. Such a platform can harmonise standards, strengthen donor recruitment, improve national data collection, coordinate staff training, enhance emergency preparedness and monitor transfusion-transmitted infections. The WHO likewise recommends that blood collection, testing, processing, storage and distribution should operate through an organised national blood transfusion system.
On this World Hepatitis Day, Pakistan must recognise that every unsafe blood transfusion carries the risk of creating another lifelong hepatitis patient. Safe blood is not merely a laboratory issue; it is a public health responsibility. Strengthening blood transfusion authorities, expanding voluntary blood donation, ensuring quality-assured screening and implementing coordinated national policies can help ensure that blood given to save a life never becomes the source of another disease.
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