Pakistan: Celebrating MSF’s Success in Hepatitis C Treatment in Machar Colony, Karachi

Karachi, 29 Jan 2025: Médecins Sans Frontières (MSF) announced the closure of its long-running hepatitis C project in Karachi, bringing to an end nine years of free, lifesaving treatment in one of Pakistan’s most underserved urban communities. A new report, “The fight against ‘a silent killer’ – The hepatitis C virus,” chronicles the successes, setbacks, and lessons learned from this initiative, which concluded in December 2024 after reaching people who often lacked access to even basic healthcare.

Pakistan carries the world’s highest burden of hepatitis C, and limited resources mean many people struggle to find treatment—particularly those living in informal settlements. MSF first concentrated on hepatitis C care in 2015, working out of its existing primary healthcare services in Machar Colony, one of Karachi’s largest informal neighbourhoods. Encouraged by early results, MSF set up a dedicated hepatitis C clinic in 2018 and ultimately launched the “Bending the Curve” campaign intended to reduce Hepatitis C infection, a door-to-door screening and treatment drive that reached over 74,000 people. Across Karachi, more than 130,000 were screened during the project, and nearly 10,000 started treatments with newer, more tolerable and effective medication.

“Providing healthcare to vulnerable communities demands not just medical skill, but a clear understanding of the economic and cultural barriers that keep people from seeking help,” said Ahmed Wileo, Head of Mission for MSF in Pakistan. “By partnering with local residents, shaping our strategies around their needs, and pushing for more affordable testing and treatments, we’ve managed to make a genuine impact. Although our hepatitis c project in Karachi has now ended, MSF will keep supporting efforts to eliminate this silent disease and will continue advocating for wider access to testing and care.”

A survey from early 2022 showed that 13.5 percent of Machar Colony residents tested positive for hepatitis C, with 4.1 percent carrying an active infection. Of those who began treatment during the “Bending the Curve” initiative, nearly three-quarters completed their first course of medication, and of those checked afterwards, more than 94 percent were fully cured. “We started by weaving hepatitis C services into basic healthcare,” said Dr Khawar Aslam, MSF’s Project Medical Referent in Karachi. “Once we saw how successful that was, we moved to a dedicated clinic and later to a mass campaign that took testing and treatment right to people’s doorsteps. Going forward, I urge health authorities to expand decentralized hepatitis C care, especially in remote and marginalized areas, and to invest in point-of-care tests that let patients start treatment more quickly.”

MSF also partnered with the health department Sindh 2023 to pilot a decentralized model of hepatitis C care at Baldia’s public primary healthcare clinic, screening over 3,300 people and initiating treatment for 146. The clinic has since been named a sentinel site for hepatitis C in Sindh Province, highlighting the programme’s long-term viability. "Eliminating hepatitis C in Pakistan seems ambitious. Our Machar Colony intervention reduced prevalence, but without robust measures, rates may rebound within a decade," said Dr Ei Hnin Hnin Phyu, Medical Coordinator for MSF in Pakistan. "Comprehensive strategies-strengthening community awareness, harm reduction, widespread testing, accessible treatment for all (including undocumented and high-risk groups), and decentralized services—are vital to break the chain of infection. These approaches should be swiftly integrated into national health policies to achieve true elimination of Hepatitis C in Pakistan." “We learned that any serious effort to combat this disease has to tackle not just the medical aspects, but also the social conditions that allow it to spread,” said Wileo. “We hope our experience here will guide policymakers to scale up proven methods and ultimately bring the country closer to ending hepatitis C.”

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Pakistan: Celebrating MSF’s success in hepatitis C treatment in Machar Colony, Karachi

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Source: Médecins Sans Frontières