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Pakistan has the second highest burden of HCV in the world, a rising number of liver cancer cases and a unique pattern of healthcare\u2010associated HCV transmission. Unfortunately, the country is not on track to meet the WHO's target of complete elimination of HCV by 2030. The current reliance on vertical programmes for hepatitis elimination may seem effective in the short term, but is often unsustainable, ineffective and contributes to the fragmentation of the health system. This review proposes a health system strengthening approach to HCV detection and prevention in the country. It critically evaluates the country's health system and the existing evidence on HCV prevention and treatment, proposing evidence\u2010based strategies for decentralising HCV services and integrating them into the primary healthcare infrastructure. It examines the effectiveness of methods such as task shifting and targeted interventions while suggesting changes to healthcare practices to reduce healthcare\u2010associated transmission of HCV and other blood\u2010borne pathogens.<\/jats:p>","DOI":"10.1111\/jvh.14050","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T09:49:47Z","timestamp":1734774587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Health Systems Strengthening Approach to Address the High Burden of Hepatitis C in Pakistan"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1365-5535","authenticated-orcid":false,"given":"Mahnoor","family":"Qureshi","sequence":"first","affiliation":[{"name":"School of Health Sciences The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa366"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5942306"},{"key":"e_1_2_8_4_1","article-title":"Global Health Sector Strategies on HIV","volume":"92","author":"Geneva: World Health Organization","year":"2021","journal-title":"Viral Hepatitis and the Sexually Transmitted Infections"},{"key":"e_1_2_8_5_1","volume-title":"Coaliton for Global Hepatitis Elimination","author":"National Hepatitis Elimination Profile","year":"2022"},{"key":"e_1_2_8_6_1","unstructured":"World Health Organization \u201c15 Million People Affected With Hepatitis B And C in Pakistan: Government Announces Ambitious Plan to Eliminate Hepatitis \u201d(Geneva:World Health Organization 2019)."},{"key":"e_1_2_8_7_1","unstructured":"Centre for Disease Control \u201cGlobal Viral Hepatitis: Millions of People Are Affected | CDC \u201d(2024) https:\/\/www.cdc.gov\/hepatitis\/global\/index.htm."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4403-7"},{"key":"e_1_2_8_9_1","first-page":"1003","article-title":"Hepatitis B and C Survey Pakistan 2007\u20132008 | Pakistan Health Knowledge Hub","volume":"3","author":"Pakistan Medical Research Council","year":"2008","journal-title":"Pakistan Journal of Medical Sciences"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2017.120"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.12779"},{"issue":"12","key":"e_1_2_8_12_1","first-page":"1045","article-title":"A Review of Hepatitis Viral Infections in Pakistan","volume":"60","author":"Bosan A.","year":"2010","journal-title":"Journal of the Pakistan Medical Association"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi048"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2008.06.019"},{"issue":"11","key":"e_1_2_8_15_1","first-page":"1149","article-title":"Comparison of Need and Supply of Syringes for Therapeutic Injections in Pakistan","volume":"62","author":"Khan A. 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