Stakeholder perspectives and the challenges in implementing hepatitis C elimination policy in Pakistan

Despite significant achievements in combating hepatitis C (HCV), HCV remains a major global public health issue with approximately 71 million cases and 400,000 deaths annually. The international community has taken several important steps for HCV control, including the Global Health Sector Strategy (2016-2021), the Global Hepatitis Action Plan (2011), and the United Nations Sustainable Development Goals (UN-SDGs) for 2030. However, achieving the World Health Assembly's goal of eliminating HCV by 2030 treating 90% of all infected individuals remains a significant challenge, particularly in Pakistan. This study delves into the perspectives of key stakeholders involved in the hepatitis elimination policy and its implementation in Pakistan, identifying barriers to effective policy execution and highlighting motivating factors. Through a phenomenological approach, interviews were conducted with ten key informants, including policymakers, clinicians and provincial hepatitis program personnel. Thematic analysis uncovered several critical themes: perceptions of hepatitis and elimination policies, the feasibility of achieving elimination goals, international collaborations, policy development, gaps in epidemiological data, and the influence of political contexts. The findings emphasize the need for a robust national database, stronger political commitment, better resource allocation, and a more integrated healthcare system. Drawing on successful models, such as Egypt, the study suggests that Pakistan must adopt comprehensive and coordinated strategies to meet the WHO targets and eliminate hepatitis by 2030.