A silent epidemic of liver disease

EDITORIAL: This year’s World Liver Day, observed on Sunday under the theme “Solid Habits, Strong Liver, ” must not pass as a mere symbolic date. It is a reminder of a public health crisis that continues to grow quietly but relentlessly in Pakistan. Marking the occasion, the Pakistan Medical Association (PMA) warned that an estimated 13. 8 to 15 million people in the country are living with hepatitis B or C, including nearly 10 million with hepatitis C alone—giving Pakistan one of the heaviest disease burdens globally. The scale of the problem is alarming. Even more concerning is the vast gap in awareness: only about a quarter of those infected know their status, leaving millions at risk of severe complications such as cirrhosis and liver cancer. Beyond its medical dimensions, this silent public health crisis carries profound social and economic costs. Each year, approximately 37, 000 lives are lost to liver-related complications, many of which are preventable. These are not just statistics; they represent families disrupted, livelihoods lost, and a healthcare system under rising strain. Moreover, the high viraemic prevalence reported in certain regions highlights stark disparities in healthcare access and awareness, particularly in underserved communities. These realities point to a deeper mix of systemic failures and evolving lifestyle risks. Unsafe medical practices, such as the use of unsterilized equipment and unscreened blood transfusions, continue to drive transmission. At the same time, changing dietary habits marked by excessive consumption of oily foods, high-fructose sugars, and ultra-processed products are fuelling non-viral liver diseases, including fatty liver. Sedentary lifestyles further compound the risk, particularly in urban populations. The response, therefore, must be both preventive and structural. Public awareness campaigns need to move beyond token messaging and promote routine screening as a social norm. Early diagnosis is critical, not only to prevent disease progression but also to reduce transmission. At the same time, people must be encouraged to adopt healthier habits: balanced diets, regular physical activity, and caution in the use of medications, particularly self-prescribed drugs that may harm the liver. Yet individual responsibility alone will not suffice. As emphasised by the PMA, the government must act decisively to strengthen primary healthcare infrastructure. Decentralising diagnostic facilities is essential to ensuring that people in remote and rural areas can access testing without prohibitive costs or travel. Equally important is the availability of affordable treatment across all provinces, as early intervention can significantly reduce mortality. Pakistan has the knowledge and the tools to address this public health challenge. What is needed now is urgency and coordination. World Liver Day should serve as a catalyst for sustained action—uniting policymakers, healthcare providers, and the public in a collective effort. Without such commitment, the silent epidemic of liver disease will continue to exact a heavy toll on the nation’s health. Copyright Business Recorder, 2026

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