For Dr. Nida Ali, eliminating viral hepatitis is not just a public health challenge, it’s personal. In 2012, Dr. Ali’s mother lost her battle to hepatitis C because she was diagnosed late and at that time, had no access to the current treatment regimens. This had a profound personal effect on Dr. Ali and charted her career in public health.
Globally, viral hepatitis is killing more people than HIV and malaria combined. An estimated 58 million people living with hepatitis C worldwide are at risk of death from progressive liver damage, liver failure, and liver cancer. The United Nations has declared hepatitis elimination as one of the Sustainable Development Goals with the intention to reduce mortality, active infections and active transmissions by 2030.
“The hepatitis elimination community in Pakistan is still very small and most infections are being transmitted through healthcare,” explains Dr. Ali. “We still need to do some real groundwork for prevention to stop it at the source, which comes down to better healthcare: preventing unsafe injections, unsafe surgeries, unsafe blood transfusions.”
The largest number of hepatitis C patients in the world are living in Pakistan, comprising 17% of hepatitis C infections worldwide. An estimated 20,000 people or more die each year in Pakistan from hepatitis-related causes. In 2019, in conjunction with World Hepatitis Day, the government of Pakistan launched a National Hepatitis Elimination Initiative to invest $125 million in hepatitis control. The ambitious initiative aims to screen 140 million people and provide treatment to those that are infected.
Dr. Nida Ali is a medical doctor and public health specialist with expertise in infectious disease prevention and elimination, including both polio and hepatitis elimination. While Dr. Ali was a Humphrey Fellow studying Global Health Policy & Program Management at Emory University in 2022, she met Dr. John Ward, Director of The Task Force’s Coalition for Global Hepatitis Elimination (CGHE), who later became her mentor.
Eliminating Hepatitis in her Hometown in Pakistan
When Dr. Ali returned to Pakistan in 2023, she became a CGHE Hepatitis Evaluation Research & Outreach (HERO) Fellow and founded an implementation research project called the Local Hepatitis Elimination and Prevention (LHEAP) in her hometown of Rawalpindi. Rawalpindi district has a population of 6.5 million people and is located in the Punjab Province of Pakistan. CGHE, in partnership with the Ministry of Primary and Secondary Healthcare of Punjab, provided technical and financial support for the LHEAP project.
“Although there are many micro-elimination projects in Pakistan, the comprehensive LHEAP project study was the first of its kind that catered to both hepatitis B and C and offered door-to-door hepatitis screenings and hepatitis treatments and vaccinations to Rawalpindi residents that ranged from newborns to age 95,” said Dr. Ali. “LHEAP screened 35,000 people, discovered 800 cases of hepatitis B and C and vaccinated 17,000 adults.”
Dr. Ali’s Global Advocacy for Hepatitis Elimination
With the support of her mentor, Dr. John Ward and the CGHE team, Dr. Ali’s advocacy for hepatitis elimination has reached beyond even the borders of Pakistan. She helps CGHE coordinate the UN Group of Friends to Eliminate Hepatitis, which, according to the WHO UN New York Office is the fastest growing UN Group of Friends dedicated to a specific disease. In 2022, CGHE reached out to Member States at the UN, under the leadership of UN Mission of Egypt, to raise diplomatic awareness and high-level political and diplomatic support for putting hepatitis elimination at the forefront of high-level health discussion agendas.
Dr. Ali is passionate about the work she is doing at the international level.
“The purpose of the UN Group of Friends is to reach the right people who actually have influence to draw the national and global finances and resources towards this cause. Mobilizing commitment, generating political will, and orienting people who hold high political and diplomatic offices about why eliminating hepatitis is so important. This is the core of the UN Group of Friends,” said Dr. Ali.
As Dr. Ali assists planning and preparations for the 3rd Annual meeting of the UN Group of Friends to Eliminate Hepatitis, which will happen on the sidelines of the 79th United Nations General Assembly in September 2024, in the back of her mind and always in her heart, she is strategizing ways that she can adopt successes from other national hepatitis programs and implement them in her own country.
In Pakistan, Dr. Ali is eager to witness even more political and financial support for hepatitis elimination.
“To eliminate hepatitis from Pakistan, we have to take the approach that Egypt did,” said Dr. Ali. “The level of commitment from President Sisi’s office and how he announced this program to screen millions of people and provide treatment in less than a year. They made this cost effective by producing their own generic antiviral pills. Learning from Egypt, we need a very holistic approach and need to have a very effective, vertical elimination program catered to hepatitis C only. I am hopeful that if we invest in enough financial and human resources, enough political will, we can make good progress and eliminate hepatitis.”
Dr. Ali is especially focused on preventing hepatitis transmission and helping people who are infected as soon as possible. “Most of the work we do in infectious disease surveillance is largely about prevention of new infections and timely diagnosis. I know that both these approaches can save lives.” On a more personal note, Dr. Ali notes, “I believe that if my mother had access to prevention, timely testing, and treatment, her life could have been saved. There is always this personal reason for being so empathetic towards people who are getting the virus, who are getting the disease, who are still dying of hepatitis. This is always in my mind as I pursue new solutions for my community and the world.”
