CDC in Pakistan: Polio, Hepatitis C and Drug-Resistant Typhoid

Three facts explain much of CDC's work in Pakistan. It is one of two countries where the spread of wild poliovirus has never been interrupted. It has one of the highest hepatitis C infection rates in the world — an estimated 4–5% of the population lives with the virus. And it is the only country where extensively drug-resistant typhoid fever is regularly reported.

CDC works with the Government of Pakistan, the Pakistan National Institute of Health and other partners to detect, prevent and respond to health threats. Pakistan belongs to CDC's Middle East/North Africa regional platform — 25 countries, with a regional office in Oman and a country office in Pakistan.

An epidemiologist conducts HIV-related contact tracing in Pakistan. CDC.

Polio

A partner in the Global Polio Eradication Initiative (GPEI), CDC has supported polio eradication and immunization in Pakistan since 2012, working also with the GPEI Afghanistan and Pakistan Hub in Amman, Jordan. The aims:

• sharper surveillance for acute flaccid paralysis, a possible sign of polio;
• better mass immunization campaigns, with fewer children missed;
• higher vaccine acceptance, through integrated services and closer work between GPEI and the Expanded Programme on Immunization;
• better data and risk assessment for decisions at national, provincial and district levels.

Hepatitis and disease surveillance

CDC has funded and advised viral hepatitis prevention and control for more than 15 years, sits on the technical advisory board of Pakistan's National Committee on Hepatitis, and helped build a national database tracking influenza and hepatitis.

Through a cooperative agreement with the Pakistan NIH, five surveillance sites set up since 2004 track influenza-like illness in outpatients and severe acute respiratory illness in hospitals; CDC helped four of the five test for influenza on site, so outbreaks are detected faster.

Drug resistance

CDC helps Pakistan detect, track and report drug-resistant organisms, including the fungus Candida auris — detecting invasive candidemia, running infection prevention and control at 12 sentinel hospitals, and supporting whole-genome sequencing of multidrug-resistant organisms to understand how spread in health care drives resistance in the community.

People and institutions

• Field epidemiologists. CDC has supported Pakistan's Field Epidemiology and Laboratory Training Program (FELTP) since 2006: the Advanced level trains national public health leaders, the Frontline level community epidemiologists. FELTP was key in several emergencies and in setting up the country's first hepatitis surveillance sites; the government took ownership of it in December 2021.
• Laboratory leaders. The Global Laboratory Leadership Program began in Pakistan in 2019; its first cohort graduated in 2023.
• Health security. Pakistan's National Public Health Institute coordinates detection and response and works on research, environmental and occupational health, nutrition, non-communicable diseases and vaccines. CDC helped Pakistan complete Joint External Evaluations of its health security in 2016 and 2023.

Sources

Based on "CDC in Pakistan," Centers for Disease Control and Prevention, Global Health; a work of the United States government in the public domain.