The Ministry of Health has instructed all the provinces to concentrate on the prevention of hepatitis in accordance with the PC-1 of Prime Minister's Hepatitis Control Programme. The federal government also slashed the quantity of the hepatitis vaccines to the provinces, sources said. The government had launched a five-year programme with Rs2.59 billion in August 2005 with a view to put brakes on the five types of disease through preventive measures. However, all the provinces had focused on the treatment component of the programme leaving aside the preventive side. The objective set forth for the programme could not be achieved during the first three years due to this trend. "The federal government has taken exception to what is being done by the provinces and has asked them to focus on prevention, because treatment is extremely expensive,' sources said. They added that under the programmes hundreds of patients had to give up their treatment incomplete owing to non-availability of the injections. The patients were visiting the designated hospitals for getting the injections that were often not available, they added. Sources said that according to the PC-1, the provinces were required to start treatment of the patients from their own resources from the third year of the programme. Only Punjab and Sindh have started the treatment programme of the patients, whereas NWFP and Balochistan are yet to allocate budget for the purpose. The federal government had also directed the provinces to contact Baitul Maal for the treatment of the patients, but no heed was paid to the directives and the provinces looked towards the Ministry of Health only. Ministry of Health had sent NWFP injections for 130 hepatitis patients for year 2007-08. Out of them 1,500 injections were for hepatitis C and 1,000 for hepatitis B patients. The patients in the NWFP have been running from pillar to post to get their treatment completed.National Programme Manager Dr Sharif Ahmad Khan told Dawn that the basic purpose of the programme was to stem the tide of the infection through putting in place preventive measures. He said that preventive measures against the disease were the only option being pursued worldwide. "We are going to expand the programme with more emphasis on control of the disease. We need to explore the causative agents of the ailments and try measures aiming at prevention,' he added. According to him, the government was taking keen interest in expansion of the programme owing to the soaring number of hepatitis patients in the country. According to him the Ministry of Health had collected 49,000 blood samples from people of various areas to know the magnitude of the hepatitis prevalence. He said that there were about 250 hospital-based studies conducted in Pakistan's premier health institutions suggesting prevalence of hepatitis B 3.4 per cent and Hepatitis C 5-6 per cent. But the government wanted a highly scientific study to know about the disease's prevalence and initiate preventive steps accordingly. Sources said that the Ministry of Health was persuading the provinces to implement the Behavioural Change Communication (BCC) strategy of the programme which called for sensitisation of the media and the general population regarding the disease. Under the preventive strategy, he said, incinerators and water purification plants were being installed in public sector hospitals.