Adapting and piloting the integrated comorbid hepatitis test-treat-prevent care of MDR-TB Tuberculosis patients and PLHIV/key population in Pakistan and Malawi.

DURATION Six months


GEOGRAPHIC AREA  Malawi and Pakistan

PARTNER Association for Social Development (ASD)


This project aims to adapt and pilot an integrated hepatitis “test-treat-prevent” care model for a) Multidrug-resistant tuberculosis (MDR-TB) patients as well as People living with HIV (PLHIV)/ key populations in Punjab; and b) PLHIV in Malawi.


Pakistan is the 2nd highest hepatitis C (HCV) burden country in the world, with China having the highest number of people suffering from HCV.

The integrated hepatitis care at the primary health care level in Punjab supported by The Hepatitis Fund (THF), was successfully implemented by the Association for Social Development (ASD) with excellent results and outcomes. It was adapted and expanded through THF support for integrated care at rural health centres.

In Multidrug-resistant tuberculosis (MDR-TB) patients, identifying and managing hepatitis comorbidity (if found) is essential for their overall health and well-being. Hepatitis screening and care have theoretically been a part of MDR-TB care. Still, it is not yet happening because of a lack of comorbid care protocols and linkages for offering “test-treat-prevent” care. This leads to the missed opportunity to screen around 3,000 MDR-TB patients and manage comorbid hepatitis accordingly.

In PLHIV and key populations (i.e., sex workers, people who inject drugs, transgender people, men who have sex with men,  etc.), identifying and treating comorbid chronic HCV/ HBV is a known priority. The Global Fund to Fight AIDS, Tuberculosis, and Malaria has recently created a window for assisting the programmes to implement integrated comorbid hepatitis test-treat-prevent care for known PLHIVs and key populations.


ASD will assist the three programmes (Hepatitis, TB and HIV/ AIDS) to adapt and pilot the integrated hepatitis comorbid care of MDR-TB patients and PLHIV/ key populations in Punjab.

ASD will also provide technical assistance and capacity building to a non-governmental organization in Malawi to adapt and pilot an integrated hepatitis comorbid care of PLHIV in primary settings in Malawi.


An adapted package for integrated comorbid hepatitis care (of DR-TB patients and PLHIV/ key populations) will be created. It will include adapted care products and care linkages for the patients to access ongoing public-funded HCV/HBV care at the ongoing Hepatitis Clinics.

Implementation of the comorbid hepatitis care of ≥1,300 MDR-TB patients at 13 MDR-TB sites and ≥1,000 PLHIV/ key populations in a selected district of Punjab

Expansion of the integrated comorbid hepatitis care of MDR-TB patients at the GFATM-supported MDR-TB sites in Punjab and other provinces of Pakistan.

Partner and programme enabling the implementation of integrated comorbid hepatitis care of PLHIV in other parts of Malawi (preferably through GFATM forthcoming work plans)

The results and the products will be shared with potential stakeholders within and outside Pakistan for the potential application of the pilot model in other settings.

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