Viral hepatitis is a pressing threat to public health. Every year, hepatitis kills an estimated 1.4 million people globally. It makes many times that number sick. Around 257 million people across the world live with hepatitis B, while roughly 71 million are infected with hepatitis C. Together these viral types account for more than 90% of hepatitis-related mortality. Significantly, the number of people that die from hepatitis annually is more than those killed by HIV/AIDS and close to the number killed by tuberculosis.
On World Hepatitis Day, we must reflect on these facts. We must also highlight the need to mobilize funding and invest in eliminating the scourge – precisely as this year’s World Hepatitis Day demands.
This is particularly true for the WHO South-East Asia Region, where hepatitis kills an estimated 410 000 people annually; where less than 10% of infected people know their status; and where less than 10% of those who do know their status are on treatment. Though resolve to fully implement the Regional Action Plan for Viral Hepatitis and achieve its time-bound targets is strong, accelerating progress and making full use of innovative policies and technologies requires increased – and targeted – investment.
That is exactly what WHO and its Member States in the Region are working to catalyze. Next month, for example, WHO will host a meeting to track the Region’s progress in implementing the Plan, at the same time as supporting Member States prioritize interventions to prevent, detect and treat the disease across services, with a focus on its most lethal forms – hepatitis B and C. As part of the meeting, specific attention will be paid to developing fully costed national plans to help secure the financing needed to achieve the Region’s targets and eliminate the disease as a public health threat by 2030, as per WHO’s Global Health Sector Strategy on Viral Hepatitis.
As burden-specific national plans are developed and earmarked funding is mobilized, there are several key areas of work that must be focused on Region-wide. This is especially so as we strive to accelerate recent momentum in controlling hepatitis B – particularly by providing the hepatitis B vaccination during infancy, including the birth-dose – and capitalize on revolutionary breakthroughs in treating hepatitis C.
To that end, efforts should be made to step up awareness and commitment. Countering hepatitis effectively requires policymakers fully appreciate the burden the disease represents and the funding an integrated response demands, both within the health sector and beyond. It also requires health workers be actively educated on the need to screen for hepatitis, particularly given it is often asymptomatic. That is also why enhanced knowledge and awareness among the public is key, and why health authorities must achieve that outcome across society generally, and among high-risk groups specifically.
As strong as awareness is, however, it must be matched by the effective implementation of key prevention strategies. As recent progress shows, the hepatitis B vaccine, which is part of routine immunization across the Region, is a powerful tool to prevent new infections. To expand its reach, all Member States should make efforts to achieve and sustain high coverage of hepatitis B vaccination during infancy, as well as rolling out the vaccine’s birth dose, which prevents mother-to-child transmission of the disease. Other key strategies should likewise be strengthened. This includes the provision of re-use preventable injection equipment, increased haemovigilance, the collection of all blood from voluntary, non-remunerated donors, and the implementation of strategies to reduce the likelihood of sexual transmission or transmission among injecting drug users.
When infection does occur, early detection and treatment is key to avoiding complications such as fibrosis or liver cancer. Recent advances in direct-acting antiviral drugs mean that most people with hepatitis C can be completely cured with just 12 weeks of treatment. Even for hepatitis B, morbidity and mortality can be considerably reduced with the provision of lifelong treatment. To achieve these outcomes, however, access to both medicines and diagnostics must be significantly increased, while recent cost reductions must be taken full advantage of. Doing so should be considered a good in itself, as well as part of the Region’s Flagship Priority of achieving universal health coverage.
As we mark World Hepatitis Day, that point should be front of mind. Making the necessary investments in preventing, detecting and treating hepatitis is crucial to ensuring an integrated, system-wide approach can be taken, with community engagement and synergies across and beyond the health sector actively pursued. That, in turn, is crucial to ensuring all people can avoid the morbidity and mortality the disease is responsible for. By any measure – whether human, social or economic – the cost of inaction is, after all, many times greater than the cost of doing what’s needed, and doing it now.