A future free of hepatitis

Source: This post is based on the article “A future free of hepatitis” published in The Hindu on 28th July 2022.

Syllabus: GS 2 – Issues relating to development and management of Social Sector/Services relating to Health.

Relevance: About the elimination of hepatitis.

News: On World Hepatitis Day, the World Health Organization (WHO) highlighted the need to make hepatitis care available, affordable and accessible to all without discrimination. This is crucial to eliminate viral hepatitis as a public health threat by 2030, a global target.

Note: Elimination would translate to a 90% reduction in incidence and a 65% reduction in mortality by 2030, compared to the corresponding figures of 2015.

Why the world should focus on eliminating hepatitis?

Firstly, Hepatitis is the only communicable disease where mortality is showing an increasing trend. About 95% of all hepatitis-related deaths are due to cirrhosis and liver cancers caused by the hepatitis B and C virus. Southeast Asia has 20% of the global morbidity burden of hepatitis.

Secondly, viral hepatitis is preventable. Clean food and good personal hygiene, along with access to safe water and sanitation, can protect us from hepatitis A and E. Measures to prevent hepatitis B and C need to focus on full coverage with hepatitis B immunisation.

Thus, the world can prevent 4.5 million premature deaths in low- and middle-income countries by 2030 globally.

Thirdly, a world free of hepatitis is practical and feasible. The world at present has the tools to diagnose, treat, prevent and therefore eliminate chronic viral hepatitis.

What are the various initiatives taken around the world to eliminate hepatitis?

The Southeast Asia region has launched an Action Plan for viral hepatitis 2016–2021. Nine countries have achieved more than 90% coverage of the third dose of hepatitis B vaccine. Four countries have achieved the hepatitis B control target of less than 1% seroprevalence among children over five years of age.

An integrated Regional Action Plan for viral hepatitis, HIV and STIs 2022–2026 is being developed by WHO. This will ensure effective and efficient utilisation of limited resources and will guide countries to adopt a person-centred approach rather than a disease-specific one.

What are the challenges in eliminating hepatitis?

a) Access to diagnose and treat hepatitis is out of reach for communities as they are usually available at centralised/specialised hospitals, b) People continue to die because of late diagnosis or lack of appropriate treatment, In the Southeast Asia region, only about 10% of people with hepatitis know their status; and of them, only 5% are on treatment.

What should be done to eliminate hepatitis?

To eliminate hepatitis by 2030, the world in 2025 must reduce new infections of hepatitis B and C by half, reduce deaths from liver cancer by 40%, and ensure that 60% of people living with hepatitis B and C are diagnosed. This can be done by,

a) Enhanced political commitment across all countries of the region, b) Ensuring sustained domestic funding for hepatitis, c) Improving access to drugs and diagnostics by reducing prices, d) Developing communication strategies to increase awareness; e) Innovate service delivery to maximise the people-centred service delivery options across HIV, viral hepatitis and STIs, and f) decentralising hepatitis care to peripheral health facilities, community-based venues and locations beyond hospital sites to improve patients’ access to diagnose and treat Hepatitis.