To mark World Hepatitis Day on Thursday, WHO urged policymakers, health care providers and political and civil society leaders in the South-East Asia Region and globally to accelerate hepatitis testing and treatment, recognizing that everyone, everywhere has just one life and one liver as the theme of this year's event suggests.
"Our targets are ambitious but achievable. By 2030, we must achieve a 90% reduction in new chronic hepatitis infections and a 65% reduction in hepatitis mortality. We must eliminate hepatitis as a public health threat. On World Hepatitis Day, WHO reiterates its support to all countries of the Region to accelerate rapid, strategic and equitable progress, for healthier livers and healthier lives," WHO Regional Director for South-East Asia Dr Poonam Khetrapal Singh, said in a message on Friday.
WHO's South-East Asia Region comprises 11 member states Bangladesh, Bhutan, Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.
Globally, an estimated 354 million people live with chronic hepatitis B and C and nearly 1.1 million die annually from hepatitis-related complications such as liver cirrhosis and cancer.
"Most of the patients come with liver cancer between the ages of 30 and 45, the most productive years in our country. It is because of hepatitis B virus infection," liver expert Prof Mamun Al Mahtab Shwapnil told Dhaka Tribune, as there had been no provision for giving hepatitis B vaccine in routine immunization once upon a time.
In Bangladesh, estimates suggest 10 million suffer from hepatitis B and C.
The hepatitis B vaccine was introduced during 2003 to 2005 into the Expanded Program on Immunization (EPI) in Bangladesh, using the WHO-recommended schedule.
"Hundreds of millions of people with hepatitis remain unaware of their status, which is why for decades it has been referred to as the ‘silent killer'," Dr Poonam Khetrapal Singh said.
Safe and effective vaccines can prevent hepatitis B and antiviral drugs can manage chronic hepatitis B and cure most cases of hepatitis C.
However, to achieve these outcomes and eliminate hepatitis as a public health threat by 2030 – the Sustainable Development Goal target – access to prompt and accurate testing is required.
The South-East Asia Region accounts for around 20% of the global hepatitis mortality burden.
An estimated 81% of all hepatitis deaths in the Region are attributable to hepatitis B and C. An estimated 60 million people live with chronic hepatitis B and about 10.5 million live with chronic hepatitis C.
Every year, the Region sees almost half a million new hepatitis B and C infections – about one every minute.
Nine countries of the Region have achieved coverage of more than 90% of the third dose of the hepatitis B vaccine. Eight countries now also provide the hepatitis B vaccine birth dose. To date, four countries have controlled hepatitis B through vaccination.
However, timely access to testing and treatment for hepatitis B and C continues to lag.
Just 10.5% of people who are eligible for treatment of hepatitis B know their status, and just 4.5% are on treatment.
For hepatitis C, just 6.9% of people eligible for treatment know their status, and of them, just 23% have access to treatment.
To accelerate Region-wide access to hepatitis testing and treatment, WHO is calling for action in several key areas, Dr Poonam Khetrapal Singh said.
First, policymakers should incorporate hepatitis testing and treatment into packages of essential primary health care services, recognizing that testing and treatment must be accessible within the community, close to where people live and work, and included as part of universal health coverage.
Second, health and community leaders should reach out to, empower and engage vulnerable and high-risk communities specifically, and people from all walks of life generally, building on the immense success of similar initiatives for HIV, as well as the region's ‘Nothing for us, without us' approach.
Third, policymakers and health care providers – including in the private sector – should actively integrate services for hepatitis, HIV and sexually transmitted infections (STIs), in alignment with the Region's integrated Action Plan for Viral Hepatitis, HIV and STIs 2022–2030, and with a focus on increasing efficiency and reducing gaps and fragmentation.
Fourth, countries should realign – as appropriate – the funding allocated to each of the three diseases, with a focus on delivering maximum impact, based on current disease burdens.