The World Health Organization (WHO) in the Western Pacific continues to build momentum in addressing the very high burden of viral hepatitis, which causes more than half a million deaths annually in the Region.
Nearly 40% of global deaths attributable to viral hepatitis occur in the Western Pacific, more than the combined death toll from HIV/AIDS, tuberculosis and malaria. Ninety-six percent of deaths from viral hepatitis are from complications following chronic hepatitis B or C infection including cirrhosis and liver cancer.
Of the 130–150 million people chronically infected with hepatitis C worldwide, more than 60 million live in the Western Pacific Region. The Region also contains nearly 60% of the world's liver cancer. About 900 people die in the Region each day from hepatitis B-related diseases mainly liver cirrhosis and liver cancer.
Both hepatitis B and C are preventable. Effective hepatitis B virus treatments reduce liver cancer risk by 50% and new hepatitis C virus treatments cure infection more than 90% of the time.
Two World Health Assembly resolutions in 2010 and 2014 have called for comprehensive country action to address viral hepatitis. The draft Regional Action Plan for Viral Hepatitis seeks to support Member States’ efforts in the development of comprehensive hepatitis strategies and to build on regional success in hepatitis B immunization in the Western Pacific.
Increased access to a cheap, safe and effective hepatitis B vaccine has resulted in the Western Pacific Region achieving the milestone of reducing childhood hepatitis B prevalence in 5-year-olds to less than 2% by 2012. Twelve countries have already achieved the regional goal of less than 1% hepatitis B prevalence by 2017. However, there remains a very large number of adults living with chronic hepatitis in our Region, many of whom are unaware of their condition.
Several challenges must be addressed to effectively deal with this issue. For example, transmission of hepatitis C within health services remains an issue in many settings and the high cost of effective treatment puts it out of reach of the vast majority of those who need it.
The WHO Regional Office for the Western Pacific recently hosted a consultation for Member States in Manila to consider the draft Regional Action Plan for Viral Hepatitis.
This action plan foresees a series of initiatives from WHO, including developing treatment guidance for chronic hepatitis B and C, providing direct support to countries developing national hepatitis action plans and adding effective hepatitis B and new oral hepatitis C antivirals to the WHO Model List of Essential Medicines.
Five priority action areas were identified during the consultation; (1) broad-based advocacy and awareness; (2) evidence-informed policy; (3) data to support a comprehensive hepatitis response; (4) stopping transmission; and (5) an accessible and effective treatment process.
It was also agreed that the response to viral hepatitis must be comprehensive, noting that action in any single area will not reduce the burden of disease. Stigmatization and discrimination continue to act as barriers to effective hepatitis prevention and care. Only through sustained collective efforts can discrimination be addressed and prevention, diagnosis and treatment be successful.
Following the consultation, the draft Regional Action Plan for Viral Hepatitis will be disseminated across the Region for feedback, focusing on the key elements for achieving consensus targets over the next 5 years. Action on viral hepatitis will be considered by Member States during the sixty-sixth Regional Committee for the Western Pacific in Guam this October.