World Hepatitis Day, marked annually on 28 July, was established by the World Health Organization (WHO) to raise awareness of the hepatitis impact and to call for actions to address this global public health challenge.
It is an opportunity to step up national and international efforts on hepatitis, encourage actions and engagement by individuals, partners and the public and highlight the need for a greater global response as outlined in the WHO's Global hepatitis report of 2017.
The date of 28 July was chosen because it is the birthday of Nobel-prize winning scientist Dr Baruch Blumberg, who discovered hepatitis B virus (HBV) and developed a diagnostic test and vaccine for the virus.
This year’s theme is “It’s time for action”. This theme emphasizes that the progress on elimination of viral hepatitis as a public health problem has stalled, and that we need to act, accelerate actions and get back on track toward elimination by 2030.
Globally, an estimated 254 million live with hepatitis B (HBV) and 49 million people live with hepatitis C (HCV). Worryingly, most remain unaware of their infection status, which is why for decades it has been referred to as the ‘silent killer'.
Viral hepatitis is the seventh leading cause of mortality worldwide and is the only communicable disease for which mortality is increasing. These rising deaths are due to hepatitis-related liver cirrhosis and cancer deaths. Untreated, hepatitis B and C infection causes progressive damage to the liver leading to cirrhosis and much elevated risks of liver cancer.
Our WHO South-East Asia Region accounts for 24% of the global burden of HBV and HCV, and the second largest numbers of new HBV infections after the African Region. In 2022, an estimated 61 million people were living with HBV, and 9 million people with HCV in our Region.
Safe and effective vaccines can prevent hepatitis B. Antiviral drugs are highly effective in controlling and preventing disease progression, and can manage chronic hepatitis B and cure most cases of hepatitis C.
However, in 2022, the Hepatitis B birth dose coverage across countries in our Region ranged widely from 8% to 99%. Similarly, the HepB3 vaccination coverage varied from 0% to 99%. Less than 5% of people living with HBV have been diagnosed and received treatment. Of people living with HCV, only 26% have been diagnosed and 14% have received treatment.
Sadly, most countries are not taking advantage of the affordable pricing and global benchmark prices of the hepatitis test and drugs, where available.
Nonetheless, we have made progress in some areas.
In 2022, seven of our Member States achieved coverage of more than 90% of the third dose of hepatitis B vaccine. Eight countries now also provide the hepatitis B vaccine birth dose. To date, six countries have been verified to have controlled the hepatitis B through vaccination.
To get back on track for hepatitis elimination and further reduce mortality, WHO is calling for greater political commitment and resource allocation to fully fund the national response needs, spanning prevention, testing, treatment and monitoring.
As most people are unaware, they are infected, access to testing and treatment needs to be expanded beyond larger hospitals or referral centers. Testing and treatment must be integrated as part of essential packages delivered by primary care facilities. Testing and treatment must be accessible within the community, close to where people live and work, and included as part of Universal Health Coverage. Accelerated coverage of testing and treatment will reduce development of liver cirrhosis and cancer, and ultimately, mortality.
In this era of Universal Health Coverage towards achieving the Sustainable Development Goals, we must break silos and reverse the fragmentation of services.
Policy makers and health care providers – including in the private sector – must be brought together to collaborate on improving integrated services that bring together communicable and non-communicable diseases, immunization and reproductive and maternal child health services with preparedness for emergency response.
Countries shall need to continue to address the cost barriers to accessing services and working towards securing the lowest price for hepatitis commodities and their availability, strengthening procurement, and supply-chain management.
Lastly, health and community leaders should reach out to champion, empower and expand engagement with vulnerable and high-risk communities, to understand more the barriers in accessing services, stigma and discrimination, inequalities and addressing them hand-in-hand.
Our goal in eliminating hepatitis as a public health threat by 2030 is ambitious. However, I believe it is achievable. On this World Hepatitis Day, we reiterate our support to all countries of our Region to accelerate equitable progress in health and achieve healthier livers and healthier lives for all.