Eliminate hepatitis: WHO

News release

27 JULY 2017 | GENEVA - New WHO data from 28 countries - representing approximately 70% of the global hepatitis burden - indicate that efforts to eliminate hepatitis are gaining momentum. Published to coincide with World Hepatitis Day, the data reveal that nearly all 28 countries have established high-level national hepatitis elimination committees (with plans and targets in place) and more than half have allocated dedicated funding for hepatitis responses.

On World Hepatitis Day, WHO is calling on countries to continue to translate their commitments into increased services to eliminate hepatitis. This week, WHO has also added a new generic treatment to its list of WHO-prequalified hepatitis C medicines to increase access to therapy, and is promoting prevention through injection safety: a key factor in reducing hepatitis B and C transmission.

From commitment to Action

"It is encouraging to see countries turning commitment into action to tackle hepatitis." said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "Identifying interventions that have a high impact is a key step towards eliminating this devastating disease. Many countries have succeeded in scaling-up the hepatitis B vaccination. Now we need to push harder to increase access to diagnosis and treatment."

World Hepatitis Day 2017 is being commemorated under the theme "Eliminate Hepatitis" to mobilize intensified action towards the health targets in the 2030 Sustainable Development Goals. In 2016, the World Health Assembly endorsed WHO’s first global health sectors strategy on viral hepatitis to help countries scale up their responses.

The new WHO data show that more than 86% of countries reviewed have set national hepatitis elimination targets and more than 70% have begun to develop national hepatitis plans to enable access to effective prevention, diagnosis, treatment and care services. Furthermore, nearly half of the countries surveyed are aiming for elimination through providing universal access to hepatitis treatment. But WHO is concerned that progress needs to speed up.

"The national response towards hepatitis elimination is gaining momentum. However, at best one in ten people who are living with hepatitis know they are infected and can access treatment. This is unacceptable," said Dr Gottfried Hirnschall, WHO's Director of the HIV Department and Global Hepatitis Programme.

"For hepatitis elimination to become a reality, countries need to accelerate their efforts and increase investments in life-saving care. There is simply no reason why many millions of people still have not been tested for hepatitis and cannot access the treatment for which they are in dire need."

Viral hepatitis affected 325 million people worldwide in 2015, with 257 million people living with hepatitis B and 71 million people living with hepatitis C - the two main killers of the five types of hepatitis. Viral hepatitis caused 1.34 million deaths in 2015 – a figure close to the number of TB deaths and exceeding deaths linked to HIV.

Improving access to hepatitis C cure

Hepatitis C can be completely cured with direct acting antivirals (DAAs) within 3 months. However, as of 2015, only 7% of the 71 million people with chronic hepatitis C had access to treatment.

WHO is working to ensure that DAAs are affordable and accessible to those who need them. Prices have dropped dramatically in some countries (primarily in some high-burden, low-and lower middle income countries), facilitated by the introduction of generic versions of these medicines. The list of DAAs available to countries for treating hepatitis C is growing.

WHO has just prequalified the first generic version of one of these drugs: sofosbuvir. The average price of the required three-month treatment course of this generic is between US$260 and US$280, a small fraction of the original cost of the medicine when it first went on the market in 2013. WHO prequalification guarantees a product’s quality, safety and efficacy and means it can now be procured by the United Nations and financing agencies such as UNITAID, which now includes medicines for people living with HIV who also have hepatitis C in the portfolio of conditions it covers.

Hepatitis B treatment

With high morbidity and mortality globally, there is great interest also in the development of new therapies for chronic hepatitis B virus infection. The most effective current hepatitis B treatment, tenofovir, (which is not curative and which in most cases needs to be taken for life), is available for as low as $48 per year in many low and middle income countries. There is also an urgent need to scale up access to hepatitis B testing.

Improving injection safety and infection prevention to reduce new cases of hepatitis B and C

Use of contaminated injection equipment in health-care settings accounts for a large number of new HCV and HBV infections worldwide, making injection safety an important strategy.Others include preventing transmission through invasive procedures, such as surgery and dental care; increasing hepatitis B vaccination rates and scaling up harm reduction programmes for people who inject drugs.

Today WHO is launching a range of new educational and communication tools to support a campaign entitled "Get the Point-Make smart injection choices" to improve injection safety in order to prevent hepatitis and other bloodborne infections in health-care settings.

Injection safety tools and resources
World Hepatitis Summit

World Hepatitis Summit 2017, 1–3 November in São Paulo, Brazil, promises to be the largest global event to advance the viral hepatitis agenda, bringing together key players to accelerate the global response. Organised jointly by WHO, the World Hepatitis Alliance (WHA) and the Government of Brazil, the theme of the Summit is "Implementing the Global health sector strategy on viral hepatitis: towards the elimination of hepatitis as a public health threat".

The 2017 Sasakawa Health Prize of US$30 000 for outstanding innovative work in health development, has been awarded to Dr Rinchin Arslan for his remarkable lifelong contribution to the advancement of primary health care in Mongolia and specifically his work in fighting viral hepatitis.

As a young doctor, graduated from Szeged Medial University in Hungary in 1967, Arslan was confronted with viral hepatitis as a growing – but then unconfirmed – health concern.

"Viral hepatitis emerged in the 1960–1970s and was declared the number one health issue causing considerable sickness and death. Children under 4 years of age made up half of the cases. Many of them had a history of life-saving intravenous blood plasma or fluid therapy and injections. My analysis indicated the possibility of hepatitis B infection, but that hypothesis needed to be proven. At that time we did not know much about hepatitis viruses, including hepatitis C, or their mode of transmission. We had no idea that the younger the person exposed to hepatitis B or C virus infection, the higher was the risk of developing chronic hepatitis that could lead to deadly liver cancer."
Through his research in the hepatitis B surface antigen, Arslan was able to demonstrate that hepatitis B was indeed endemic in Mongolia, and affected mainly children.

Arslan then devoted the next years to tackling viral hepatitis, advocating for improvements in injection and blood safety, and increases in hepatitis B vaccination. He designed the Mongolia National immunization programme which was crucial in significantly reducing viral hepatitis transmission at birth and acute viral hepatitis infection in young children.

Arslan was influential in expanding this programme in the 1990s, with the support of JICA,WHO, UNICEF and later GAVI, to sustain other much needed childhood vaccines – polio, DTP, measles and etc., during a difficult period of transition to democratic reforms in the country.

“Mongolia has made significant progress in fighting hepatitis B, but much more needs to be done if we are to end hepatitis C and B in the near future.”

The constantly changing economic, political, and development environment in Mongolia, as in many countries, determines the evolving health challenges.

In addition, Mongolia is prone to natural disasters – extreme cold – called “dzud“ – flooding, earthquakes, and disease outbreaks (such as influenza).

“Our preparedness for relief operations to protect young children, women and the most vulnerable, as well as our counseling services and psychosocial support, has always been a central concern. In my life-time I would love to see a quality health service which is accessible and affordable to all, with improved health education and training of our medical doctors, public health specialists, and health staff in remote areas of our country.

In 2017, the Mongolian government included hepatitis C medicine into the national health insurance program, which today covers a large proportion of its population. In addition, Mongolia has been a model country in its implementation of the hepatitis B birth dose and infant immunizations, as highlighted especially today by the Sasakawa Award presented to Dr Rinchin Arslan.

The Sasakawa Health Prize was established in 1984 by Mr Ryoichi, Chairman of the Japan Shipbuilding Industry Foundation and President of the Sasakawa Memorial Health Foundation for outstanding accomplishments in health development.

Funds from the prize will be used to support the Ministry of Health to implement Government programmes on the control and reduction of hepatitis B. They will also be used for activities to increase advocacy for better health services and laboratory testing in remote facilities, implement best practices to avoid infection, and reduce possible stigma in families, workplaces, and schools. Funds will also be dedicated to co-organizing, with non-State actors, World Hepatitis Day (28 July) and to provide financial support to young researchers in hepatitis B.

“I am proud and happy to become a laureate of the prestigious Sasakawa award in recognition of my contribution to tackling viral hepatitis and the immunization of children as part of primary health care in my country. I would also like to stress the importance of contributions of the specialists of the former USSR to fighting infectious diseases, including viral hepatitis in Mongolia, and recognize the exclusive leadership and role of WHO, particularly under Dr Chan, in raising awareness of viral hepatitis in member countries.“

SOURCE WHO

Nigeria: Gombe Flags-Off Own Nutrition Programme to Address High Prevalence

Gombe (Nigeria) — In an effort to curb malnutrition, Gombe state government in northeast Nigeria has flag-off its Food and Nutrition Policy, and a five-year work plan on malnutrition programme in the state.

The policy and the 5-year implementation plan was developed by the state government with support from Save the Children International, who provided technical and financial resources.

Investigation reveals that from January to December 2016, a total of 13,059 children (6,483 males and 6,570 females) aged 6 – 59 months were admitted in health facilities, out of which 11,031 were treated, 833 defaulted, 149 non-recovered and 105 died.

From January to June this year 6,330 malnourished children were admitted, 4,470 treated, 25 deaths while 101 defaulted.

Speaking at the flag-off, State Commissioner for Economic Planning, Mohammed Danladi Pantami, said, malnutrition remained a great challenge particularly for mothers and children, adding the NDHS 2013 has revealed that half of million children death each year, or about one out of every 2 child deaths in the country are as a result of malnutrition.

Malnutrition statistics given by the NDHS 2013, which northeast has 43.5 percent and the state has the highest rate, he said that the government seeing the need to address the situation and prevent it.

He however said, “Throughout the years of our developmental efforts, Gombe state and Nigeria have undergone remarkable challenge, where more children are surviving, the economy is growing, girls are better educated, more children are completing school and mothers attending pre and post-natal care”, he said.

Mr. Pantami said Federal government has set up National Council on Food and Nutrition chaired by the Vice President, and National Committee on Food and Nutrition which is coordinated by the Ministry of Budget and National Planning for strengthened multi-sectoral approach to the malnutrition issues in Nigeria

He urged all the line ministries and agencies to ensure that they capture their sectoral interventions in their respective annual budgets and make sure that they also apply to secure the release of the funds for implementation of these interventions.