On 28 July, WHO celebrates World Hepatitis Day to increase awareness of this disease, which inflames the liver and can lead to liver cancer and cirrhosis.
This year’s theme is “hepatitis can’t wait” and we call on all countries to rapidly improve access to services to prevent, diagnose and treat hepatitis.
In Africa, hepatitis is a silent epidemic. More than 90 million people are living with hepatitis in the Region, accounting for 26% of the global total. More than 124,000 Africans are dying every year from the consequences of undetected and untreated hepatitis.
Around 4.5 million African children under five years old are infected with chronic hepatitis B, reflecting an enormous 70% of the global burden in this age group. The global target of less than 1% incidence of hepatitis B in children under 5 years has been reached, but the African Region is lagging behind at 2.5%.
Most of these cases could be prevented by eliminating mother-to-child transmission of the disease, during or shortly after birth and in early childhood. Key interventions against hepatitis B include vaccination at birth and in early childhood, screening pregnant women, and providing timely treatment.
So, in the WHO African Region, we are urging especially that “mothers can’t wait.”
We are encouraging countries to integrate the Hepatitis B PMTCT in the Ante-Natal Care package together with the HIV and Syphilis PMTCT program.
Yet only 14 countries in the Region are implementing hepatitis B birth-dose vaccine. Among people who are infected, nine out of 10 have never been tested because of limited awareness and access to testing and treatment. Even among countries offering hepatitis B birth-dose vaccine, health systems are facing challenges in ensuring pregnant women and mothers are tested and that those who test positive are treated.
At the same time, there are many promising developments on hepatitis. With the launch of the first global strategy on hepatitis in 2016, along with increased advocacy in recent years, political will is starting to translate into action. Hepatitis medicines have become much more affordable, with prices as low as US$ 60 per patient for a 12-week treatment.
Considering this advantage, African Heads of States have committed to address viral hepatitis as a public health threat in the Cairo Declaration in February 2020. In this line, the Egyptian Initiative planned to provide hepatitis C treatment for 1 million Africans. So far, this initiative has reached more than 50,000 people in South Sudan, Eritrea and Chad.
A part of them, Rwanda, Uganda and Benin have established free testing and treatment programmes for hepatitis, and 16 other countries are starting pilot projects in this direction.
To guide action on hepatitis, 28 African countries now have strategic plans in place and at the global level WHO guidelines were launched last year on prevention of mother-to-child transmission of hepatitis B.
The WHO Regional Office for Africa is developing training materials in order to help countries to implement the five hepatitis core interventions and decentralize the diagnosis and treatment.
Going forward, as WHO we are seeking to integrate hepatitis B interventions into antenatal care services. We also want to strengthen collaboration with key partners, such as the Organization of African First Ladies for Development, which have championed progress towards a HIV-free generation. By expanding programmes to incorporate hepatitis, action can be quickly scaled-up.
So, this World Hepatitis Day, I urge all stakeholders in maternal and child health to consider how hepatitis can be integrated into existing initiatives such as the First Ladies “free to shine” initiative which is working in countries for an AIDS-free generation in Africa.
Health systems also play vital roles in preventing transmission by making sure blood donations are screened and that syringes are only used once and then safely disposed. Finally, I want to encourage individuals to seek testing and treatment for hepatitis and to learn more about this disease, to end the silent epidemic.