Op-ed on World Hepatitis Day 2016 by Dr Arvind Mathur, WHO Representative to Maldives

Know Hepatitis, act now!

WHO urges Maldives to take rapid action to improve knowledge on hepatitis prevention and care and for technologies to be made available at all levels of the health system.

Viral Hepatitis is a group of diseases which affects 400 million people globally. Hepatitis B and Hepatitis C are the most notorious of them all. Hepatitis B and C infections are transmitted through contaminated blood, needles and syringes in healthcare setting including among people who inject drugs. The viruses can also be transmitted through unsafe sex and from an infected mother to her newborn child.

In the WHO South East Asia Region, Hepatitis B alone kills around 350,000 people each year with approximately 100 million people suffering from the disease’s chronic form, causing unbearable fatigue, jaundice, abdominal pain and cancer. This ultimately causes surges in health costs and restricts workforce contribution.
People can live with the disease/s without any obvious symptoms for years, leading to delay in seeking care. Today, only 1 in 20 people with viral hepatitis know their status. And just 1 in 100 with the diseases is being treated. Yet, Hepatitis is fully preventable and treatable: there are effective vaccines and treatments for hepatitis B, and over 90% of people with hepatitis C can be successfully treated.

With better understanding of the routes of infection, injection and blood safety, adequate hygiene, proper sanitation and importantly vaccination for hepatitis A and B; people can prevent themselves from getting infected or passing the infections on to others. The availability of effective vaccines for Hepatitis B and affordable treatment for Hepatitis C has made it possible to potentially cure more than 90% of patients suffering. The Hepatitis B vaccine is highly effective when provided within 24 hours of birth to the newborn child, with follow up of at least two more doses of vaccine during the first year of life. Hepatitis B vaccination has been an integral part of Maldives primary immunization schedule. The vaccine protects newborns from mother to child transmission of the disease and from infection later in life. Safe injection practices such as eliminating unnecessary and unsafe injections can also prevent transmission. Importantly all blood products needs to be screened for the viruses and only safe ones processed for transfusion services. Unfortunately in many countries; current policies, regulations and medicine prices keep the treatment options out of people’s reach.

In May 2016, at the World Health Assembly, 194 governments adopted the first-ever Global Health Sector Strategy on viral hepatitis and agreed to the first-ever global targets. The strategy includes a target to treat 8 million people for hepatitis B or C by 2020. The longer term aim is to reduce new viral hepatitis infections by 90% and to reduce the number of deaths due to viral hepatitis by 65% by 2030 from 2016 figures. The strategy is ambitious, but the tools to achieve the targets are already in hand.

On the World Hepatitis Day, WHO again urges countries to take rapid action to improve knowledge on hepatitis and for acceleration of access to services and medicines for all people in need. A multifaceted approach to encourage more people to get tested including national testing campaigns but also testing in workplaces, health centers and prisons needs to be considered. Given the widespread use of internet in Maldives, reaching out through social media and electronic means is a need for greater engagement of communities to advance knowledge on Hepatitis.
As WHO Representative to the Maldives, I extend my highest commitment and full support to the Government of Maldives, policy makers, health workers and the people in our battle to eliminate Hepatitis. I believe that the vision of eliminating hepatitis as a public health threat by 2030 can be achieved, if people and countries affected by this disease are better equipped and enabled to “know hepatitis” and “act now“.

Dr Arvind Mathur
WHO Representative to Maldives

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