On 28th July 2024 WHO marked World Hepatitis Day with the theme “it’s time for action”, calling for increased awareness of viral hepatitis. It stated that prevention, diagnosis, and treatment must be accelerated to address the tragedy of a death every 30 seconds from a hepatitis-related illness. Despite diagnosis and treatment innovation, alongside decreased product prices, WHO notes that “testing and treatment coverage rates have stalled”. However, it is hopeful that the 2030 elimination goal “should still be achievable, if swift action is taken now”.
Threat to the liver
Hepatitis is a liver inflammation that is “usually caused” by a viral infection or non-infectious agents like drugs, toxins, and alcohol. There are five main strains of the hepatitis virus (A, B, C, D, and E). They all cause liver disease, but types B and C combined are the “most common” cause of liver cirrhosis, loss of liver function, liver cancer, and viral hepatitis-related deaths. In 2022 they caused 1.3 million deaths, with around one hepatitis death every 30 seconds.
Around 220 million people with hepatitis B are undiagnosed, and nearly 36 million people with hepatitis C undiagnosed. As most symptoms emerge after the disease has advanced, many people only discover that they have hepatitis B or C when they develop serious liver disease or cancer. However, even after a diagnosis, coverage of treatment and care for people with hepatitis is “astonishingly low”.
WHO’s key messages
Under the World Hepatitis Day campaign WHO shared 4 “key messages”:
- A liver performs over 500 vital functions every single day to keep us alive. That’s why testing, treating, and preventing viral hepatitis is so important.
- Deaths from viral hepatitis-related causes are increasing.
- Globally, there’s a huge number of undiagnosed and untreated people living with hepatitis.
- So many hepatitis infections – and deaths – can be prevented.
- Reaching 2030 targets
WHO urges action to achieve the “ambitious targets” for 2030, suggesting that simplified care services for viral hepatitis should ensure that:
- All pregnant women living with chronic hepatitis B have access to treatment and their infants have access to hepatitis B birth vaccines to prevent infection
- 90% of people living with hepatitis B and/or hepatitis C are diagnosed
- 80% of diagnosed people are cured of hepatitis C or treated according to newer hepatitis expanded eligibility criteria.
Although there are tools and guidance to diagnose, treat, and prevent chronic viral hepatitis, these services are “still too often out of reach”. For example, rapid diagnostic tests for viral hepatitis cost less than US$2, but many people still face “out of pocket costs” for testing. Furthermore, despite the availability of affordable generic viral hepatitis medicines, too many countries overpay; medicines that are used to treated hepatitis C cost US$60 for a 12-week course, but countries can pay up to US$10,000.
Time to take action
WHO calls for action to prioritise testing, treatment, and vaccination to realise a hepatitis-free world and meet 2030 targets. Key actions include:
- Expanding access to testing and diagnostics to ensure more people can access the treatment they need
- Strengthening primary care prevention efforts to prevent hepatitis through vaccination, safe infection and injections practices, and education
- Decentralising hepatitis care to bring care closer to patients by utilising community-based services
- Integrating hepatitis care within existing healthy services, combining hepatitis treatment with primary care, HIV services, and harm reduction programmes where relevant to offer more accessible and comprehensive care
- Engaging affected communities and civil society, ensuring that the insights and experiences of people affected viral hepatitis are at the heart of prevention and treatment efforts
- Mobilising domestic or innovative financing to secure new funding avenues to support and sustain hepatitis elimination programmes.
ECDC marks World Hepatitis Day
The European Centre for Disease Prevention and Control (ECDC) also shared a statement addressing World Hepatitis Day 2024, focusing on the prevention of liver cancer. It states that chronic hepatitis is “among the main risk factors” for liver cancer, which is the sixth leading cause of cancer-related deaths in Europe; it accounted for nearly 55,000 deaths in 2022. Around 3.6 million people in the EU/EEA are chronically infected with hepatitis B virus (HBV) and hepatitis C virus (HBC), but infection prevalence and access to prevention and care “varies considerably”. A particularly high burden is identified in “vulnerable groups”, including people who infect drugs, people in prison, and some migrant populations.
ECDC calls for “enhanced efforts and collaboration between governments, healthcare providers, and communities, to accelerate progress”. It suggests that scaling up vaccination programmes, implementing targeted testing initiatives, ensuring systematic linkage to care, and enhancing infection prevention measures, we can “achieve a healthier future for all”. Dr Piotr Kramarz, ECDC Chief Scientist, demands intensified efforts.
“The power to prevent cancer is within our reach.”
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