How can the world end viral hepatitis by 2030? 5 experts explain

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Matthew Oliver, Consultant, World Economic Forum

  • World Hepatitis Day is July 28, 2021.
  • More than 1 million people die from hepatitis B and C every year.
  • We asked four experts for their proposals to eliminate hepatitis.

More than 1.1 million people die from hepatitis B and C every year. An estimated 296 million people worldwide are living with hepatitis B, but only 2% of those are receiving treatment. For hepatitis C, which is curable, only 21% of the 58 million people worldwide who are affected by the disease are diagnosed, and fewer than two-thirds of those are on treatment.

Nonetheless, despite the scale of the problem, remarkable progress is being made against viral hepatitis. The number of people receiving treatment for hepatitis C increased nine-fold between 2015 and 2019. Between 2014 and 2020, Egypt, which had the highest rates of hepatitis in the world, screened 50 million people and treated 4 million people and is poised to eliminate hepatitis C within its borders.

Indeed, viral hepatitis is one of the few major endemic diseases worldwide where the 2030 targets to eliminate it as a public health threat could be realized. In doing so, according to estimates from the World Health Organization, 4.5 million deaths could be prevented in just the next nine years. Health and healthcare

How is the World Economic Forum bringing data-driven healthcare to life?

The application of “precision medicine” to save and improve lives relies on good-quality, easily-accessible data on everything from our DNA to lifestyle and environmental factors. The opposite to a one-size-fits-all healthcare system, it has vast, untapped potential to transform the treatment and prediction of rare diseases—and disease in general.

But there is no global governance framework for such data and no common data portal. This is a problem that contributes to the premature deaths of hundreds of millions of rare-disease patients worldwide.

The World Economic Forum’s Breaking Barriers to Health Data Governance initiative is focused on creating, testing and growing a framework to support effective and responsible access – across borders – to sensitive health data for the treatment and diagnosis of rare diseases.

The data will be shared via a “federated data system”: a decentralized approach that allows different institutions to access each other’s data without that data ever leaving the organization it originated from. This is done via an application programming interface and strikes a balance between simply pooling data (posing security concerns) and limiting access completely.

The project is a collaboration between entities in the UK (Genomics England), Australia (Australian Genomics Health Alliance), Canada (Genomics4RD), and the US (Intermountain Healthcare).

The World Economic Forum is working with partners from across the hepatitis community to find ways to support countries deliver on their plans to eliminate hepatitis. We’re establishing a Hepatitis Elimination Initiative, bringing together public, private and non-profit stakeholders to unlock new financing, and design public-private partnerships to help eliminate the disease as a public health threat.

To mark World Hepatitis Day, we asked five representatives from organizations that are part of the Hepatitis Elimination Initiative to tell us what they think the global community needs to do to eliminate hepatitis.

The cure for hepatitis? Partnership.

Robert Ford, President and Chief Executive Officer, Abbott Laboratories

We can eliminate hepatitis.

As a global community, we have the knowledge and the capability. To finish the job, we need to summon the collective willpower.

There are four elements in such a program: education, testing, vaccination, and treatment. We at Abbott have been heavily involved in the first two; peer healthcare innovators are active in the second two. And public health partners – governments, intergovernmental institutions, NGOs, and others – are critical throughout the chain.

A powerful example is our partnership with the Egyptian Ministry of Health to conduct a mass screening program that tested over 60 million people, more than 2 million of whom needed, and have subsequently received, treatment. We’re working to replicate this program in other countries. On the education front, we’ve sponsored the African Hepatitis Summit in Kampala, Uganda, and supported awareness efforts in multiple countries.

This is the only way to tackle big, global challenges: working in concert, across sectors. None of us can do it alone.

Championing a multisectoral agenda

Dr Zsusanna Jakab, Deputy Director-General, WHO

Advocacy, high level political commitment and strong partnerships including community engagement are key if we are to end hepatitis by 2030. WHO’s evidence-based normative guidance and public health approaches for hepatitis prevention, treatment and care must be taken up more aggressively by countries.

To reach our global SDG goals of 90% reduction of new hepatitis infections and 65% reductions of deaths, one of our major roles will be to reorient hepatitis programmes towards a comprehensive public health approach. This will mean championing a multisectoral agenda to leverage the response across healthcare systems strengthening, including immunization, infection control, harm reduction and testing and treatment services, while ensuring financial security and health equity for all.

COVID-19 innovations can be catalytic to change the trajectory of the global hepatitis response and provide new opportunities and hope for elimination of viral hepatitis as a public health threat by 2030. #Hepatitis Can’t Wait

Integration, integration, integration

Manal El-Sayed, Professor of Pediatrics at Ain Shams University, Board member ICE-HBV & The Hepatitis Fund

Egypt managed to make great strides towards hepatitis elimination by taking a whole-society approach to tackle this important public heath challenge.

By integrating hepatitis C screening with NCD (non-communicable disease)screening in primary healthcare facilities, Egypt managed to test 60 million people. Now this fully integrated approach is being replicated for triple elimination of mother to child transmission (HBV, HIV and Syphilis).

Egypt’s success was supported by the mobilization of the whole country. Nine million children were tested at school. Civil society was highly instrumental in community and leadership mobilization. Big and small businesses, trust funds and philanthropy supported screening, diagnosis and treatment – in some places even before the government was able to provide it. All ministries contributed to the campaign, showing unwavering political will. Media’s involvement brought everyone on board.

Thanks to political leadership, we had fruitful volume price negotiations which allowed us to diagnose and cure more than 3 million people.

Action now!

Dr Su Wang, President of the World Hepatitis Alliance

Viral hepatitis is the most overlooked global health crises of our time. For people living with hepatitis like me, it’s hard to understand how we allow this tragedy to continue. Every 30 seconds, one of us perishes from our condition. Each death is a loved one lost – a family missing a parent, child or spouse.

We have vaccines and effective treatments for hepatitis B, and a cure for hepatitis C. With these tools, hepatitis can be eliminated, but progress is too slow. Hepatitis can’t wait any longer. People are dying.

How many more children need to have their lives cut short before a low-cost vaccine is provided to all newborns? How many more people must die from liver cancer caused by chronic hepatitis infection before hepatitis treatments are made accessible to all?

By their inaction, national governments, global donors, development funds, and institutions have accepted the unnecessary deaths caused by hepatitis. They must commit and act.

What will eliminate hepatitis? Action now.

9 key steps

Dr John Ward, Director – Coalition for Global Hepatitis Elimination

Achievement of hepatitis elimination goals by 2030 will prevent more than 7 million deaths.

Countries with early success in adopting elimination goals reveal the program components needed to end hepatitis:

  • 1. Strategic information for national planning and to monitor program performance
  • 2. International assistance to catalyze “micro-elimination” pilots and national initiatives
  • 3. National action plan with prevention, testing and treatment policies
  • 4. Coalitions to mobilize political support and community resources
  • 5. Focus on equity and reducing health disparities
  • 6. Integration of hepatitis elimination services within existing health systems
  • 7. Sustainable national financing until elimination targets are achieved
  • 8. Participation in operational research
  • 9. Revision of targets as program experience is accrued.

On World Hepatitis Day, the Coalition for Global Hepatitis Elimination, together with coalitions in 30 countries, begins development of national hepatitis elimination profiles revealing the strengths and limitations of these components and advocacy for feasible next steps to accelerate progress toward hepatitis elimination.

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