Access to viral hepatitis diagnosis and treatment is still limited: WHO

In Africa, less than eight countries provide subsidised testing and treatment for viral hepatitis
Photo: Marco Verch / Flickr
Photo: Marco Verch / Flickr

Hepatitis B and C cause 1.1 million deaths and 3 million new infections every year, respectively, according to the World Health Organization (WHO). But diagnosis and treatment remain low.

Only 10 per cent people with chronic hepatitis B infection are diagnosed and 22 per cent receive treatment. For hepatitis C infection, 21 per cent are diagnosed and 62 per cent receive treatment.

Viral hepatitis affects the poor and displaced people disproportionately, the WHO report published on May 20, 2021 said. “Injecting drug use is a major contributor to the number of people newly infected with hepatitis C globally.”

Global targets aim to reduce new hepatitis B and C infections by 30 per cent through 2020 and 90 per cent through 2030. Around 1.5 million people were newly infected with chronic hepatitis B and 1.5 million with chronic hepatitis C, according to new estimates for 2019.

New chronic infections from hepatitis B have declined due to increasing coverage of the highly effective hepatitis B vaccine among infants, the report mentioned. “Globally, 85 per cent of all infants had received the recommended three doses of the hepatitis B vaccine in 2019, up from 30 per cent in 2000.”

The vaccination coverage has achieved the global health sector target to reduce hepatitis B surface antigen prevalence to less than 1 per cent among children younger than five years by 2020, WHO said. But still major gaps remain in regions such as sub-Saharan Africa and southeast Asia, it highlighted.

WHO said in the report:

The 10-fold scale up of hepatitis C treatment has led to a stabilisation of mortality for the first time, although the annual number of people acquiring hepatitis C infection (1.5 million) and dying from this (290,000)remain unacceptably high.

In Africa, access to viral hepatitis diagnosis and treatment is still limited, including among populations most severely affected. Hepatitis reporting has improved significantly in the continent but major gaps remain, the report mentioned.

The gaps are most acute for key populations such as men who have sex with men, people who inject drugs, sex workers, transgender people and people in prisons, the health agency highlighted.

There are major gaps in hepatitis testing and treatment with less than eight countries providing subsidised testing and treatment for viral hepatitis, according to the report. “Uganda has started free nationwide hepatitis B treatment, and Rwanda is providing free treatment for both hepatitis B and C.”

WHO suggested the following steps to address the gaps by 2030:

  • Develop guidance on differentiated human resources support for hepatitis services
  • Initiate forecasting for hepatitis C commodities in the 2021 forecasting meeting for drug and diagnostics stakeholders

In Egypt, universal access to treatment has resulted in declining mortality and incidence, said the report.  The country has initiated support for planning towards eliminating viral hepatitis in sub-Saharan African countries, it added.

In Africa, 28 countries had national hepatitis strategic plans in 2018, WHO said.

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