Hepatitis data highlights need for global response

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An estimated 325 million people worldwide are living with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, and many of these individuals lack access to life-saving testing and treatment, the World Health Organisation (WHO) has said.

“Viral hepatitis is now recognised as a major public health challenge that requires an urgent response,” said Dr Margaret Chan, WHO director-general. “Vaccines and medicines to tackle hepatitis exist, and WHO is committed to helping ensure these tools reach all those who need them.”

In 2015, viral hepatitis took the lives of 1.34 million people, a toll comparable to deaths caused by tuberculosis (TB) and HIV. However, while TB- and HIV-related deaths have been declining, deaths from hepatitis are on the rise. WHO noted HBV and HCV epidemics in regions and hotspots across the world, and it said that treatment access is low.

There is no HCV vaccine as yet, and access to treatment for HBV and HCV is low. The WHO Global Hepatitis Report, 2017 also notes progress in some countries, such as China achieving 96% coverage for the timely birth dose of HBV vaccines and Mongolia improving uptake of hepatitis treatment by including HBV and HCV drugs in its National Health Insurance scheme.

The new report aims to provide a starting point for hepatitis elimination by indicating baseline statistics on HBV and HCV infections, including mortality, and coverage levels of key interventions, WHO said. The report also revealed that increased coverage of HBV vaccinations among children have contributed substantially to preventing deaths from that virus.

Globally, 84 per cent of children born in 2015 received the three recommended doses of HBV vaccine. However, an estimated 257 million people, mostly adults born before the introduction of the HBV vaccine, were living with chronic HBV infection in 2015. There is also currently no vaccine against HCV, and access to treatment for both HBV and HCV is low.

HBV infection requires lifelong treatment, and Hepatitis C can be cured within a relatively short time using the correct medicines, making the need for testing and treatment all the more important. “We are still at an early stage of the viral hepatitis response, but the way forward looks promising,” Gottfried Hirnschall, Director of WHO’s Department of HIV and the Global Hepatitis Programme, said.

“More countries are making hepatitis services available for people in need – a diagnostic test costs less than $1 and the cure for HCV can be below $200.” Findings have also revealed that Hepatitis B levels vary across the planet. WHO’s Western Pacific Region (115 million people) and its African Region (60 million people) have the highest number of such patients.

These roughly equate to 6.2 per cent and 6.1 per cent of their respective total populations. Similarly, HCV prevalence by regions varies from about seven million (in WHO Americas Region) to 15 million (in the UN agency’s Eastern Mediterranean Region). The report has also shown that that despite challenges, some countries have made strides in scaling-up hepatitis services.

China, for instance, achieved a high coverage of nearly 96 per cent for the timely birth dose of HBV vaccines, and reached the Hepatitis B control goal of less than one per cent prevalence in children under the age of five in 2015. Mongolia, too, has improved the uptake of hepatitis treatment by including HBV and HCV medicines in its National Health Insurance Scheme, which covers 98 per cent of its population.

Similarly, generic competition among medicines has also contributed substantially, in Egypt, for example, the price of a 3-month cure for Hepatitis C has reduced to less than $200 (in 2016) from $900 (in 2015) also, in Pakistan, the same course currently costs as little as $100.