Health
Urgent action needed to meet WHO targets
Asia-Pacific countries are unlikely to meet their pledge to eliminate hepatitis by 2030 unless they declare a public health emergency, as they have done with COVID-19, disease experts have suggested.
According to the World Health Organization (WHO), hepatitis (inflammation of the liver) has surpassed tuberculosis and is the second deadliest infectious disease in the world after COVID-19, claiming 3,500 lives every day.
In 2016, the WHO set goals for eliminating the disease by 2030: reducing new infections by 90%, reducing deaths by 65% and treating 80% of infected people.
However, Syed Hamid, professor and dean of the Aga Khan University School of Medicine in Pakistan, stressed at an infectious disease forum in Vietnam on June 20 that “at the current pace, most Asia-Pacific countries will not achieve their elimination targets by 2030.”
Hamid, the hepatitis specialist, said that despite advances in diagnostic techniques and falling costs of testing and treatment, there are still significant gaps in coverage, with too few people receiving treatment and, when they do, it is often too late, he explained.
The disease is deadly because it can occur years after infection and symptoms only appear at an advanced stage, which is why testing is so important.
Hamid cited the unprecedented and rapid response by countries to the spread of COVID-19 as proof that “if there is political will, it can be done,” and said that “a state of emergency needs to be declared in all countries with a high burden.”
There are five main types of hepatitis viruses, called A, B, C, D, and E. Hepatitis A and B can be prevented with safe and effective vaccines, but there are no widely available vaccines specific to the other types.
The Asia-Pacific region has the highest burden of hepatitis, with Pakistan currently having the highest number of hepatitis C cases in the world, at 8.8 million. Healthcare-related exposures, such as improper sterilization of medical equipment, are the primary source of transmission of the disease in the region. In the World Hepatitis Report 2024 in April, WHO Director-General Tedros Adhanom Ghebreyesus said that viral hepatitis kills more than one million people worldwide each year and infects a further three million, stressing that these figures are likely underestimates.
The WHO report highlights 10 countries that account for two-thirds of the global burden of hepatitis B and C viruses: China, India, Indonesia, Nigeria, Pakistan, Ethiopia, Bangladesh, Vietnam, the Philippines and Russia.
There were 304 million people living with hepatitis in 2022. Hepatitis B and C are the most common causes of cirrhosis and liver cancer, and are currently the third most common cancer in the Asia-Pacific region.
Hamid highlighted Egypt's success in fighting the disease: Egypt once had the highest rate of Hepatitis C infections, but after the “100 Million Healthy Lives” campaign, the infection rate dropped dramatically.
More than 60 million people have been tested in Egypt and over 4 million have been treated, resulting in a decline in new infections from 300 per 100,000 people in 2014 to 9 per 100,000 people in 2022. The goal for hepatitis C elimination is to have fewer than 5 new infections per 100,000 people per year.
Hamid said Pakistan aims to replicate Egypt's success in its ongoing large-scale hepatitis health campaign.
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