The WHO is calling for accelerated efforts to combat hepatitis in Southeast Asia to address rising deaths from liver cancer.

The World Health Organization today called on countries in the Southeast Asia region to urgently scale up efforts to provide universal access to prevention, vaccination, diagnosis and treatment for viral hepatitis B and C. Although these chronic infections are preventable and treatable, they are causing increasing serious illness and deaths from liver cancer, cirrhosis and liver failure.

Currently, liver cancer is the fourth leading cause of cancer deaths in the region and the second leading cause of cancer deaths in men. Approximately 75% of cirrhosis is due to hepatitis B and C infections. In 2022, the number of people with viral hepatitis B and C in the region reached 70.5 million. Early testing and treatment can cure hepatitis C and prevent hepatitis B from causing cirrhosis and cancer, helping to reverse the prediction that liver cancer deaths in the Southeast Asian region will double by 2050 to more than 200,000 people per year.

“While we have the knowledge and tools to prevent, diagnose and treat viral hepatitis, people living with chronic hepatitis B and C are still waiting to receive the services they need. We need to accelerate efforts to provide equitable services closer to communities at the primary health care level,” said Saima Wazed, WHO Regional Director for South-East Asia, on World Hepatitis Day. This year's theme is “The Time to Act is Now”.

Globally, hepatitis B and C together cause 3,500 deaths per day and 6,000 new cases of viral hepatitis occur each day. An estimated 254 million people worldwide are infected with hepatitis B and 50 million with hepatitis C. Many remain undiagnosed, and even among those diagnosed, the numbers accessing services and treatment remain extremely low.

In 2022, the number of deaths from viral hepatitis was approximately 1.3 million, matching the number of deaths from tuberculosis. Viral hepatitis and tuberculosis were the second leading cause of death from infectious diseases in 2022, after COVID-19.

In the WHO South-East Asia Region, coverage of testing and treatment for hepatitis B and C remains low: in 2022, only 2.8% of people were diagnosed with hepatitis B, and 3.5% of those diagnosed received treatment. For hepatitis C, only 26% and 14% were diagnosed.

“We have a safe and effective vaccine that can prevent hepatitis B infection. Antiviral medications are highly effective in slowing and preventing the progression of the disease, managing chronic hepatitis B and curing most cases of hepatitis C. We need to do more to provide these life-saving interventions that benefit everyone, regardless of who they are or where they live,” Wazed said.

Hepatitis B and C affect the general population and specialised populations, including those at high risk or with a history of infection from unsafe blood supplies, unsafe medical injections and other medical procedures, newborns and children at risk of mother-to-child transmission of hepatitis B and C, particularly in settings with high viral hepatitis prevalence, indigenous and migrant and immigrant populations from high-prevalence countries, and key populations that may be disproportionately affected in a range of settings, such as people who inject drugs, people in prisons and other closed settings, sex workers and men who have sex with men.

Because most people are unaware that they are infected with hepatitis B or C, access to hepatitis testing and treatment needs to be expanded beyond large hospitals and referral centers. Testing and treatment must be available in communities by primary health care facilities and general practitioners close to where people live and work, and must be included as part of universal health care systems. Accelerated coverage of hepatitis B and C testing and treatment would also reduce the incidence of cirrhosis and liver cancer, and ultimately mortality, she said.

It is vital that the needs of people affected by viral hepatitis are placed at the heart of all efforts and that all stakeholders, including the private sector, work together at all levels to reverse the current impacts on health.

Investment case studies from several countries estimate that for every dollar invested in viral hepatitis control, there is a return of two to three dollars to prevent rising mortality rates and the high costs of cancer treatment and care.

“Viral hepatitis is the major public health challenge of the decade. Leveraging a public health approach and investments in universal health coverage in countries, it is possible to eliminate viral hepatitis by 2030,” the Regional Director said. Taking action between 2024 and 2026 to expand equitable access to viral hepatitis interventions will put countries back on track to achieve the Sustainable Development Goals (saving lives, preventing new infections, cancers and deaths for future generations, and reducing costs). “We have a collective responsibility to save lives today and protect the health of future generations. The time to act is now,” Wazed said.