A make-or-break moment for the first viral hepatitis strategy

26 May 2016 Tara Farrell

REPOSTED FROM DEVEXBy Jenny Lei Ravelo @JennyLeiRavelo 

Six years ago, advocates against viral hepatitis experienced a huge win: Member states at the World Health Assembly adopted resolution WHA63.18, which allows the organization to draw global attention to the disease on a specific day of each year — July 28.

This was followed with another resolution in 2014 that called on the World Health Organization to examine the feasibility of viral hepatitis’ elimination, which led to the development of a strategy that’s now before member states at the 69th World Health Assembly.

The question is: Will advocates’ winning streak continue?

Every year, viral hepatitis kills more than 1 million people worldwide. WHO refers to it as “one of the most prevalent and serious infectious conditions in the world.” Hepatitis B and C are among the most common causes of liver cirrhosis and cancer, according to the U.N. health agency.

But attention has been meager, as has funding.

“Engaging with potential funders takes a lot of education, and tailored education [at that] … we have to conduct that before we even start asking for money. So it’s a bit of a chicken and egg, the fact that there’s such low awareness, it’s really hard to get people to actually say, ‘yes, this is a compelling issue and we will fund you,’” Jennifer Johnston, executive director at the Coalition for the Eradication of Viral Hepatitis in Asia-Pacific, told Devex in an interview in August 2015.

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She mentioned making calls to the Bill & Melinda Gates Foundation, but the donor, which has a huge portfolio on global health, didn’t identify viral hepatitis as a priority.

The tide, however, may be finally turning for those fighting for viral hepatitis to also be part of the global agenda, with the inclusion of the disease in the Sustainable Development Goals.

“Each of these achievements has led us one step closer to reaching our overall goal,” Raquel Peck, CEO of World Hepatitis Alliance, told Devex.

But their fight is not yet over. The alliance, along with the wider hepatitis community, fear that some member governments may not adopt the draft global health sector strategy on viral hepatitis, which aims to reduce new infections and annual deaths to 90 percent and 65 percent, respectively, by 2030.

The main issue they are seeing is cost. Implementing the strategy with all its specific targets would cost low- and middle-income countries an estimated $11.9 billion within the next 15 years, based on WHO estimates.

If adopted, governments will be expected to develop national plans in tackling viral hepatitis, which would require prioritization and budgetary decisions — a situation that only 36 countries out of the 194 WHO member states were able to accomplish as of February 2016, Peck said. Apart from the 36, only 33 of the total member countries have started work on their own national plans.

But if not, Peck anticipates a period of consultation will ensue, with governments trying to make amendments to the targets.

“At this stage, it’s very hard to predict, as the hepatitis strategy will need a unanimous decision from 194 countries to be adopted,” Peck said.

She is however hopeful. With viral hepatitis part of the new global development agenda, all U.N. member states are “required” to reach the target on the disease to meet their obligations under the SDGs, the CEO argued — although the Millennium Development Goals prove this is not always the case.

Plus, the targets in the strategy are, in her own words, “feasible and achievable,” what with vaccines and effective treatments for hepatitis B, and a cure for hepatitis C now available.

Still, if all else fails, Peck and her colleagues have no plans of backing down.

Regardless of Thursday’s outcome, on July 28 the World Hepatitis Alliance will launch NOhep, a global movement aimed at galvanizing support toward the elimination of viral hepatitis by 2030. They also plan to move forward with the second World Hepatitis Summit in March 2017, which they are co-sponsoring with WHO and which will convene a wide range of stakeholders, from health ministers, international aid agencies, hepatitis-focused organizations and civil society groups, funding agencies, and members of the private sector. The theme is to be “Implementing the Global Health Sector Strategy on viral hepatitis: Towards elimination of hepatitis as a public health threat.”

“If governments do not take the lead then, just as we did when we established World Hepatitis Day, we — the community — will,” Peck said.