9 June, 2022  

The World Hepatitis Summit continued Wednesday with speakers convening to discuss key issues surrounding the elimination of viral hepatitis worldwide including liver cancer control, fighting stigma and discrimination, prevention and vaccination, the Sustainable Development Goals (SDGs) and Youth Can’t Wait.  

WHO hepatitis C guidelines 

Philippa Easterbrook, Senior Scientist in the Global Hepatitis Programme at the World Health Organization (WHO), announced that WHO will be launching new hepatitis C guidelines on integration, decentralization and task shifting for hepatitis C testing and treatment. The updated guidelines will also include a section on hepatitis C in children.  

These guidelines are an important step in ensuring that hepatitis C testing and treatment are delivered within communities and in ways that are designed to best serve people living with viral hepatitis. The update on hepatitis C in children will also help ensure better access for children living with hepatitis C. 

Uzbekistan Presidential Decree 

Dr Erkin Musabaev, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, shared challenges, progress and plans for hepatitis C elimination in Uzbekistan. Starting with a pilot programme (Uzbekistan Hepatitis Elimination Pilot, UHEP), using simplified recommendations of screening and treatment of hepatitis, this was implemented on a national level, across seven regions, through a joint approach by the Ministry of Health. Dr Musabaev presented how the UHEP programme, with the support of CDA Foundation, had delivered screening, testing and treatment across hepatitis B and C, and reached hundreds of thousands of people. Simplified test and treat protocols were used to provide high outputs for elimination of hepatitis, meaning Uzbekistan can achieve the WHO goal of viral hepatitis elimination by 2030. A key outcome of the success of the programme was the Presidential Decree to control the spread of viral hepatitis, which means increased financing and budget for early diagnosis for hepatitis B and C, treatment of hepatitis C, increased prevention through vaccination, implementation of new technologies for early diagnosis of liver fibrosis and hepatocellular carcinoma after viral hepatitis, and improving the quality of services of virologic laboratories.  

Hepatitis and the Sustainable Development Goals (SDGs) 

In the panel Julia Tainijoki-seyer, Senior Medical and Advocacy Advisor, World Medical Association, provided a physician’s point of view on how strengthening health systems relates to hepatitis elimination.  

She discussed that there are many health systems which are still fragile with 122 countries reporting disruption of NCD services because of Covid-19. A focus on prevention, diagnosis, treatment, secondary care and rehabilitation are vital she believes. Julia stated “physicians in hepatitis find the prevention aspect to be very important. It’s not a cost, it is an investment. Investing now is cheaper than treating later on”.  

Justin Koonin, Co-chair at UHC2030 stated that, “UHC is essentially SDG 3.8 and means that all people should have access to the health services they need and shouldn’t put them under financial stress to do so.”  

He went on to say “the way UHC is conceptualised is as a cube. Who gets served with health services, what gets covered and how is it paid for?” You can’t end hepatitis without UHC, Justin believes and UHC at its core is about strengthening fundamental aspects of health systems. “Community engagement, supply chains and data analytics. At end of the day when a person goes for treatment it is critical that services are all aligned”, he told audiences. 

Hepatitis and liver cancer 

Lewis Roberts, Professor of Medicine at The Mayo Clinic opened the session stating liver cancer prevalence is particularly high in Africa and Asia. He told how treating viral hepatitis B and C reduces incidences of liver cancer. According to Lewis, early-stage liver cancer is easier to cure than late-stage, therefore surveillance for early-stage cancer makes a huge difference in survival outcomes. “Outcomes of liver cancer in Africa are abysmal”, Lewis told audiences, however. “Egypt has done the most aggressive effort to treat liver cancer due to their epidemic of viral hepatitis C.”  

Eleonora Feletto, Senior Research Fellow, The Daffodil Centre, presented the risk factors of liver cancer in the Western Pacific Region. “Liver cancer is the sixth most common cancer globally and the third most common cause of cancer death”, she stated. The Western Pacific has the highest incidence of liver cancer of all WHO regions. Eleanora referenced that hepatitis B prevention has had a major impact on preventing liver cancer. The prevention of alcohol and tobacco use will also help to reduce liver cancer, she believes. 

Prevention and vaccination 

During the session, Partha Sarathi Mukherjee, Secretary, Liver Foundation, West Bengal, discussed organising the project “Finding the Missing Millions” to reach tribal areas in West Bengal. In the tribal areas there was a lack of hepatitis awareness and stigma associated with the hepatitis vaccine. As part of the project, the organisation arranged billboards with informative messages in the village. The billboards were successful in raising awareness and understanding of the vaccine. 

Michaela Jackson, Prevention Policy Manager, Hepatitis B Foundation told audiences that hepatitis B remains a large issue in the United States, with around 2.4 million adults living with it. Areas of the opioid epidemic are particularly impacted. She reiterated that adult vaccination rates remain low in the United States and poorly monitored. “Since ACIP voted to approve vaccination for all adults”, Michaela noted, “this has helped with increased vaccination, and we have created an advisory council to develop implementation strategies”. 

The World Hepatitis Summit is organized by World Hepatitis Alliance and co-sponsored by World Health Organization (WHO). Its mission is to support countries in meeting the targets needed to eliminate viral hepatitis. The Summit continues until the 10th June.  

For more information contact:   

tajinder.tiwana@worldhepatitisalliance.org   

james.gillies@worldhepatitisalliance.org