World Hepatitis Day 2016: Eliminate viral hepatitis

NOhep: the global movement to eliminate viral hepatitis

As part of celebrations to mark World Hepatitis Day, the World Hepatitis Alliance, along with a large coalition of civil society organisations, is launching 'NOhep', the global movement to eliminate viral hepatitis by 2030.

NOhep aims to unite those working in the field of hepatitis with others from across the health sector with the aim of raising awareness for viral hepatitis and building the momentum needed for governments to take action. NOhep is calling on individuals and organisations across the world to sign-up to be part of the next greatest achievement, the elimination of viral hepatitis.

The Union for International Cancer Control (UICC) supports this campaign. Addressing viral hepatitis will be crucial to reducing the global burden of liver cancer, and the movement underscores the importance of integrating cancer control measures across national health plans. Links with vaccination programs, HIV services, child and maternal health services, and occupational health and safety are vital to ensuring sustainable reductions in cancer burdens. 

Viral hepatitis are a major cause of cancer

Each year, more than 782,000 people die from liver cancer making it the sixth leading cancer among men and women globally. 78% of these cases are caused by viral hepatitis infections and, given the available vaccination and treatment options, the majority of these deaths are preventable. However, individuals need to be aware of their infection and have access to the appropriate treatment for this to be achieved.  

Lack of awareness, at an individual, community and government level, is cited as one of the main reasons for the continuing high global burden of viral hepatitis. Less than 5% of people living with viral hepatitis worldwide are aware of their condition, as the disease is largely asymptomatic and many individuals lack access to routine Hepaitis screening. The result is that for many the opportunity to access highly effective vaccinations and treatment which can prevent liver disease, cirrhosis and liver cancer is missed.

“We have the right to know if we are living with a cancer-causing virus” said Raquel Peck, CEO of World Hepatitis Alliance. “On World Hepatitis Day, we are calling on governments to take responsibility by scaling up hepatitis testing services and by providing treatment to reduce needless deaths, since most people were infected through poor infection control in the healthcare system”. 

At the 69th World Health Assembly in May, the WHO Global Viral Hepatitis Strategy was unanimously adopted. This outlines commitments to achieve 90% access diagnosis and 80% access to treatment services by 2030. It also outlines an overarching goal of eliminating viral hepatitis by 2030, which has the potential to save 7.1 million lives globally. 

On World Hepatitis Day, it is great to see the World Hepatitis Alliance focus global health attention on a leading cause of one of the deadliest cancers globally and call for more action on hepatitis C infection, which UICC supports. Combined, hepatitis B and C are attributed to 78% of all liver cancers. Liver cancer has a high mortality globally, particularly amongst men, and is second only to lung cancer. This burden disproportionally affects low- and middle-income countries and the world's poorest.

Hepatitis B infection is responsible for 420,000 cases of liver cancer per year, however it does have a highly effective prophylactic vaccine1. Global coverage with three doses of hepatitis B containing vaccine is estimated at 82%, but access to this safe, cheap and effective prevention for liver cancer varies greatly by region and country. Implementation of the vaccine is recommended as a highly cost-effective public health intervention in the WHO Global Action Plan for the Prevention and Control of NCDs 2013-2020, but there is a lot more to be done with a call in the Global Hepatitis Strategy for an increase in routine childhood hepatitis B virus vaccination coverage from 82% in 2015 to 90% by 2020.

Viral hepatitis B and C are blood-borne infections, with significant transmission occurring in early life and through unsafe injections and medical procedures, and less commonly through sexual contact. The prevention and treatment of hepatitis is eminently achievable and underscores the importance of integrating cancer control information and prevention programs across national health plans. For example about 2.6 million people living with HIV are co-infected with hepatitis C virus and hepatitis B virus and therefore have a high risk for liver cancer, but which can be managed if patients are aware.

The World Health Organization Global health sector strategy on viral hepatitis 2016-2021 highlights key interventions which require more national attention, including:

• Mother-to-child transmission of hepatitis B virus is a major mode of transmission in settings with a high prevalence of hepatitis B infection. Integrating information into child and maternal health programs; monitoring of infected mothers; and vaccinating babies within 24 hours of birth needs more global attention to effectively bring down infection rates. Currently 96 countries have introduced a birth dose of the hepatits B vaccine, and global coverage stands at 38%2.
• An often neglected story is the need to protect healthcare workers with robust safe needle procedures in occupational settings, and this includes all invasive medical interventions, promotion of injection safety measures and securing the safe supply of blood products

About the World Hepatitis Alliance

The World Hepatitis Alliance (WHA) is a patient-led and patient driven non-governmental organisation (NGO). With over 230 member patient groups from 82 countries, WHA provides global leadership to drive action to help eliminate viral hepatitis as a public health threat by 2030. Their

aim is to work with governments, members and other key partners to support and elevate patient voices, to raise the profile of viral hepatitis and to help establish comprehensive hepatitis strategies, which include robust prevention measures and access to affordable diagnostics and treatment.

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