Nothing to do, the WHO goal of eliminating hepatitis by 2030 is realistically unattainable. And if it is true that talking about it has created greater and growing awareness, it is equally true that we are far from declaring the end of the emergency. An emergency that will count, by 2040, more deaths than AIDS, tuberculosis and malaria combined. Hepatitis is currently the seventh leading cause of death in the world, and the fact that it can be defeated with appropriate investments in vaccines and drugs does not take away the bitterness of the lack of commitment shown by governments and investors in the effort to defeat viral infections.
Hepatitis alarm, the cure for Delta arrives
by Sandro Iannaccone
Hard speech of Michel Kazatchkineformer executive director of the Global Fund against AIDS, Tuberculosis and Malaria, currently director of the Global Health Center in Geneva, in front of the Hepatitis Fund and Chai, the Clinton Health Access Initiative, represented by Chelsea Clintonby the WHO Director-General, Tedros Adhanom Ghebreyesus and former New Zealand premier and current Hepatitis Fund ambassador, Helen Clark. Hepatitis can be defeated – he reiterates – there are tools to prevent, diagnose and treat them. But we need national action plans, national and global investments, identifying the most vulnerable key populations, such as injecting drug users, ensuring tests and therapies.
The numbers
About 350 million people worldwide live with chronic viral hepatitis infection: 295 million with hepatitis B (HBV) and 55 million with hepatitis C (HCV). And there are about 1.1 million deaths a year from hepatitis B or C, with 3.3 million new infections. The highest number of cases in Africa, Asia and the Mediterranean regions of the East. Nonetheless, the investment in eliminating viral hepatitis is minimal when compared to other deadly infections. And this despite the fact that there are very effective ways to do it, such as vaccines, prophylaxis for mother-to-child transmission, which remains the main mode of transmission of the virus, and lifelong treatments for hepatitis B, very effective therapies for hepatitis C and others on the way for hepatitis D. Hepatitis C antiviral drugs could cure more than 95 percent of people with HCV, but only 21 percent know they have the disease, and only 13 percent of those diagnosed have received the treatment.
Africa is the hardest hit
According to the World Health Organization report, more than 70% of hepatitis B infections are registered in Africa, and 70% of these infected are children under 5 years of age. To prevent hepatitis B, vaccination with the first dose within 24 hours of birth is a very effective tool but unfortunately coverage in Africa is extremely low: only 30% of African countries have introduced it. “In 2021, only 17% of newborns in Africa received the dose at birth – he specified oriel fernandezsenior director of the global viral hepatitis program at CHAI – and only 14% of countries in the African region have routine immunizations.”
Hepatitis, world day. An extension is needed for screenings (of C).
by Elvira Naselli
Hepatitis B is mainly sexually transmitted, and above all vertically during childbirth, hepatitis C is still massively linked to the use of non-sterile syringes and is a particularly significant problem in Eastern European countries, where the percentage linked to syringes
it reaches 80%, and in the regions of central and south-eastern Asia, and in some regions of the western Pacific. The tools to prevent and treat hepatitis are there, money and a more concrete commitment are lacking. US$6 million a year would be enough to stop viral hepatitis in 67 low- and middle-income countries, preventing 4.5 million deaths by 2030. “For every dollar spent to eliminate these diseases – specify the organizers of the meeting in Geneva – there is a two to four times return on investment.
The cost of medicines
Finally, the cost of medicines. “There is no reason why the daily therapy of chronic hepatitis B, tenofovir – continues Kazatchkine – at the same dosage used in combination in HIV therapy, must not be priced the same as HIV programmes. And as for hepatitis C, it can be diagnosed, treated and cured according to WHO standards for about $80 per patient: costs should never be an obstacle to saving lives, but when costs are affordable we have a moral imperative to intervene. Over one hundred countries have developed comprehensive hepatitis elimination programs. It’s not enough, we must make the efforts we supported to fight AIDS. Because hepatitis is the new epidemic.”