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GUEST EDITORIAL  
Year : 2009  |  Volume : 6  |  Issue : 1  |  Page : 14-18
Viral hepatitis : The need for action


World Hepatitis Alliance, Rue du Marché, 1204 Geneva, Switzerland

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Date of Web Publication19-Feb-2011
 

How to cite this article:
Gore C. Viral hepatitis : The need for action. Hep B Annual 2009;6:14-8

How to cite this URL:
Gore C. Viral hepatitis : The need for action. Hep B Annual [serial online] 2009 [cited 2019 Oct 15];6:14-8. Available from: http://www.hepatitisbannual.org/text.asp?2009/6/1/14/76901


There is an urgent need for coordinated global action to tackle viral hepatitis and 2010 presents an important opportunity for progress. About 500 million people worldwide, or one in 12 of the global population, are infected with chronic viral hepatitis B or C and most of them are unaware that they are infected. The World Health Organization (WHO) estimates that over 2 billion people worldwide have been infected with the hepatitis B virus (HBV) and of these, approximately 350 million individuals are chronically infected and at risk of serious illness or even death, mainly from liver cirrhosis and hepatocellular carcinoma (HCC).

The global statistics are overwhelming and they even underestimate the true disease burden. Together, hepatitis B and C represent one of the biggest threats to global health, killing approximately 1 million people every year. Governments are aware of the statistics and yet there has been very little appetite for action despite the compelling evidence; an international mandate is now essential.

For the first time in 2010, Health Ministers have the opportunity to pass a resolution on viral hepatitis. A WHO resolution is an opportunity for genuine global leadership and the strategic direction required for countries to address viral hepatitis. It is a vital first step toward achieving action that will halt the death toll and improve the lives of people living with chronic hepatitis B and C, through the provision of a framework to deliver improvements in awareness, prevention, care, support and access to treatment. This is an opportunity that the global community cannot afford to miss.

In May 2009, in response to the efforts by the World Hepatitis Alliance and national patient groups, Brazil, supported by China, Oman and Afghanistan, succeeded in adding viral hepatitis to the agenda for the 62 nd annual World Health Assembly. Brazil then submitted a draft resolution on viral hepatitis, which was set to be discussed by Health Ministers. Unfortunately, the 62 nd World Health Assembly was shortened in response to the global efforts required to tackle H1N1 influenza. As a result, discussion of the scheduled resolution on viral hepatitis has now been postponed until the WHO Executive Board meeting in January 2010. The Executive Board consists of 34 individuals who are technically qualified in the field of health, each one designated by a Member State. India has been elected to sit on the Executive Board from 2009 to 2012, and has the opportunity, if there is political will, to play a major part in ensuring that the resolution on viral hepatitis is passed.

It is true, and as it should be, that the WHO is a sum of its member states and their wishes. This means that consensus is required for resolutions to be passed. The support of Executive Board member nations, including India, is vital. If the Executive Board recommends a resolution to the World Health Assembly in May 2010, the World Health Assembly will be in a position to deliver a global mandate that will have far reaching effects for millions of people worldwide -- not least the estimated 40 million people who have been infected with the hepatitis B virus in India.

India's role in supporting a resolution on viral hepatitis cannot be underestimated; firstly at the meeting in January 2010 and then at the World Health Assembly meeting in May. In order for the WHO to pass a resolution, member states need to be clear on the issues and broadly supportive of them; and this is where all healthcare professionals and patient groups can play a part in ensuring a successful resolution.

The World Hepatitis Alliance has written to all governments represented on the Executive Board to impress upon them the importance of this resolution. As part of our ongoing policy work, the World Hepatitis Alliance has encouraged member groups to continue lobbying nationally through the framework of the '12 Asks', which are a series of requests for policy commitments from government that recognize the impact of hepatitis B and C and reflect the need for action. As national patient groups, advocacy organizations and medical organizations are best placed to understand local healthcare priorities and needs, the '12 Asks' are divided into six national Asks, which can be adapted locally, and six universal 'Asks.' In 2009, Scotland signed up to the '12 Asks' making it the first government to do so. National lobbying work from patients and healthcare professionals, potentially using the '12 Asks' framework, is a highly effective way to engage policy makers on viral hepatitis. This work has never been so important - national pressure is essential to encourage WHO Executive Board member states, including India, to support the resolution on viral hepatitis.

A WHO resolution is crucial; however, for the resolution to be effective, it needs to be robust. The World Hepatitis Alliance has outlined 12 recommendations, set out below, to ensure that we make the most of this opportunity to bring about global change:

  • The WHO should develop a comprehensive, prioritized global strategy including measurable goals, both regional and global, and a clear timeline for the prevention and control of viral hepatitis. This should be submitted through the Executive Board to the 64 th World Health Assembly in 2011.
  • The WHO Director-General should report to the Health Assembly biennially through the Executive Board on progress made in implementation of the resolution.
  • The WHO should provide member states with technical support to help them develop appropriate national strategies, including clear goals and timelines for the prevention and control of viral hepatitis.
  • National governments should recognize viral hepatitis as an urgent public health issue, prioritize hepatitis-related programs accordingly and strengthen international, national and local political commitment to prevent and control viral hepatitis. Governments should assign national resources to ensure that the most locally and epidemiologically appropriate strategies are effectively implemented and target populations are reached.
  • The WHO should provide technical support to ensure that national governments are able to conduct effective surveillance and publish national incidence and prevalence statistics. This national data should be collated and published by the WHO to allow comparative analysis of country approaches and specific national needs.
  • National governments should establish clear, quantifiable targets for reducing incidence, prevalence and mortality and appoint an individual to lead Government strategy nationally.
  • Awareness-raising programs help to reduce stigma and prevent infection and are one of the most cost-effective ways to tackle viral hepatitis. A World Hepatitis Day, celebrated annually on 19 th May, should be the culmination of year-round intensified implementation of national hepatitis control strategies and public awareness campaigns.
  • The WHO should work with member countries and suppliers to ensure the affordable supply of auto-disable syringes and a timeline for their mandatory use in all national healthcare systems
  • Governments should collect complete and accurate data on the screening of donated blood and institute or strengthen blood screening programs.
  • Governments should develop programs to increase access to free and anonymous (or confidential) testing.
  • Governments should commit to developing goals for hepatitis B control, in line with WHO SAGE recommendations.
  • International organizations and financial institutions should be encouraged to assign resources to support developing countries in their efforts to prevent and control viral hepatitis, increasing the use of reliable prevention, diagnostic and treatment methods suitable to local needs.


Altogether, these recommendations form the basis of a robust framework for effective global action. If the World Health Assembly passes a resolution on viral hepatitis in May 2010, then there is a responsibility on governments to ensure that this resolution is translated into action. While this could be the most difficult task of all, experience has shown that global consensus is one of the most important factors in ensuring changes in national health policy are delivered.

Viral hepatitis poses a major public health problem across the globe, especially in developing countries with underdeveloped health systems. However, in an era of global migration, this burden is shared by all nations, making a coordinated global response even more vital.

For too long, the urgent need for action to combat viral hepatitis has been overlooked. The WHO Executive Board has an opportunity to make a difference to the hundreds of millions of people living with chronic viral hepatitis and the many more at risk of infection. Delaying action will cost lives; hepatitis B and C kill approximately a million people every year. The Executive Board must grasp this opportunity and reach consensus ahead of the World Health Assembly. The world simply cannot afford to wait.

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Correspondence Address:
Charles Gore
World Hepatitis Alliance, 4th Floor, c/o LKM,7, Rue du Marché, 1204 Geneva
Switzerland
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9747.76901

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