A survey of World Health Organization member countries released ahead of World
Hepatitis Day on 28 July shows that nearly two-thirds still have no national
plan to combat hepatitis, despite a 2010 World Health Assembly resolution
recognising viral hepatitis as a global health problem.
Only 37% of countries have a national plan to combat viral
hepatitis and only 40% have engaged in activities to promote World Hepatitis
Day. National plans were most likely to focus on vaccination against hepatitis
B and prevention of transmission in healthcare settings. Only 37 of 47
national plans addressed treatment and care for viral hepatitis.
Prevention activities were similarly fragmented.
Seventy-three per cent of states have prevention and control programmes that
target specific groups, but only 54% of these programmes include targeting of
injecting drug users and 38% target prisoners. Both of these groups are at high
risk of acquiring viral hepatitis, especially hepatitis B or C.
Forty-five per cent of states report that hepatitis C testing
is compulsory for members of specific groups, such as blood donors, healthcare
workers, pregnant women, people living with HIV, patients receiving
haemodialysis and prisoners.
Although 82.5% reported having a national surveillance
programme that collects data on viral hepatitis, only half of those states
collected reports on chronic hepatitis B and C infections, which are
responsible for the vast majority of the burden of disease and death associated
with viral hepatitis.
“Many of the measures
needed to prevent the spread of viral hepatitis disease can be put in place
right now, and doing so will offset the heavy economic costs of treating and
hospitalising patients in future,” says Dr Sylvie Briand, Director, Pandemic
and Epidemic Diseases at WHO.
The survey was carried out by the World Health Organization
and World Hepatitis Alliance. One hundred and twenty-six member states
responded (64% response rate), with the highest level of non-responses from
African nations. Within the WHO European region, Greece, Portugal and Romania
were among the nations that failed to respond, despite the growing burden of
viral hepatitis in each country.
Publicly funded treatment for hepatitis C is available in
59.5% of states, predominantly in the form of pegylated interferon or
interferon alpha and ribavirin. Sixty-two per cent of states report that they
provide publicly funded treatment for hepatitis B, most commonly in the form of
lamivudine (66%), tenofovir (48.4%) and pegylated interferon (50%) or
interferon alpha (54%).
Newer drugs for the treatment of hepatitis B and C are
available in a minority of countries. Protease inhibitors for the treatment of
hepatitis C (in combination with pegylated interferon and ribavirin) are
available in 18 to 19% of respondent countries. Entecavir and telbivudine for the
treatment of hepatitis B are available in 34% and 23% of respondent countries
”New, more effective medicines to prevent the progression of
chronic hepatitis B and C are in the pipeline. However, these will be expensive
and therapy will require monitoring with sophisticated laboratory tests. To
cure and reduce the spread of these viruses, medicines must become more
accessible,” said Dr Stefan Wiktor, Team Lead of WHO’s Global Hepatitis