WHO hepatitis report: almost two-thirds of countries lack a national strategy on viral hepatitis

Keith Alcorn
Published:
24 July 2013

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 respectively.

”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 Programme.

Download the report

You can download the full report, which includes regional breakdowns of information, at:

http://www.who.int/csr/disease/hepatitis/global_report/en/index.html