The World Hepatitis Day, observed annually on 28th July, is an initiative aimed at raising awareness about viral hepatitis. The theme for 2022 revolves around “Bringing hepatitis care closer to you” – a call-to-action for making hepatitis care more accessible via primary health care facilities to ensure better reach of treatment and care.
Hepatitis: What Is It and What Causes It?
Hepatitis is an inflammation of the liver that can be acute (sudden onset with symptoms such as jaundice, fever, and vomiting) or chronic (lasting over six months with essentially no symptoms). The primary agents causing it are the hepatotropic (liver-directed) viruses, including Hepatitis A, B, C, D, and E. Various other viruses like the varicella virus (chicken pox cause) and SARS-CoV-2 can also lead to it. Other factors include drug and alcohol abuse, fat buildup in the liver (fatty liver hepatitis), and autoimmune processes. Hepatitis currently stands as the only communicable disease showcasing an increasing mortality trend.
Treatment Modalities for Hepatitis
While Hepatitis A and E are self-limiting and do not require specific antiviral treatments, effective medications are available for Hepatitis B and C.
The Global and Indian Scenario of Hepatitis
Globally, approximately 354 million people suffer from hepatitis B and C. Southeast Asia bears the brunt of around 20% of the global morbidity burden. Around 95% of hepatitis-related deaths occur due to cirrhosis and liver cancers caused by hepatitis B and C viruses.
In India, viral hepatitis remains a major public health issue. It has an “intermediate to high endemicity” for Hepatitis B, with an estimated 40 million chronic HBV infected people, constituting approximately 11% of the estimated global burden.
Challenges in Tackling Hepatitis
Healthcare services are often out of reach for many, with specialized care available only at centralized hospitals which come at a cost not affordable by all. Late diagnosis or lack of appropriate treatment leads to mortality. Early diagnosis is crucial for both prevention and successful treatment. Statistics indicate very low levels of hepatitis detection and treatment rates in Southeast Asia.
Global Targets: Eliminating Hepatitis as a Public Health Threat
The Global Target aims to eliminate viral hepatitis as a public health threat by 2030. The measures to achieve this include reducing new infections and death rates from liver cancer, ensuring higher diagnosis rates, and expanding the reach of effective treatments.
Strategies to Achieve the Global Target
Achieving the target requires collaboration across all countries of the region. Key steps include ensuring sustained domestic funding, improving access to drugs and diagnostics by lowering prices, developing communication strategies to raise awareness, and innovating service delivery to maximize patient-centric care.
Integrated Regional Action Plan and Way Forward
An Integrated Regional Action Plan for viral hepatitis, HIV, and Sexually Transmitted Infections (STIs) 2022–2026 is being developed by WHO. The plan seeks to ensure effective utilisation of limited resources. Personal hygiene, safe water and sanitation, full coverage of hepatitis B immunization, and safe blood, sex, and needle usage are critical preventive measures. Vaccines for hepatitis B and powerful antiviral drugs for managing chronic hepatitis B and curing most hepatitis C cases can prevent premature deaths globally.
Hepatitis B in India’s Universal Immunization Programme
Hepatitis B is part of India’s Universal Immunization Programme (UIP), which provides free vaccination against various vaccine-preventable diseases. Countries in the WHO’s Southeast Asia region, like Bangladesh, Bhutan, Nepal, and Thailand, have successfully controlled Hepatitis B. Additionally, an automated coronavirus testing device called ‘COBAS 6800’ has been launched that can detect viral Hepatitis B & C.
Despite the challenges posed by diseases like HIV-AIDS, TB, Malaria, and Hepatitis, concerted efforts by WHO and global healthcare agencies continue to raise awareness and combat these diseases effectively.