Commonwealth of the Northern Mariana Islands achieves hepatitis B milestone

Feature story

The Commonwealth of the Northern Mariana Islands – a stretch of 14 islands in the northwest Pacific – may be small, but it is scoring big goals in health. This island chain in political union with the United States of America has just been confirmed by the World Health Organization (WHO) as having reduced hepatitis B infection among children to less than 1%.

The Northern Mariana Islands have a strong hepatitis B vaccination programme which provides babies with their first dose of hepatitis B vaccine within 24 hours of birth, followed by two more doses within the first year of life. Pregnant women are also screened for hepatitis B. Before implementing this aggressive hepatitis B immunization programme, the Northern Mariana Islands had a 7% estimated prevalence of chronic infection among 5-year-old children. Immunization against hepatitis B protects children against infection with the hepatitis B virus, which can cause liver disease including liver cancer later in life.

“On behalf of WHO, I wholeheartedly congratulate the Northern Mariana Islands for reaching this important public health milestone,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific.

“Reducing hepatitis B infection among children to less than 1% means a generation of children virtually free of hepatitis B infection – who will grow up with massively reduced risk of developing diseases like liver cancer later in life,” Dr Shin said.

"We are grateful for the recognition and continuous support from WHO. Our health agency along with the immunization team, led by Mr Jeremy Sasamoto and Ms Margaret Aldan, are very dedicated in protecting the health of the people of the CNMI. We hope to continue this success with our other health improvement goals," said Ms Esther L. Muna, CEO of Commonwealth Healthcare Corporation.

"The success of CNMI's immunization program in reducing hepatitis B among children is the result of the commitment and dedication of Mr Sasamoto and his team, with the support of partners," said Ms Aldan, Director of Public Health, Commonwealth of the Northern Mariana Islands.

Hepatitis B is a major global health problem, with nearly 260 million people around the world living with the disease. Nearly 800 000 people die from hepatitis B-related liver disease every year. In the WHO Western Pacific Region – which stretches from Mongolia in the north to New Zealand in the south, and includes 1.9 billion people – 115 million people live with chronic hepatitis B infection, accounting for 45% of infections worldwide.

Hepatitis B is a virus that is transmitted through blood and other bodily fluids. It is often transmitted during childbirth. Hepatitis B is known as a "silent killer", since people with chronic hepatitis B acquire the infection in early childhood and usually do not have symptoms for many years. They are often unaware of the infection until it is too late, when progressive liver disease has already developed, leading to liver cirrhosis or liver cancer.

The Northern Mariana Islands joins 17 other countries and areas in the Western Pacific Region that have been verified as having achieved the 2017 Regional goal of less than 1% prevalence among 5-year-old children. The other previously verified countries and areas are American Samoa, Australia, Brunei Darussalam, China, the Cook Islands, French Polynesia, Guam, Hong Kong SAR (China), Macao SAR (China), Malaysia, Mongolia, New Zealand, Niue, Palau, the Republic of Korea, Singapore and Tokelau.

The World Health Assembly has called for the elimination of viral hepatitis as a public health threat by 2030 in the Global Health Sector Strategy on Viral Hepatitis 2016–2021. WHO works closely with countries and partners to promote vaccination against hepatitis B among babies as a key part of implementing this global strategy.