WHO in the Western Pacific: Working towards a hepatitis-free Region
MANILA, 25 July 2014 - Viral hepatitis causes an estimated 1.4 million deaths worldwide each year—which is close to the number of deaths caused by HIV/AIDS, and more than those caused by malaria and tuberculosis. Despite the high burden on individuals, families and societies, political and financial engagement remains inadequate. The World Health Organization (WHO) estimates that more than 500 million people worldwide are affected by chronic hepatitis B and C.
The WHO Western Pacific Region bears a disproportionately high burden of hepatitis B virus (HBV). The Region is home to about one quarter of the world population, but accounts for about half of chronic hepatitis B infections. The burden of hepatitis C virus (HCV) is also high in the Region.
“Thirty countries and areas of the 37 in our Region have already reached the 2012 milestone of reducing chronic hepatitis B infection prevalence among 5-year-old children to less than 2%,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “But I am convinced that we can do better.”
“Given the high endemicity of viral hepatitis in the Region—especially hepatitis B and C—we need to increase focus on prevention and screening, but also redouble our efforts in the treatment of those already infected,” he added.
Chronic hepatitis B infection is endemic in the Western Pacific Region. With few exceptions, most countries have chronic HBV infection rates of more than 6% among adults. Chronic, life-long infection caused by HBV can lead to cirrhosis and liver cancer, with an estimated 78% of all liver cancer cases and 57% of cirrhosis caused by chronic HBV or HCV infections.
Substantial progress in hepatitis B control through vaccination has been made in the Region, leading to marked reductions in prevalence among children. However, adults who have not been vaccinated continue to die from hepatitis B-related liver disease and liver cancer. Today, hepatitis B and C can be prevented and treated.
Globally, of the 1.4 million deaths caused by viral hepatitis each year, hepatitis B and C account for nearly 90%: almost 800 000 are due to hepatitis B and 500 000 due to hepatitis C.
Currently, patients with hepatitis B and C are treated by hepatologists, gastroenterologists and infectious-disease experts but specialists are hard to find in low- and middle-income countries. Treatment on a larger scale would require expanded primary health-care settings and workers. Further training in diagnosis, management and treatment of patients with chronic hepatitis B and C is needed.
Hepatitis B virus infection is potentially life-threatening. It can cause chronic liver disease and puts people at high risk of death from liver cirrhosis and liver cancer. The hepatitis B virus is transmitted through exposure to infected bodily fluids. Infection often occurs during childbirth or early childhood but can be prevented through vaccination at birth followed by at least two additional doses during infancy.
Hepatitis C can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, life-long illness. The virus is most commonly transmitted through unsafe injection practices; unsterile medical equipment in health-care settings, and unscreened blood and blood products.
In May 2014, the World Health Assembly, the governing body of WHO, recognized viral hepatitis as a global public health problem and called on governments and populations to take immediate action to prevent, diagnose and treat the disease. The Health Assembly also urged Member States to support or enable an integrated and cost-effective approach to the prevention, control and management of viral hepatitis.
In 2012, a framework for global action to prevent and control viral hepatitis infection was issued. The framework aligned actions along four strategic axes: (1) raising awareness, promoting partnerships and mobilizing resources; (2) evidence-based policy and data for action; (3) prevention of transmission; and (4) screening, care and treatment.
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