Health agencies warn that viral hepatitis could kill more people by 2040 than HIV, tuberculosis and malaria combined if it remains a neglected disease and efforts to fight it remain underfunded.
The World Health Organization reports every year that viral hepatitis, a potentially life-threatening liver infection, affects more than 350 million people globally and kills more than a million. Ninety percent of these infections and deaths are in low- and middle-income countries.
Despite a cure for hepatitis C and a vaccine for hepatitis B, campaigners for a world free of this dangerous and debilitating disease remain far off that mark.
“Over the last 10 years, we have seen really remarkable progress in this journey to eliminate viral hepatitis,” said Oriel Fernandez, senior director of the Viral Hepatitis Global Program at the Clinton Health Access Initiative, or CHAI.
“We have the tools to prevent, diagnose and treat viral hepatitis,” she said. “Secondly, the price of hepatitis drugs and diagnostics has significantly fallen over the years.”
For example, Fernandez noted that in 2018, CHAI supported the government of Rwanda to set the lowest price for WHO-approved hepatitis B treatment.
“The total cost to cure a patient dropped by 96%, from over $2,500 per person to less than $80 per person cured. And this made the idea of elimination affordable for Rwanda and really established a benchmark price for all countries to aim for,” she said.
Pledging conference
But funding to help poor countries pay for the treatments and vaccines to cure and eliminate this debilitating disease remains elusive. To address this issue, the Hepatitis Fund and CHAI will hold the first-ever pledging conference in Geneva next week.
The conference hopes to raise $150 million to support countries that are committed to the elimination of viral hepatitis and have taken action to implement programs toward this end. Organizers cite Egypt, Rwanda, Georgia, India, Indonesia, Nigeria and Vietnam among other countries that have begun this process.
Kenneth Kabagambe, who has been living in Uganda with hepatitis B since 2012, is the founding executive director of the National Organization for People Living with Hepatitis B. He said he started the organization to raise awareness of the disease and to shatter the myths that stigmatize people and discourage them from seeking help.
“For example, there are issues to do with the myths and misconceptions, which actually are drawn from the lack of clear information about the transmission of hepatitis B and hepatitis C in the communities,” he said. “These actually have led to domestic violence in some families because people think that hepatitis B is just casually transmitted, which is not correct.”
Hepatitis B is spread through sexual transmission and through contact with the blood, open sores or body fluids from a person infected with the disease. The main mode of transmission, however, is from mother to child during birth and delivery.
WHO reports that about 70% of hepatitis B infections worldwide occur in Africa, and 70% of those infected with the disease are children younger than 5.
Birth doses
While vaccination is the best way to prevent hepatitis B, Fernandez noted that the first birth dose of this vaccine has very low coverage in Africa.
“In 2021, only 17% of newborn babies in the WHO Africa region received a timely hepatitis B birth dose,” she said. “And only 14 of the countries in the region have policies for routine HB-dose vaccinations.”
Fernandez said effective and affordable treatments are available for both hepatitis B and hepatitis C, which is largely spread through unsafe drug injections and is a particularly huge problem in countries in the Eastern Mediterranean and Central and Southeast Asian regions, as well as some countries in the Western Pacific.
“I think the bottom line is we do have effective tools for prevention in the case of hepatitis C and B, and treatment in the case of a cure for hepatitis C,” she said. “They just have not been implemented effectively, and to do this, we need a surge in financing. It is not an insurmountable goal. Countries have shown that we can do this.”
Conference organizers say that investing $6 billion annually to end hepatitis in 67 low- and middle-income countries would prevent the deaths of 4.5 million people by 2030.
They add, “For every dollar spent on HBV [hepatitis B virus] elimination activities, there is a two to four times return on investment.”
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