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No time to neglect hepatitis, 70m Africans are infected

Tuesday August 03 2021
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Hepatitis results in the inflammation of the liver. There are different forms of hepatitis A, B, C, D and E each attributed to a different type of virus. PHOTO | SEARCH

By The Conversation

In 2016, the World Health Organisation (WHO) set an ambitious target to eliminate viral hepatitis by 2030. This was followed by commitments from governments including African countries to develop national strategic plans for viral hepatitis and earmark resources to eliminate the disease.

Hepatitis results in the inflammation of the liver. There are different forms of hepatitis A, B, C, D and E each attributed to a different type of virus. Unfortunately, most people who have the most serious forms of the disease, particularly the B and C viruses, are unaware of infection.

This allows the infection to spread unchecked, leading to serious damage to the liver.

This year World Hepatitis Day is marked under the theme “Hepatitis Can’t Wait.” It is a clear call to improve efforts towards eliminating a disease that globally kills one person every 30 seconds.

Many African countries that committed to eliminating the disease have either not ratified their guidelines or not increased access to hepatitis care. Of the 47 countries in the WHO Africa region, 28 have developed national plans to eliminate the disease.

However, only 13 countries have disseminated them. The childhood vaccine given at birth is effective, but in many rural and remote parts of Africa over 40 percent of children are still unable to get the vaccines when they need them.

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Reasons for this include erratic vaccine supplies and outdated vaccination schedules. These challenges have been further compounded by the Covid-19 pandemic, which has eroded some of the gains that had been made in the past few years.

With movement restrictions and social distancing as part of the responses to curb the spread of infections, people have been less able to use services to prevent and cure hepatitis and other diseases.

The disease in Africa, 70 million people are infected and 200,000 die annually from hepatitis.

This is despite the availability of treatment. Hepatitis B is the most common form of the illness. It is spread through infected body fluids, either through sex with an infected partner, at birth (from an infected mother to her baby), direct contact with open wounds or blood of an infected person, sharing syringes, razors or toothbrushes with infected persons.

The mainstay strategy for managing hepatitis B is prevention through the administration of a vaccine. It is also treatable, through oral antiviral drugs which in most cases must be taken for life. This is because the treatment, in most people, only leads to the suppression of the virus and not its complete eradication.

To prevent its progression, it is highly recommended that treatment begins within the first three months of infection. The call again this year is therefore for renewed efforts to ensure that no baby is born with hepatitis, pregnant women get tested and treated, awareness is raised about the disease as well as testing and treatment, and governments invest more in efforts to end the disease.

More concerted efforts are needed to keep services going even amid the disruptions caused by the pandemic. Countries need to commit more domestic resources to fast-track elimination. Cape Verde, Uganda and Rwanda provide positive lessons.

They have committed more resources to ensure a 99 percent birth dose vaccination rate, free national hepatitis B treatment and free treatment for hepatitis B and C. This shows what political will can achieve.

Cape Verde’s government funds all vaccine services and implemented hepatitis screening for pregnant women in 2002 and the pentavalent vaccine in 2010. (This is a combination vaccine which protects against five killer diseases: diphtheria, pertussis, tetanus, hepatitis B and Hib.)