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[WHO spearheads global initiative to eradicate hepatitis B]
1Karolinska sjukhuset, Stockholm. staffan.sylvan@sme.sll.se
It is estimated that over 350 million people live with a chronic hepatitis B virus (HBV) infection, claiming over one million deaths per year due to progress of the chronic disease to cirrhosis and/or hepatocellular carcinoma (HCC). An extended program of immunization including hepatitis B vaccine for children under one year of age has been launched in more than 110 countries. Recent studies conclude that mass hepatitis B immunization is effective in preventing HBV infection and has resulted in a decrease in the occurrence of HCC in children living in countries where hepatitis B is endemic. However, the vast majority of infected children live in the poorest developing countries in Africa and Asia that currently cannot afford the vaccine or lack the basic infrastructure necessary to deliver a national immunization service. The Global Alliance for Vaccines and Immunization (GAVI) was established in 1999 as an alliance of WHO, UNICEF, the World Bank, industry, foundations, and other partners to reinvent immunization for the 21st century, by forging a common vision and new ways of working together at global, regional and national levels. WHO recommends global elimination of hepatitis B by universal infant and/or adolescent immunization, but health planners in Sweden and the other Scandinavian countries, the Netherlands and UK have not yet been convinced of the cost-effectiveness of HB-prevention through routine childhood immunization with HB-vaccine. The inclusion of hepatitis B vaccine in already available multivalent vaccines may alter this situation in the future, but until then an intensified vaccination strategy aimed at those groups of individuals that are particularly at risk for hepatitis B should be adopted in accordance with the recommendations of The Swedish National Board of Health (SOSFS 1991:2) and local instructions from the County Medical Officer for Communicable Disease Control.
It is estimated that over 350 million people live with a chronic hepatitis B virus (HBV) infection, claiming over one million deaths per year due to progress of the chronic disease to cirrhosis and/or hepatocellular carcinoma (HCC). An extended program of immunization including hepatitis B vaccine for children under one year of age has been launched in more than 110 countries. Recent studies conclude that mass hepatitis B immunization is effective in preventing HBV infection and has resulted in a decrease in the occurrence of HCC in children living in countries where hepatitis B is endemic. However, the vast majority of infected children live in the poorest developing countries in Africa and Asia that currently cannot afford the vaccine or lack the basic infrastructure necessary to deliver a national immunization service. The Global Alliance for Vaccines and Immunization (GAVI) was established in 1999 as an alliance of WHO, UNICEF, the World Bank, industry, foundations, and other partners to reinvent immunization for the 21st century, by forging a common vision and new ways of working together at global, regional and national levels. WHO recommends global elimination of hepatitis B by universal infant and/or adolescent immunization, but health planners in Sweden and the other Scandinavian countries, the Netherlands and UK have not yet been convinced of the cost-effectiveness of HB-prevention through routine childhood immunization with HB-vaccine. The inclusion of hepatitis B vaccine in already available multivalent vaccines may alter this situation in the future, but until then an intensified vaccination strategy aimed at those groups of individuals that are particularly at risk for hepatitis B should be adopted in accordance with the recommendations of The Swedish National Board of Health (SOSFS 1991:2) and local instructions from the County Medical Officer for Communicable Disease Control.