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Hepatitis B and hepatitis C in southeast and southern Asia: challenges for governments
Suzanne Wait1, Emily Kell1, Saeed Hamid2
1The Health Policy Partnership, London, UK.
Insights
Experts identified persistent barriers to eradicating hepatitis B virus (HBV) and hepatitis C virus (HCV) in Asia Pacific. Sustainable elimination requires addressing systemic, cultural, and financial challenges, alongside enhanced government action.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Viral hepatitis, specifically hepatitis B virus (HBV) and hepatitis C virus (HCV), poses a significant health burden in the Asia Pacific region.
- Despite varying policy responses, systemic, cultural, and financial barriers impede the elimination of HBV and HCV across numerous countries.
Purpose of the Study:
- To summarize discussions among hepatitis experts from seven Asia Pacific countries regarding challenges and sustainable approaches to HBV and HCV elimination.
- To identify common obstacles and promising strategies for combating viral hepatitis in the region.
Main Methods:
- Convened leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand.
- Summarized expert discussions on challenges, experiences, and sustainable approaches to HBV and HCV elimination.
Main Results:
- Common challenges include limited epidemiological data, low public awareness, high transmission rates via blood products, inadequate care for people who inject drugs, stigma, and financial barriers.
- Despite challenges, effective programs, public-private initiatives, and innovative approaches are emerging across the studied countries.
Conclusions:
- The WHO Global Health Sector Strategy on Viral Hepatitis provides a framework, but national governments and the international community must recognize the urgency.
- Translating strategic plans into resources and concrete actions, led by national governments, is crucial for a sustainable response to the rising burden of hepatitis B and C.
Abstract:
In 2015, the Coalition to Eradicate Viral Hepatitis in Asia Pacific gathered leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand to discuss common challenges to the burden posed by hepatitis B virus (HBV) and hepatitis C virus (HCV), to learn from each other's experience, and identify sustainable approaches. In this report, we summarise these discussions. Countries differ in their policy responses to HBV and HCV; however, substantial systemic, cultural, and financial barriers to achievement of elimination of these infections persist in all countries. Common challenges to elimination include limited availability of reliable epidemiological data; insufficient public awareness of risk factors and modes of transmission, leading to underdiagnosis; high rates of transmission through infected blood products, including in medical settings; limited access to care for people who inject drugs; prevailing stigma and discrimination against people infected with viral hepatitis; and financial barriers to treatment and care. Despite these challenges, promising examples of effective programmes, public-private initiatives, and other innovative approaches are evident in all countries we studied in Asia Pacific. The draft WHO Global Health Sector Strategy on Viral Hepatitis 2016-21 provides a solid framework upon which governments can build their local strategies towards viral hepatitis. However, greater recognition by national governments and the international community of the urgency to comprehensively tackle both HBV and HCV are still needed. In all countries, strategic plans and policy goals need to be translated into resources and concrete actions, with national governments at the helm, to enable a sustainable response to the rising burden of hepatitis B and C in all countries.