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Sunday, May 19, 2024, 4:35 am

Sunday, May 19, 2024, 4:35 am

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Why is the World Health Organisation issuing a viral hepatitis alert?

World Health Organisation
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What are the findings of the Global Hepatitis Report 2024? What factors contribute to India’s high prevalence of hepatitis B and C? Is the predominance of non-viral types of the illness, such as alcoholic and non-alcoholic fatty liver disease, contributing to the burden?

Hepatitis B may be avoided with vaccination, and the study emphasises the need of ensuring coverage. Hepatitis C can be cured with medications.

According to the World Health Organization’s (WHO) Global Hepatitis Report 2024, India had the second-highest viral hepatitis disease burden globally in 2022, accounting for 11.6%. Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation, and Vietnam account for roughly two-thirds of the global burden of hepatitis B and C.

What key points does the report highlight?

According to the research, the illness is the second biggest infectious cause of mortality globally, accounting for 1.3 million fatalities annually, which is comparable to TB, the top infectious killer. According to statistics from 187 countries, the anticipated number of fatalities from viral hepatitis climbed from 1.1 million in 2019 to 1.3 million by 2022. Hepatitis B was responsible for 83% of the cases, whereas hepatitis C caused 17%. Every day, 3,500 people globally die from hepatitis B and C infections. Chronic hepatitis B and C infections affect half of the population aged 30-54, and 12% of children under 18. Men represent 58% of all cases.

So, what exactly is hepatitis?
Hepatitis is an inflammation of the liver caused by several pathogenic viruses. Non-infectious substances can cause serious health issues, including death. The hepatitis virus has five primary strains: A, B, C, D, and E. Liver disease is caused by several factors, such as mode of transmission, severity, and geographic distribution. Types B and C produce chronic illness and are the leading cause of liver cirrhosis, liver cancer, and viral hepatitis mortality. According to the WHO, an estimated 354 million people worldwide have hepatitis B or C, with most unable to access treatment.

What makes India so vulnerable?
The high number of cases can be attributed to factors such as high population density, lack of knowledge of symptoms, inadequate screening and treatment, and lack of access to basic hygiene practices.
Chronic infections can go untreated for years due to a lack of screening initiatives and knowledge of the significance of testing. “Undiagnosed cases perpetuate the infection cycle, increasing the disease burden. The expanding frequency of non-viral types of hepatitis, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD), is a significant contributor to the rising number of hepatitis patients. High alcohol intake, especially in metropolitan areas, has been linked to a significant increase in ALD cases. Sedentary lifestyles and dietary changes have contributed to an epidemic of nonalcoholic fatty liver disease (NAFLD) in both urban and rural populations. These circumstances can lead to serious liver disease, increasing the prevalence of hepatitis in India.
Men report a greater number of instances.  This is related to high-risk behaviours such as IV drug usage, injection sharing, and sexual conduct. “Multiple sex partners, or male to male sex is a very high-risk factor for these hepatitis B and C infections,” .

What can be done to avoid it?

The research emphasises the need of ensuring vaccine coverage for Hepatitis B, whereas Hepatitis C may be treated with medications. Experts in India claim that viral hepatitis mortality are not similar to TB, and treatment costs are lower due to the country’s production of generic medications. Additionally, the government’s viral hepatitis control programme provides the vaccination to high-risk persons, including healthcare personnel. The initiative offers treatment for both hepatitis B and C. After introducing the hepatitis B vaccine in certain cities and districts in 2002-2003, the Indian government added the Chronic Hepatitis B Infection (HBV) vaccine to the paediatric immunisation programme in 2011-12.

Why is the report important?

This is the first unified WHO study on viral hepatitis epidemiology, service coverage, and product access, providing actionable data. This paper provides current estimates of the disease burden and coverage of key viral hepatitis services in 187 countries worldwide. At the end of 2022, only 13% of individuals with chronic hepatitis B infection had been identified, with about 3% (7 million) receiving antiviral medication across all areas. In hepatitis C, 36% of persons were diagnosed and 20% (12.5 million) received curative therapy. The results fall short of the worldwide aim of treating 80% of chronic hepatitis B and C patients by 2030. However, there has been a minor but constant improvement in diagnostic and treatment coverage since the 2019 report.

What are the next steps?

Eliminating hepatitis B in India requires comprehensive treatment coverage, immunisation of all newborns, and eliminating discrimination against patients. Mother-to-child transmission accounts for the majority of new infections. The paper highlights that despite the availability of affordable generic viral hepatitis drugs, many nations struggle to obtain them at reduced prices. Pricing inequalities remain among and within WHO regions, with many countries paying higher than global norms.

According to the research, care delivery for viral hepatitis remains centralised and vertical, leaving many affected people with out-of-pocket payments. The plan aims to accelerate efforts towards eradicating viral hepatitis by 2030 using a public health strategy. WHO recommends extending access to testing and diagnostics, implementing fair treatment policies, enhancing preventative efforts, and improving global and national health budgets.







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