Message of WHO Regional Director for Africa, Dr Matshidiso Moeti
The world marks World Hepatitis Day on 28 July every year, to raise awareness of this “silent killer” which is responsible for the deaths of about 125 000 people in Africa every year, despite the availability of treatment.
This year’s theme, “Bringing hepatitis care closer to you”, aims to highlight the need to bring hepatitis care closer to primary health care facilities, and so communities, to ensure better access to treatment and care.
More than 90 million people are living with hepatitis in Africa, accounting for 26% of the global total. But because the disease goes mostly undetected due to an absence of symptoms until it is too late for treatment, preventable loss of life is the tragic result.
Today, WHO in the African Region launches the 2021 scorecard for hepatitis, with blood tests revealing high prevalence of Hepatitis B in more than 8% of the total populations of 19 countries. For Hepatitis C, prevalence in 18 countries is more than 1%.
Transmission of Hepatitis B from mother-to-child also remains high, with prevalence of 2.5% among children younger than five in the Region. Only 14 African Region countries have managed to reduce that number to the 1% milestone, which has been achieved by all other WHO Regions.
The 2021 Global Hepatitis Report reminded us that only 2% of people living with Hepatitis B in Africa know their status, and that less than 1% are receiving treatment. For Hepatitis C, only 5% of patients know their status, with an alarming 0% treatment rate.
In addition, only 6% of babies have received the Hepatitis B birth-dose vaccine that prevents transmission of the virus from their mothers. This is a travesty considering the capacity of this available vaccine to save hundreds of thousands of lives.
The main barriers include that hepatitis services are centralized in cities and major urban areas, being delivered primarily by specialists, along with the high cost of diagnosis and medicines, and an inadequate laboratory platform.
In 2021, WHO in the African Region adopted the 2021-2030 Framework for an Integrated Multisectoral Response to TB, HIV, STIs and Hepatitis in region. The aim is to support milestones that include the introduction of the Hepatitis B birth dose vaccine in 35 Member States, the diagnosis of at least 30% of those with chronic hepatitis infections, and the achievement of 30% of people with Hepatitis B and Hepatitis C on treatment.
To reach these ambitious milestones, countries must advance towards decentralized care. WHO is supporting these efforts with the launch of targeted training materials to capacitate health workers to scale up delivery of simplified Hepatitis B and Hepatitis C services, in line with Universal Health Coverage principles.
The many promising developments in the fight to eliminate hepatitis are reason for hope. The launch of the global strategies on hepatitis in 2016 and 2022, along with increased advocacy and political will, are beginning to translate into action.
Hepatitis medications have, for example, become much more affordable, with prices now as low as US$60 per patient for a 12-week course of Hepatitis C treatment. In Rwanda, more than 50 000 patients had received treatment by the end of last year, and countries including Benin, Burkina Faso, Mozambique and Uganda are mobilizing domestic resources to implement hepatitis programmes.
On World Hepatitis Day this year, I call on all African governments to commit to decentralizing care to primary health level, to reach everyone, no matter where they live, and to prioritize funding to address this preventable health threat.
I encourage our countries to capacitate health systems to screen blood donations for hepatitis, and to ensure once-only use of syringes, and their safe disposal. These are important contributors to hepatitis transmission.
Finally, I appeal to people across Africa to seek testing and treatment for hepatitis. We need to take collective responsibility for eliminating this disease by 2030.
Learn more:
Viral Hepatitis Scorecard 2021: African Region
Hepatitis training materials WHD 2022
Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021