Health and Healthcare Systems

It's time to rid the world of viral hepatitis. Here's how to do it

Hepatitis virus particles seen through an electron microscope

Hepatitis virus particles seen through an electron microscope Image: Dr. Erskine Palmer, USCDCP / Pixnio

Vanessa Candeias
Senior Director, The Hepatitis Fund
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This article is part of: Centre for Health and Healthcare
  • Globally 360 million people are living with viral hepatitis.
  • We have the tools, treatments and knowhow to eliminate this disease.
  • Greater investment in eliminating hepatitis will generate high returns.
  • With leadership, resources and multi-stakeholder collaboration, elimination of viral hepatitis is achievable.

This year's Nobel prize for Medicine was awarded to the three scientists – Harvey J. Alter, Michael Houghton and Charles M. Rice – who discovered the hepatitis C virus. Globally, 71 million people are living with chronic hepatitis C; that's more than the population of the UK or nearly twice the population of Canada. A significant proportion of those people will develop cirrhosis or liver cancer.

This was the second time in history that a Nobel prize related to viral hepatitis was attributed. The first was in 1976 for Baruch Blumberg’s discovery of the hepatitis B virus.

Why is this important today?

Since these discoveries were made in 1960 (for hepatitis B) and 1989 (for hepatitis C), significant progress has been made and the lives of many people around the world have improved. We have been able to develop diagnostic tools, a vaccine for hepatitis B and even a cure for hepatitis C infection. However, these viruses still kill nearly 1.4 million people every year. Moreover:

- In the Asia-Pacific region, more people die from viral hepatitis than from HIV, tuberculosis and malaria combined every year.

- Over 180,000 newborn babies in the western Pacific region alone are newly infected by hepatitis B through mother-to-child transmission.

- Of the nearly 360 million people living with viral hepatitis worldwide, only 12% know they are living with it and only 2% have received treatment – so a very small proportion of those affected are actually benefitting from the Nobel prize winning discoveries.

Hepatitis' prevalence around the world
Hepatitis' prevalence around the world Image: Polaris Observatory

We can eliminate viral hepatitis around the world

The tools required to eliminate viral hepatitis are both affordable and available. A timely hepatitis B vaccination of newborns, plus vaccination during school years and the adequate diagnosis and treatment of mothers living with chronic hepatitis B during pregnancy can reduce mother-to-child transmission of the infection more than 95% of the time and break the cycle of transmission across generations. Available drugs can cure more than 90% of people with chronic hepatitis C infection, preventing liver cancer and liver failure.

COVID-19 has triggered one of the worst crises of our times. If we don’t act swiftly, its impact will also include millions of new hepatitis B infections in children for years to come.

The pandemic is adding to the severity of the situation as healthcare services, vaccination, screening and treatments have in many areas been disrupted, delayed or stopped altogether. Because of COVID-19's disruptions to hepatitis B vaccination programmes, there will be millions of new chronic hepatitis B infections among children born between 2020 and 2030. But by acting collectively we can mobilize stakeholders and change the course of history.

More investment in the elimination of viral hepatitis is needed, because investing at scale will deliver positive economic returns in the short and long-term. Liver cancer and cirrhosis caused by viral hepatitis often hits individuals and families in their most productive years. It imposes a significant cost to healthcare systems and society, as in many cases when people do get sick they lose their jobs, are often pushed into poverty, pay less taxes, and reduce their productivity, earnings and spending. Healthy individuals and healthy populations on the other hand tend to have higher productivity, higher disposable income and reduced healthcare costs.

The numbers are unequivocal. For example each $1 spent on hepatitis B elimination in the Philippines will earn back $2.23 and each $1 dollar spent on hepatitis C elimination in Vietnam will earn back $3.42 dollars. In India, a hepatitis C cure costs less than $40 and a year of hepatitis B treatment costs less than $30. At these prices, curing hepatitis C will result in healthcare cost savings within three years. The Government of Pakistan has also been able to procure hepatitis C curative treatments at similarly low prices. These are investments worth making in order to have healthier populations.

Spending on hepatitis treatments is an investment in the future
Spending on hepatitis treatments is an investment in the future Image: CDA Foundation

Changing the course of history

The UN Sustainable Development Goals and the World Health Organization Global Strategy for Hepatitis Elimination, which was endorsed by 194 countries, call for the elimination of viral hepatitis by 2030. At current rates of diagnosis and treatment, fewer than 10 countries around the world will have eliminated hepatitis by 2030. Governments and businesses are increasingly recognizing the urgency of the need to tackle viral hepatitis and both have critical roles to play in eliminating it. Within the healthcare sector, businesses can support national goals and plans through the provision of services and products and can train the health workforce. Businesses can develop new technologies and business models to increase testing and referral. Businesses with large workforces can also play a pivotal role by providing hepatitis screening and care for their employees. Furthermore, other sectors, such as education, financial services and infrastructure, will be critical for increasing awareness around achieving elimination, and also for highlighting the importance of investment in an area with high socio-economic returns but a wide investment gap.

In order to address this gap, The Hepatitis Fund works with donors, philanthropists, businesses and investors to pool funds and enable changes at scale, and it supports countries, civil society and academia in increasing their financial contribution towards eliminating viral hepatitis. With adequate resources, visionary leadership, multi-stakeholder collaboration and full integration of existing solutions in universal health coverage plans, elimination of viral hepatitis by 2030 is achievable. Join us and the hepatitis community and become one of the game changers in the drive to eliminate one of the deadliest infectious diseases of the century.

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