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World Hepatitis Day brings care closer to you
We must sustain hepatitis services as part of universal health coverage

World Hepatitis Day brings care closer to you

The theme for this year, “Bringing hepatitis care closer to you”, was chosen to raise awareness about the need to simplify and bring hepatitis care to primary health facilities, community-based venue and locations beyond hospital sites.

Effectively, to bring the care of hepatitis closer to communities and people wherever they are. It is aimed that by 2030, viral hepatitis would be eliminated globally. Hepatitis is simply an
inflammation of the liver.

So many things can cause this inflammation but for the WHD, the focus is on viral hepatitis. There are five main types of the hepatitis virus – A, B, C, D and E. Hepatitis B and C infection lead to chronic disease, and together are the most common cause of liver damage, liver cancer and viral hepatitis-related deaths.
The viral hepatitis responses have differed drastically across regions and countries. New data estimates that 9.4 million people have received treatment to cure viral hepatitis C.

This scale of progress has been shown to halt the trend of increasing hepatitis C virus (HCV) mortality. Mortality has witnessed a steady decline from 2016 onwards. Although hepatitis B infection prevention in infants has been remarkable, overall diagnosis and treatment in most populations remain limited as almost 90 per cent of people living with viral hepatitis are unaware of their
status.

As we inch closer to the year 2030, we risk halting the progress made with a risk of
resurgence if we lose focus. All countries should work towards the common goal of
elimination of viral hepatitis regardless of the burden of disease or intensity of transmission. This is only possible where there is sustained national and sub-national public health system or services. Successful elimination requires scaling up of the five key interventions:

1. Childhood vaccinations against hepatitis B
2. Preventing mother-to-child transmission of HBV
3. Injection and blood safety
4. Harm reduction
5. Testing and diagnosis, treatment and care.

On World Hepatitis Day 2022, WHO calls for simplified service delivery of viral hepatitis services, bringing care closer to communities. To achieve hepatitis elimination by 2030, we need to reduce new infections of hepatitis B and C by 40 per cent and reduce deaths from liver cancer by 50 per cent by 2025.

To eliminate hepatitis and achieve the WHO’s new ambitious interim targets by 2025, 60 per cent of people living with hepatitis B and/or C should be diagnosed and 50 per cent eligible for treatment should be cured (HCV) or receive
therapy.

For this to happen, we need to urgently simplify hepatitis care and make it more accessible to more people in need. We need to establish high-quality hepatitis
services to ensure that people have access to equitable, effective, efficient, timely and quality
hepatitis services that respond to their needs.

By decentralising hepatitis care to peripheral health facilities, community-based venues and locations beyond hospital sites, we are putting patients at the heart of hepatitis care, eliminating the need for long-distance travel to receive
care.
In addition, there is the need to promote task sharing to aid in delivering decentralised care for hepatitis using non-specialist doctors and nurses trained in these areas. Integrating and linking hepatitis care with existing public health services would ensure sustained and continuous care which will go a long way to hasten elimination of viral hepatitis. So on WHD 2022, the call to action is made on the public to:

• Get tested for and treat hepatitis B while pregnant to prevent transmission to babies
• Vaccinate every new born against hepatitis B within 24 hours of birth.
• Educate ourselves and play a part to stop transmission of hepatitis in the community

• Speak to your healthcare worker and ensure timely testing and treatment to prevent cirrhosis and liver cancer The call also goes to national leaders and especially those in highly affected
countries to:

• Know that a world without viral hepatitis by 2030 starts with their country. Scale up and decentralise testing and treatment services to primary health care
• Enhance integrated service delivery and task sharing delivered by trained non-specialist clinicians
• Integrate hepatitis reporting and monitoring into existing surveillance and health information systems

• Sustain hepatitis services as part of universal health coverage
• Engage communities in hepatitis services, leverage private sector and beyond health sector
Global leaders are called to:
• Decentralise care to lower-level facilities, primary health and other relevant services, including HIV, harm reduction and prison services

• Embed hepatitis care with primary health care to promote person-centred care
• Adequate funding for hepatitis care and mobilisation of domestic funds
• Universal health coverage for all people living with chronic hepatitis B and C HCV transmission in both general and key populations.
• Assessment and progress in reduction of mortality for hepatitis- associated liver cirrhosis and liver cancer.

• Identification of specific country gaps to assist in the development of tailored solutions to bridge and close gaps towards elimination.
• Attainment of path to elimination for high-burden countries.

• Promoting the validation of hepatitis elimination in every country.
So on this World Hepatitis Day, let our social media handles buzz with messages about our collective responsibility to eliminate viral hepatitis by 2030.
The Mirror Doctor is a member of Paediatric Society of [email protected]

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