Uganda is the first and only country in Africa to reach and surpass the World Health Organisation 2020 target of ensuring access, treatment and awareness creation of Hepatitis B, according to a new scorecard launched to track progress against the viral infection on the continent.
WHO hopes that by 2020, some five million people will have received treatment for chronic Hepatitis B and that the number of new cases will have dropped to 30 per cent from those witnessed in 2015.
Uganda has spent some $3 million annually from 2015 on a free Hepatitis B screening programme and conducted a community mobilisation and sensitisation drive on the viral infection. More than four million people have been screened to date.
“More than 30 per cent of the population who are infected with Hepatitis B are now aware of their status and can have access to free medical care, making Uganda the first country in Africa to surpass the 2020 target of 20 per cent,” notes the WHO scorecard.
Hepatitis B spreads through blood and bodily fluids including mother to child transmission. It attacks the liver and kills approximately 1.4 million people every year, across the globe, mostly through liver scarring (cirrhosis) and cancer. Hepatitis C, which also attacks the liver and has similar symptoms to Hepatitis B, usually spreads only through blood-to-blood contact.
Kenya is among countries in Africa with a high prevalence of Hepatitis B. Uganda and Tanzania are among countries with more than 100,000 children with chronic Hepatitis B. Almost 50,000 children with chronic Hepatitis B virus (HBV) live in Kenya and Rwanda
Although most countries have Hepatitis B and C care at tertiary and specialist centres, eliminating the disease requires a public health and decentralisation approach, the WHO notes.
Uganda and Rwanda have made progress in this area.
“Only Rwanda (Hepatitis C) and Uganda (Hepatitis B) have started free nationwide screening as a decentralised service, and are on track to reach the 2020 target for screening and community awareness,” notes WHO.
An increasing number of countries have small-scale demonstration projects or treatment access programmes with subsidised specific antiviral drugs for Hepatitis B or C.
“You can live a full, dignified life with Hepatitis B, but the most important thing is prevention, especially vaccination in newborns. For adults, testing, linking to care, education and treatment as needed are crucial — as there is no cure, and treatment is often lifelong,” said Kenneth Kabagambe, who founded Uganda’s National Organisation for People Living with Hepatitis B in 2012.
“Over the years, we’ve been working hard for more government support, and we’re proud that Uganda is one of the first African nations to fund domestic action against Hepatitis B.”
He said that African nations must fund domestic efforts to prevent the spread of both Hepatitis B and C.
“African governments must also swiftly start work on their own action plans at home, including awareness-raising, as you simply cannot prevent something you know nothing about,” noted Kabagambe.
Prof Olufunmilayo Lesi, the Viral Hepatitis officer for the WHO regional Office for Africa, said Uganda has a superb lesson to share, adding that “we support these important exchanges as they are helping to build evidence-based policies and promoting partnerships for more concerted action against viral Hepatitis across the region.”
Every year more than 200,000 people in Africa die from complications of viral Hepatitis B and C-related liver disease, including cirrhosis and liver cancer.
Data shows that viral Hepatitis B (HBV) and C (HCV) affects more than 71 million people in sub-Saharan Africa.
Hepatitis C affects 10 million people around the globe, while Hepatitis B affects more than 60 million people. Yet, only one in 10 infants in Africa receives the Hepatitis B vaccine at birth, despite its low cost — at less than $0.20 per child.
THREE COUNTRIES ON TRACK
The scorecard — the first to examine Hepatitis prevalence and response in the WHO African region, shows that only three of the 47 countries are on track to eliminate the disease that affects one in 15 people.
“This analysis is the first to track each country in the region and to assess progress towards the goal of saving the lives of more than two million Africans who may develop progressive Hepatitis B or C liver disease in the next decade if countries fail to ramp up their efforts,” said WHO regional director for Africa, Matshidiso Moeti.
The scorecard provides vital information about the status of the regional Hepatitis response, measuring progress against the Framework for Action for the Prevention, Care and Treatment of Viral Hepatitis in the African Region (2016–2020).
It was created as a guide for member states on the implementation of the Global Health Sector Strategy on Viral Hepatitis, which calls for the elimination of Hepatitis by 2030 (defined as a 90 per cent reduction in new cases and 65 per cent reduction in deaths).
By Christabel Ligami