Bangladesh drawing up strategy to eliminate viral hepatitis

Bangladesh is devising a strategy to eliminate viral hepatitis as a public health threat by 2030, an expert involved with the process says.

Dr Mamum Al Mahtab has told bdnews24.com they have drafted a strategy and working to get the final go-ahead.

Vaccination of adults, free treatment, and extensive awareness plan are some of the key features of the strategy, Dr Mahtab said.

An associate professor at Bangabandhu Sheikh Mujib Medical University’s Department of Hepatology, he spoke to bdnews24.com on Thursday, ahead of the World Hepatitis Day on Friday.

The 2030 elimination target means that 95 cases must be diagnosed, new infections reduced to 90 percent and treatment of at least 90 percent cases would have to be ensured.

Dr Mahtab, who is also the general secretary of the Association for the Study of Liver Diseases Bangladesh (ASLDB), said they estimate that only 5 percent of the total hepatitis cases are being diagnosed in Bangladesh as elsewhere in the world, though there is no official statistics on the actual number of hepatitis patients in the country.

Ahead of the day, WHO Regional Director for South-East Asia Dr Poonam Khetrapal Singh said viral hepatitis is a major public health problem in the South-East Asia Region, and every person has a stake in controlling and eliminating it.

Each year, viral hepatitis infects millions of people across the region that comprises 11 countries including Bangladesh, causing the death of around 410, 000 persons – more than HIV and malaria combined.

“It is also a major cause of liver cancer and cirrhosis, contributing to premature morbidity and mortality, and undermining economic growth and the push to achieve health and wellbeing for all,” she said.

Despite hepatitis’ outsized burden, it is estimated that just one in ten people infected with the disease know their status.

Many others remain unaware that effective treatments exist, or that preventive measures are available, from basic hygiene to the hepatitis B vaccine.

Stigma and discrimination against those suffering the disease remain common.

Dr Khetrapal Singh said, to overcome these barriers and eliminate hepatitis as a public health threat by 2030, as per regional and global targets, enhanced awareness and understanding of how to prevent, treat and manage the disease is “vital”.

To achieve this, health authorities across the region can increase the prominence of hepatitis-related information and advocacy, she said.

“Clear, concise and accurate messaging regarding how hepatitis infection can be prevented, what its signs and symptoms are and how it can be treated is essential to empowering people to take action.”

According to the WHO, simple hygiene measures such as hand-washing and consumption of safe drinking water and hygienic food, for example, are powerful tools for preventing hepatitis A and E.

Messaging targeted towards high-risk groups such as intravenous drug users and sex workers can meanwhile increase uptake of harm-reduction measures, while messaging aimed at political leaders and donors can highlight resource gaps and help obtain high-level buy-in.

“Health authorities can likewise expand the hepatitis-related knowledge and skills of health workers at all levels. From nurses and midwives to doctors and technicians, a clear understanding of viral hepatitis testing, treatment and care is needed,” WHO says.