28 July 2022 (PAHO) – To mark World Hepatitis Day, Guyana is launching its first hepatitis C treatment program. With the technical cooperation and support of the Pan American Health Organization (PAHO), Guyana is receiving rapid testing kits as well as life-saving medicines.
“Viral hepatitis remains a global public health threat and Guyana’s leadership is an opportunity to showcase the collaboration between national authorities, civil society and other stakeholders committed to its elimination,” Dr. Luis Felipe Codina, the PAHO/WHO Representative in Guyana said.
Guyana’s new hepatitis C campaign, spearheaded by the Minister of Health Dr. Frank Anthony, is part of a global effort that comes after WHO Member States endorsed goals to eliminate viral hepatitis by 2030. These commitments were renewed earlier this year in the new Global Health Sector Strategies (GHSS) on HIV, STI and Viral Hepatitis by the World Health Assembly.
“In Guyana, data on hepatitis is primarily available from among blood donors, dialysis patients, and to some degree among HIV/STI patients,” said Dr. Rainier Escalada, a PAHO Advisor on Health Surveillance, Disease Prevention and Control who is working on the rollout of medicines for approximately 600 hepatitis C patients at the start of the campaign in Guyana.
Hepatitis is the general medical term for an inflammation of the liver, for which there are many causes. Viral transmission, such as for hepatitis B or C infections, takes up a significant share of cases and mortality globally. It is estimated that 57 percent of cases of liver cirrhosis and 78 percent of cases of primary liver cancer are due to hepatitis B or C.
“Programs that aim to eliminate hepatitis B and C have been irregular across the world, which is why amplifying access to treatment, such as Guyana is doing, is of utmost importance,” Dr. Leandro Sereno, Advisor for Viral Hepatitis Prevention and Control at PAHO said. Many people do not know they have the disease, and consequently do not seek treatment, but “timely vaccination, testing and treatment can prevent illness and deaths.”
A new-born that is vaccinated against hepatitis B in the first 24 hours of life will have lifelong protection. And while there is currently no vaccine against hepatitis C, which is a blood-borne infection, an effective (90 percent) cure comes in the form of a three-month medical treatment consisting of orally ingested tablets.
High cost and a complex patent protection system, however, make hepatitis C treatment prohibitive for many countries in the region, but PAHO has been able to facilitate access to several countries.
“Through the PAHO Strategic Fund, we are pleased to have aided Guyana in obtaining good quality rapid diagnostic tests and life-saving medicines for hepatitis C at a significantly lower cost,” Dr. Codina said.
COVID 19 setbacks
The pandemic had a negative effect on global efforts towards the elimination of viral hepatitis, as health services were strained with the response to COVID-19. Additionally, human and financial resources that were used for testing and treatment were re-allocated to deal with the surge in COVID-19 cases.
“This issue is not exclusive to hepatitis, of course, as mobility restrictions and the reorganization of health services during the pandemic have impacted access to testing and treatment,” Dr. Sereno said. “Post-pandemic, however, countries should resume and prioritize hepatitis elimination strategies to achieve the 2030 target.”
In order to support countries in defining national strategies, WHO has published updated recommendations encouraging countries to decentralize and expand viral hepatitis testing to lower-level care facilities and integrating it with existing services, such as primary care.
In the coming months, PAHO will also continue to assist countries in the region to ramp up hepatitis C testing capacity, in an effort supported by the Government of the United States and other partners.
Hepatitis in numbers
World Hepatitis Day is observed each year on 28 July to raise awareness of viral hepatitis, which may lead to severe disease and liver cancer. Globally, there are more than 350 million people still living with this life-threatening disease. PAHO estimates that every 30 seconds someone loses their life to hepatitis B or C, making testing crucial.
WHO estimates around 5.4 million people living with hepatitis B and 4.8 million living with chronic hepatitis C in the Region of the Americas.
Latest regional data indicate approximately 10,000 new chronic hepatitis B infections each year, and 23,000 deaths. Approximately 18 percent of people living with hepatitis B have been diagnosed, while only 3 percent of them are receiving treatment.
For hepatitis C, there are 67,000 new infections every year and 84,000 deaths in the Americas. Hepatitis C is also significantly underdiagnosed, with only 22 percent of people chronically infected have been diagnosed, and just 18 percent of them receiving treatment.