It can be prevented. Timely testing and treatment of viral hepatitis B and C can save lives.
Op-ed by Dr Arvind Mathur, WHO Representative on the occasion of World Hepatitis Day observed on 28 July every year
Viral Hepatitis B and C affectsan estimated 50 million people in WHO South East Asia Region. They are the root causes of liver cancer and chronic liver disease and an estimated 410,000 deaths every yearin the region. In the Maldives,this health problem is also common. Though comprehensive data amongst Maldivians is not available but population remains at risk especially common amongst the large number of expats that reside in the country. In 2017, 513 positive cases of Hepatitis B alone were detected amongst expats through their work permit medical exams. Alarmingly, Hepatitis B and C are chronic infections that may not show symptoms for a long period, sometimes years or decades. At least 60% of liver cancer cases are due to late testing and treatment of Viral Hepatitis B and C.
Thus Hepatitis is around us. We need to be aware and careful. It can be prevented, treated and many a times, cured. Let me shed a light on how this can be done.
Firstly, viral Hepatitis can easily be prevented through vaccination, ensuring blood safety, practicing safe sex and needle usage amongst other measures. Food safety and hygienic practices, including safe drinking water and sanitation can prevent hepatitis A and E as well. Simple and reliable tests are available and Hepatitis can be detected early. Through treatment and counselling further spread of Hepatitis can be prevented!
Effective new medications are available to treat Hepatitis B and cure Hepatitis C. These drugs are not still in the Essential list of drugs and not easily available in the Maldives. We need to make them accessible and available in the country and importantly bring them under Asandha coverage. With a functional health facility in every inhabited island supported by secondary and tertiary services in atoll and Male; it is important that policy makers, health care providers and people realize that it is far too efficient to treat Hepatitis B and C within country. Cost effective and efficient solutionscan be delivered in the country which will not only save time but precious resources both for the country and the people.
In the Maldives, policies and plans are being implemented against Hepatitis. Maldives introduced Hepatitis Vaccine in routine Immunization in 1993. The coverage of the vaccine has beenmore than 95% for decades. As a result Hepatitis B in people less than 25 years is rare. 91 health facilities across the island nation now offer serological testing for Hep B and Hep C.Significantly, viral hepatitis testing is already integrated with HIV, antenatal care, blood services, cancer screening and treatmentservices.All blood products are screened for transfusion transmitted infections like HIV, Hepatitis B and C,Syphilis etc. Such screening will ensure infected blood is not given to a recipient and the Hepatitis infected person is directed to clinicians for services. These are major achievements of the country and need to be cherished and sustained.
Despite these gains, there are rooms for improvement. We need to continue investing to build the capacity of health workers and empower them to deliver quality service, maintain confidentialitywithout prejudice and stigma. Quality of surveillance of Hepatitis is another area that needs to be further improved and worked with sectors beyond health.
Knowledge is power and brings actions. People should be educated on prevention methods, signs and symptoms, and on where they can get tested and treated. The high risk groups should be specially targeted and reached with key messages and behavioral change plans.People with Hepatitis should not be discriminated against at any cost and I am confident that the highly informed citizens of Maldives will continue to fight against all discriminations.
As WHO Representative, I commend the Ministry of Health and Government of Maldives in their efforts to combat Hepatitis in the Maldives through a multi-sectoral approach. The progress Maldives has achieved in ensuring Hepatitis testing and treatment under the umbrella of Universal Health Coverage is commendable.
On World Hepatitis Day, I extend my highest commitment and full support and call upon Government of Maldives, policy makers, health care providers and workers, civil society organizations and importantly the people to join hands in the battle to eliminate viral hepatitis in the Maldives. Together, we have the means and the resources to end this life threatening disease. Let me urge every Maldivian, where ever they live, to play their role and commit to Prevent, Test, Treat Hepatitis.
Dr Arvind Mathur,
WHO Representative
Prevent, Test, Treat Hepatitis
