The Zimbabwean Government in partnership WHO and other various stakeholders is working towards developing a National Viral Hepatitis Strategic plan (2019 – 2022) to bring the rising epidemic under control in the country, a senior Government official has said.
Acting Permanent Secretary of Health and Child Care, Dr Gibson Mhlanga, speaking during a Stakeholder Consultative Meeting On Development of the National Strategic Plan Towards Ending Viral Hepatitis In Zimbabwe, said a national strategy was required to tackle this neglected public health challenge.
Dr Mhlanga said the strategy was critical to putting the country on course to meeting the Sustainable Development Goal number 3 targets, which aims among other things to eradicate epidemics of Hepatitis, TB, HIV, and malaria by the year 2030.To kick-start the crafting of the strategy, the Government in collaboration with WHO commissioned a viral hepatitis rapid assessment in 2017, to determine the current national status in viral hepatitis prevention, treatment, care, and surveillance services.
The World Health Organization estimates that globally, 257 million and 71 million people are living with chronic hepatitis B and C viruses infection respectively. In addition, among the estimated 36.7 million people living with HIV reported in 2015, an estimated 2.7 million (7%) and 2.3 million (6%) also had chronic hepatitis B virus and chronic hepatitis virus C infection respectively.
Chronic infection with hepatitis B and C viruses results in severe damage to the liver, which may lead to cirrhosis and hepatocellular cancer, the burden of which is particularly high in the African region.
According to the WHO 2015 Global Hepatitis report, hepatitis B and C viruses are among some of the leading infections responsible for the greatest burden of disease at a global level.
WHO country representative Dr Alex Gasasira speaking at the same occasion hailed Zimbabwe for being among the first countries in Africa to set up a program for the prevention and treatment of this important public health disease.
He said viral hepatitis was an important international public health challenge, comparable to other major communicable diseases, including HIV, tuberculosis and malaria but despite the significant burden it places on communities across all global regions has been largely ignored as a health and development priority until recently.
Dr Gasasira said while mortality from HIV, tuberculosis, and malaria was on the decline, mortality caused by viral hepatitis was on the rise which necessitated an urgent need to reverse the alarming trend, through high-impact cost-effective interventions such as Hepatitis B vaccination which can score an early win for prevention.
For success in the Viral Hepatitis program in Zimbabwe, still, at an early phase, Dr Gasasira, called on partners to consider supporting different components of this important public health intervention.
He said it was important to draw lessons and leverage on the strengths of pre-existing programs such as that for HIV to provide an effective response to the challenge.
He hailed Zimbabwe for being among countries that have made good progress in keeping the blood supply safe and improving injection safety in health-care settings which substantially reduces the risk of hepatitis C virus infections.
In May 2016, the World Health Assembly adopted WHO’s first “Global Health Sector Strategy on viral hepatitis”, with elimination as its overarching vision.
The strategy calls for the elimination of viral hepatitis as a public health threat by 2030 (reducing new infections by 90% and mortality by 65%). The strategy covers the first six years of the post- 2015 health agenda, 2016-2021, building on the Prevention and Control of Viral Hepatitis Infection.
It addresses all five hepatitis viruses (hepatitis A, B, C, D and E), with a focus on hepatitis B and C, owing to the relative public health burden they represent (they are responsible for 96% of all hepatitis mortality).
In November 2017, Ministry of Health and Child Care (MOHCC) conducted a rapid assessment of the status of viral hepatitis prevention, treatment, care and control implementation in the country. Among the key findings were that there is strong political will and commitment to establish viral hepatitis services at all levels. Hepatitis B vaccine is part of the national infant immunization schedule and coverage has been increasing, estimated to be 87% in 2015.
However, no Hepatitis B vaccination birth dose is included in the schedule and there is no policy on vaccination for Health workers. There are no national guidelines for the assessment and treatment of acute and chronic viral hepatitis and no medicines specifically for the management of viral hepatitis in the public sector.
Among other things, the strategic plan being developed and expected to be finalized by end of June 2019, will provide strategies for addressing the identified gaps.