Some 20 million people in the hemisphere live with hepatitis B or C. The new plan focuses on vaccinating newborns against hepatitis B and expanding access to new treatments for hepatitis C.
Washington, D.C., 30 September, 2015 (PAHO/WHO) — Ministers of health from throughout the Americas agreed today on a series of actions to prevent and control viral hepatitis infection, with emphasis on hepatitis B and C, which affect an estimated 20 million people in the region.
The new Plan of Action for the Prevention and Control of Viral Hepatitis 2016-2019 was approved during the 54th Directing Council of the Pan American Health Organization (PAHO), which is being held this week in Washington, D.C.
Globally, hepatitis B and C together cause some 80% of all liver cancer deaths globally, equivalent to nearly 1.4 million lives lost each year. Without treatment (which is particularly effective for hepatitis C), many of the 20 million people estimated to have hepatitis B and C in the Americas will go on to develop long-term problems including cirrhosis and liver cancer.
The new regional plan lays out lines of action to reduce illness, disabilities and deaths from hepatitis and paves the way for eliminating hepatitis B and C as public health problems in the Americas by 2030.
"The regional response to viral hepatitis has lacked focus in the past, but we now have the opportunity to build a vigorous public health approach," said Marcos Espinal, director of PAHO's Communicable Diseases and Health Analysis department. "Today the possibility of eliminating viral hepatitis is on the horizon."
Rates of hepatitis infection vary across the region. The Amazon basin is one of the most affected areas, with hepatitis B prevalence estimated at 8%. In other areas of the region, prevalence ranges from less than 1% to 4%.
PAHO mortality data indicate that about 3% of all deaths in Latin America and the Caribbean between 2008 and 2010 were due to liver cancer, liver failure, chronic hepatitis, acute viral hepatitis or cirrhosis.
There are effective vaccines to prevent hepatitis A and B that prevent up to 95% of infections, and new treatments for hepatitis C have a cure rate of 90% or more.
PAHO/WHO recommends a first dose of hepatitis B vaccine for newborns within the first 24 hours, followed by two or three additional doses at 2, 4 and 6 months of age. With support from PAHO's Revolving Fund for Vaccine Procurement, countries in Latin America and the Caribbean, as of 2013, were reaching 90% of children under 1 with the required three doses of hepatitis B vaccine. Currently, 84% of the region's babies receive a first dose of the vaccine within their first 24 hours of life, as recommended. This dose is the most important to prevent mother-to-child transmission of hepatitis B. The new plan of action calls on all countries to ensure that all newborns receive their first dose within 24 hours of birth.
New treatments for hepatitis C are highly effective and have fewer side effects than earlier, interferon-based treatments. Some countries are beginning to make these drugs available to patients in advanced stages of the disease, who are at higher risk of developing complications. But these newer treatments are much more expensive, and access to them is limited in most countries of the region.
To reduce the impact of viral hepatitis and to advance toward regional elimination of hepatitis B and C, the new plan of action proposes that countries:
- Create national plans for fighting hepatitis.
- Integrate prevention, surveillance, treatment and control of viral hepatitis into health systems and services through budgeted national strategies or plans.
- Implement information campaigns, including the celebration of World Hepatitis Day, to raise public awareness of the severity of hepatitis in all its forms and how it can be prevented and treated.
- Maintain and expand hepatitis B vaccination to reach all children and target high-risk and vulnerable population groups, including health-care workers, men who have sex with men, sex workers and drug users.
- Promote strict application of protocols and norms to prevent viral hepatitis infections in health-care settings.
- Develop and implement guidelines for prevention, diagnosis, care and treatment of viral hepatitis in line with the latest WHO recommendations.
- Strengthen systems for reporting and monitoring hepatitis cases.
- Maintain high safety standards for diagnostic techniques and blood supplies.
- Pursue options to expand access to medicines, such as collective negotiation and generic competition.
The plan calls on PAHO to support countries in these efforts with technical cooperation and to use its Regional Revolving Fund for Strategic Public Health Supplies to make essential diagnostic tools, vaccines, supplies and treatments against hepatitis more affordable.
About viral hepatitis
Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E. These five types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.
The PAHO Directing Council brings ministers of health and other high-level delegates from member countries to in Washington, D.C., to discuss and analyze health policy and to set priorities for PAHO technical cooperation programs and regional public health collaboration.
PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.
—54th Directing Council
—Documents of 54th Directing Council
—PAHO Governing Bodies