World Hepatitis Day recognises the enormous public health challenge viral hepatitis represents and gives us a chance to tackle the stigma around the disease
In recent years, the global infectious diseases agenda has been dominated by HIV and Aids, TB and malaria. Then, last year, the World Health Organisation adopted a resolution establishing an official World Hepatitis Day and Thursday 28 July is the first one. This recognises, at last, what an enormous public health challenge viral hepatitis presents.
Something as prevalent as viral hepatitis, to which a third of the global population has been exposed, with which a 12th is chronically infected and from which 1 million die every year, is more than just a health issue. It is a social, human rights, economic and even environmental issue.
In my work for the World Hepatitis Alliance, I was in China two weeks ago where recent efforts have significantly reduced the overall prevalence of hepatitis B, with neonatal vaccination cutting rates to less than 1% in children under five. Nonetheless, there are still 90 million people with hepatitis B in the country. Aside from the health issue, discrimination has been a major problem. There was a widespread practice of testing anyone applying for a job or to attend university, and refusing all those testing positive for hepatitis B. The Chinese government has now made this illegal.
In Peru, which I visited last month, I found another equally disturbing problem. Hepatitis B is decimating the indigenous peoples of the Amazon – one of the tribal leaders I met had seen his father and three brothers die from it – and, the day before I arrived, the Peruvian government announced a strategy that will, I hope, address the problem. This is urgent because it appears that the indigenous people are having to allow logging and oil and gas extraction on their lands so that they can afford the antiviral medicine that is the only way to prevent hepatitis B causing liver cancer. This, of course, is adding to the destruction of the rainforest. In a sense, hepatitis B is now starting to destroy our climate.
The World Hepatitis Alliance is supporting the ministry of health in Senegal in hosting a viral hepatitis summit meeting of African francophone nations on Thursday. Much hepatitis B and some hepatitis C is contracted at birth from mothers who are living with viral hepatitis and, because of the slow rate of progression, this results in liver cancer and other life-threatening liver disease in adults between 20 and 40 years old, key productive years.
How much viral hepatitis is impacting on poverty and impeding the achievement of the millennium development goals, not just in Africa but throughout the developing world, and whether it should be considered within the framework of the MDGs are crucial questions. So far, little work has been done to answer them, not least because until last year viral hepatitis had almost no global profile.
World Hepatitis Day presents an opportunity to start changing that, to give viral hepatitis the priority and action it requires. The theme for the day is "Hepatitis affects everyone, everywhere. Know it. Confront it", because in almost every country it is a significant public health problem and, in some, such as Egypt, which has 10% to 15% of its population living with hepatitis C, and Vietnam, where the prevalence of hepatitis B is 15% to 20%, it is simply overwhelming. Now is the time for people to get informed, to use that information to tackle the stigma that has kept this epidemic so silent for so long and, yes, to confront it.
• Charles Gore is president of the World Hepatitis Alliance, an NGO established in 2007 working with more than 280 chronic hepatitis B and C patient groups around the world
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