Prevention and control of viral hepatitis : proposed global hepatitis strategy
•Als PPTX, PDF herunterladen•
1 gefällt mir•1,025 views
Dr Gabriel Riedner, Regional Adviser, AIDS and Sexually Transmitted Diseases
Empfohlen
Weitere ähnliche Inhalte
Was ist angesagt?
Was ist angesagt? (20)
Andere mochten auch
Andere mochten auch (20)
Ähnlich wie Prevention and control of viral hepatitis : proposed global hepatitis strategy
Ähnlich wie Prevention and control of viral hepatitis : proposed global hepatitis strategy (20)
Mehr von WHO Regional Office for the Eastern Mediterranean
Mehr von WHO Regional Office for the Eastern Mediterranean (20)
Kürzlich hochgeladen
Kürzlich hochgeladen (20)
Prevention and control of viral hepatitis : proposed global hepatitis strategy
- 1. Prevention and control of viral hepatitis Proposed global hepatitis strategy Agenda item 2(c) 62nd Session of the WHO Regional Committee for the Eastern Mediterranean 5–9 October 2015, Kuwait 1
- 2. Hepatitis has long been a silent epidemic: High death toll – low awareness 2000 2013 Data Source: Global Burden of Disease Study 2013 (GBD 2013) Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2014. 0 0.02 0.04 0.06 0.08 0.1 0.12 0.14 Malaria HIV TB Hepatitis Mortality in the Eastern Mediterranean Region Hepatitis C Hepatitis B Hepatitis A&E 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 Malaria HIV TB Hepatitis Millions Global mortality Prevention and control of viral hepatitis Proposed global hepatitis strategy 2
- 3. New global developments • New, effective and better tolerated treatment • Increasing global awareness and commitment to action: – National plans and resources – Civil society engagement – Global partners – WHA 2014; Emerging call for hepatitis elimination; Global Hepatitis Strategy – SDGs Raquel Peck, World Hepatitis Alliance: “We have to drive down prices of treatment.” Prevention and control of viral hepatitis Proposed global hepatitis strategy 3
- 4. Global hepatitis strategy: Key effective interventions are known • Hepatitis B vaccination (including birth-dose) • Safe injection practices and safe blood • Harm reduction for injecting drug users • Promotion of safe sexual behaviour • Hepatitis B treatment • Hepatitis C cure Prevention and control of viral hepatitis Proposed global hepatitis strategy 4
- 5. Global hepatitis strategy: Targets • Proposed impact targets (by 2030) • Supported by coverage targets for key interventions 90% reduction in new cases of of chronic HBV and HCV infection 65% reduction in deaths from chronic HBV and HCV Intervention Baseline 2015 2020 2030 HBV vaccination HBV vacc. at birth 81% 38% 90% 50% 90% 90% Safe injection 5% 50% coverage 90% HBV treatment <1% 8 million treated (5m HBV, 3m HCV) 80% HCV treatment <1% 80% Prevention and control of viral hepatitis Proposed global hepatitis strategy 5
- 6. Proposed way forward in the Region • Regional action plan for WHO and countries • Tailored action in countries (guided by national plans, based on analysis of disease burden and focus on most efficient investments) Prevention and control of viral hepatitis Proposed global hepatitis strategy 6
- 7. Thank You! http://www.emro.who.int/health-topics/hepatitis/index.html Prevention and control of viral hepatitis Proposed global hepatitis strategy 7
Hinweis der Redaktion
- Excellencies Ministers of Health, delegates and colleagues, Last year, the World Health Assembly re-iterated its concern about Hepatitis being a global public health threat and its call upon WHO to develop a global Hepatitis strategy. With this short talk we would like to update on recent global developments and bring the draft global hepatitis strategy to your attention, which will be discussed at the Executive Board meeting in January 2016.
- Hepatitis has long been a silent epidemic. Globally, there is an estimated 400 million people living with hepatitis B or hepatitis C infection. No country or region is unaffected. 1.4 million people die every year from complications of viral hepatitis yet most of these deaths can be prevented. Still there is a lack of awareness and most persons with hepatitis remain undiagnosed. In the WHO Eastern Mediterranean Region viral hepatitis B and C is causing more deaths than each of HIV, Malaria and Tuberculosis. Two of the countries with the highest burden of Hepatitis C in the world are in this Region: Pakistan and Egypt. Mortality data shown on this slide stem from the Institute of Health Metrics and Evaluation’ global burden of disease database. The data represent outputs of estimation models which are based on available country data. Hepatitis B: ~ 4.3 million new HBV infections / year Hepatitis C: ~ 800,000 new HCV infections / year
- There are, however, some encouraging global developments. New, more effective and tolerable medicines make treatment more feasible. WHO has included several of those medicines in the WHO essential drug list. However, affordability of those medicines has been an issue since prices have been very high. Meanwhile several countries, foremost Egypt but also the private sector in Pakistan have negotiated prices as low as 1% of the price paid in the US. Also, Moreover, recently generica have been entering the market and some countries, including Morocco and Egypt have started local production. Gilead, the producer of Sofosbuvir, has initiated an access program which allows most low income countries to purchase Sofosbuvir and Harvoni at preferential prices. We also observe increased global awareness and commitment: Countries develop national plans for Hepatitis and allocate additional resources. Civil society engages. Patient voices and demands are becoming louder and are being heard. Some global partners expand their scope to include Hepatitis, such as Medicins sans Frontieres, UNITAID and the Clinton HIV/AIDS Initiative. A call for Hepatitis elimination as a major public health threat is emerging. This has first been expressed at the World Health Assembly in 2014 where WHO was asked to examine the “feasibility of and strategies needed for the elimination of hepatitis B and hepatitis C with a view to setting global targets”. Extensive data collection and their use for modeling of Hepatitis epidemiology and the impact of interventions has so far led to the conclusion that viral hepatitis B and C can be eliminated as a public health issue of concern. Sustained transmission can be removed as well as hepatitis as a leading cause of mortality. This is technical feasible by scaling up six key interventions to high coverage.
- The key interventions to reduce new infections and to prevent severe disease and deaths of Hepatitis B and C are well known. They range from vaccination, safe injection practices, safe blood, harm reduction for drug users, safe sexual behaviour including protection through condoms to treating infected patients to keep the virus under control or even eliminate it completely from the infected person. Coverage of those interventions varies largely globally and in the Region, but it is inadequate in the majority of countries.
- With the view towards eliminating Hepatitis B and C as a public health issue of concern the proposed global hepatitis strategy suggests targets for reducing new infections and mortality by 2030. The aim is to achieve a 90% reduction of new infections and a 65% reduction deaths due to chronic Hepatitis B and C. Those impact targets are supported by coverage targets for key interventions. The table shows 2020 milestones and 2030 targets for some of the key interventions. The current draft strategy and these targets were developed in consultation with a wide range of stakeholders and try to balance feasibility with ambition. They will require massive efforts in terms of Hepatitis B vaccination at birth, injection safety and treatment scale up.
- What we propose as next steps in the Region: EMRO shall engage Ministries of Health, regional Hepatitis experts, patient organizations, the private sector and partner agencies in developing a regional Hepatitis action plan based on the global strategy. We hope to present this plan at the next Regional Committee for endorsement. Ministries of Health are encouraged to develop national targets and plans through a similar consultative process so to get all stakeholders on board needed to master the challenging tasks ahead. Egypt has been particularly proactive in this regard. An ambitious national plan is the basis of a huge effort to confront the major Hepatitis C epidemic. We will now have the opportunity to learn more about this Egyptian experience.