Viral hepatitis 20,000 deaths preventable: Now is the time to act

Tuesday, July 28^th is World Hepatitis Day – and a stark reminder of the mounting challenges posed by viral hepatitis, particularly hepatitis B and C, in Bangladesh.

Viral hepatitis (especially hepatitis B and C) affects more than fifteen million people in Bangladesh, and causes approximately twenty thousand deaths every year – more than malaria, cholera, or TB. Yet most people know little about viral hepatitis and those who do, regard it with stigma and do not necessarily realise that most cases of hepatitis B and C can be prevented, treated, and often even cured.

This year, the WHO included the newest hepatitis treatments in their Model List of Essential Medicines as a signal to governments that they should make them available to those who need them. However, many of these treatments are prohibitively expensive for a country like Bangladesh. Public private partnerships involving the pharmaceutical companies developing these drugs, national governments, international donors, and research institutes are gradually being tried and tested in several countries – and one can only hope that this will be the case in Bangladesh as well.

Yet as we learnt from HIV/AIDS, providing access to drugs is not enough. Our healthcare and public health systems need to scale up to stop the infection from being spread and ensure people at risk get screened, and those infected receive appropriate treatment and follow-up.

The magnitude of the response needed is baffling. But simple solutions could make a big difference. For example, unsafe injection practices are responsible for many of the new infections with hepatitis B or C viruses in Bangladesh. Avoiding re-use of syringes could reduce the number of people infected by hepatitis C by over 1.5 million, and those infected by hepatitis B by close to 280,000 (Hepatology International 2013).

This year, the Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP), a multi-stakeholder partnership whose aim is to achieve the elimination of viral hepatitis across the region, had as its motto 'now is the time'. As members of CEVHAP, we urge the government to put this motto into practice.

Now is the time to start putting into place concrete steps towards the elimination of viral hepatitis from our society. Some of these steps will be small, some big – but all will require political commitment, smart allocation of available resources, and a better understanding of the 'silent epidemic' which we talk so little about.

Professor Stephen Locarnini

Victorian Infectious Diseases Reference Laboratory

North Melbourne, Australia

Co-Chair, CEVHAP

Professor Ding-Shinn Chen

National Taiwan University College of Medicine

Taipei, Taiwan

Co-Chair, CEVHAP

Dr. Mamun-Al-Mahtab

Associate Professor of Hepatology, Bangabadnhu Sheikh Mujib Medical University

Secretary General, Association for the Study of the Liver, Dhaka, Bangladesh