Lack of policy limiting crucial care for patients

Chronic hepatitis B and C infections account for 78 per cent of liver cancer cases globally.

The Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP) is urging the region’s governments to address the absence of national hepatitis action plans, which contributes to rising hepatitis mortality and liver cancer.

They said these plans would help reduce the burden of both hepatitis and liver cancer, and save lives. 

CEVHAP also called for governments to work with the World Health Organisation (WHO) in developing coordinated national policies and allocate resources to hepatitis prevention, care, treatment, education and research. 

In March, WHO released the draft global health sector strategy for viral hepatitis 2016-21, in which hepatitis elimination targets were proposed. Its final version will be sent to the next World Health Assembly for consideration. WHO regional offices are developing action plans to guide the setting up of national hepatitis programmes.

The GBC study shows that 792,000 cases of liver cancer were diagnosed globally in 2013, of which 597,000 (75 per cent) were diagnosed in Asia Pacific. Compared to 1990, incidence in Asia Pacific has increased by more than 65 per cent, and in some parts of the region, the increase was much higher: 213 per cent in the Pacific Islands (Oceania); 183 per cent in Australia and New Zealand combined (Australasia); 145.41 per cent in Southeast Asia; and 99 per cent in South Asia.

“While a comprehensive approach is important, successful implementation will hinge upon strong links between effective hepatitis screening and accessible treatment,” says Professor Stephen Locarnini, CEVHAP co-chair and director of the WHO collaborating centre for virus reference and research at the Victorian Infectious Diseases Reference Laboratory. 

“People diagnosed with hepatitis are not followed up with adequate care, due to gaps in the system for hepatitis management. Stigma and misinformation about hepatitis abounds. In many countries, healthcare professionals don’t fully understand how hepatitis should be managed,” says Professor Ding-Shinn Chen, CEVHAP co-chair and former dean of the National Taiwan University’s College of Medicine.

To link hepatitis screening to treatment, effective case referrals, monitoring and follow-up should be built into healthcare systems, while primary and specialist healthcare professionals need training to manage hepatitis cases, CEVHAP urged. As hepatitis treatment remains expensive to people in low and middle-income countries, governments need to find sustainable ways to fund hepatitis programmes, working in collaboration with the WHO and donors.

Professor Locarnini said, “Now is the time to set hepatitis policies on the right course, and adequate funding is critical. We urge governments as well as donors to invest in hepatitis programmes.”