The Task Force for Global Health

Saving a Million Lives from Viral Hepatitis in LMICs

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Viral hepatitis is a global health threat causing 1.4 million annual deaths. With the availability of effective vaccines, reliable tests, and curative treatments, the World Health Assembly unanimously set global elimination goals. Yet 10 million new infections occur annually and 95% of the 328 million infected persons remain undiagnosed and untreated. Hepatitis burden is greatest in low/middle income countries (LMICs). Two LMICs, Mongolia and Egypt, have successfully strengthened national health systems to provide the prevention, testing and treatment services necessary to achieve elimination. These countries have sustainably-financed models of improved maternal-child health to prevent perinatal-transmission, better injection safety for patients, and open access to diagnostics and treatment with accurate data to monitor progress toward elimination; these improvements assist other health initiatives. To accelerate progress toward global hepatitis elimination, we formed a global coalition to assist LMICs to implement these models and prevent at least a million deaths from viral hepatitis.

Problem Statement

An estimated 1.4 million persons die of viral hepatitis each year because of poor access to protective vaccines, reliable tests and effective treatments; deaths are increasing and projected to exceed deaths from malaria, TB and HIV combined. Low and middle income countries (LMIC) particularly in Asia and Africa have the highest burden of viral hepatitis and related deaths; risk populations include children and certain marginalized populations. To effect change globally, the United Nations called on nations to combat hepatitis. WHO set elimination goals including a 65% reduction in hepatitis mortality and expanded vaccination, testing and treatment policies to achieve reductions in hepatitis mortality. The challenge now is to help countries take the necessary actions to prevent premature deaths from hepatitis. Pilot programs in Mongolia, Egypt and other countries demonstrate how LMICs can develop effective, nationally financed programs that implement interventions within existing health systems that virtually eliminate viral hepatitis transmission, and drastically decrease prevalence and mortality. These actions are cost-saving. Five most influential ways to effect change are 1) data to inform program development and setting of time goals 2) financial tools for budget based planning 3) technical assistance to guide local implementation and 4) communications tools to engage local stakeholders and the public; 5) and data for monitoring and quality improvement.

Solution Overview

Despite state-of-the-art treatments, diagnostics, and clinical program models for solving many global health challenges, the gap between evidence and practice can be significant due to fragmented planning and policy making and bottlenecks to disseminating these best practices. This is especially the case with viral hepatitis where lack of access to effective prevention and treatment in many countries causes 1.4 million preventable deaths annually. However, new paradigms integrating technologies and innovative policies are aligning incentives among disparate health actors for coordinated supply and care. These paradigms have been pioneered in Mongolia and Egypt through leadership from civil society, government and industry partners. These countries are now on track to achieve goals for elimination. This project aims to scale the new, proven paradigm to other LMICs and through doing so prevent at least a million deaths from viral hepatitis. In most countries, achieving hepatitis elimination requires improved vaccination of children and expanded treatment access expansion to all populations, even those who are stigmatized and marginalized, such as persons who inject drugs. In addition to individual patients and their families and communities, society at large benefits expanded access to hepatitis prevention and treatment. Liver cancer, cirrhosis, and other hepatitis-related morbidities impose costly burdens on health systems. However, within the first five years of a large-scale national program, investments in hepatitis prevention and cure will free up billions of dollars that can reallocated to other pressing health priorities.

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