WHO calls for accelerated action against hepatitis to address increasing liver cancer deaths in South-East Asia

The World Health Organization today called on countries in the South-East Asia Region to urgently scale up efforts to provide universal access to prevention, vaccination,  diagnosis, and treatment of viral hepatitis B and C. Despite being preventable and treatable, these chronic infections are increasingly causing serious illness and deaths from liver cancer, cirrhosis, and liver failure.

Today, liver cancer is the fourth biggest cause of cancer deaths in the Region, and the second most common cause of cancer deaths among men. Almost 75% of liver cirrhosis is due to hepatitis B and C infection.  In 2022, the Region accounted for 70.5 million people living with viral hepatitis B and C. Early testing and treatment can cure hepatitis C and  prevent hepatitis B from causing liver cirrhosis and cancer and can help reverse the predictions that liver cancer rates in South-East Asia Region are set to double by 2050 to over 200,000 deaths annually.

"We have the knowledge and tools to prevent, diagnose and treat viral hepatitis, yet people with chronic hepatitis B and C are still waiting to access the services they need. We need to accelerate efforts to deliver equitable services closer to communities, at the primary health care level," said Saima Wazed, Regional Director WHO South-East Asia on the World Hepatitis Day. The theme this year is 'It's time for action'.

Globally, hepatitis B and C combined cause 3500 deaths per day, with 6000 people newly infected with viral hepatitis each day. An estimated 254 million people are living with hepatitis B and 50 million people are living with hepatitis C, worldwide. Many people remain undiagnosed, and even when diagnosed, the number of people getting services and receiving treatment remains extremely low.

In 2022, about 1.3 million people died of viral hepatitis, the same as deaths caused by tuberculosis. Viral hepatitis and tuberculosis were the second leading causes of death among communicable diseases in 2022, after COVID-19.

In WHO South-East Asia Region, the coverage of hepatitis B and C testing and treatment remains low. In 2022, only 2.8% people with hepatitis B were diagnosed, and 3.5% of those diagnosed received treatment. Only 26% and 14% of people with hepatitis C were diagnosed and treated, respectively.

"We have safe and effective vaccines that can prevent hepatitis B infection. Antiviral drugs are highly effective in controlling and preventing disease progression, managing chronic hepatitis B and curing most cases of hepatitis C. More needs to be done for these life-saving interventions to benefit each person, irrespective of who they are and where they live," Wazed said.

Hepatitis B and C affect the general population and specific populations such as those at higher risk of or with a history of exposure through unsafe blood supplies, unsafe medical injections and other health procedures; newborns and children at risk through mother-to-child transmission of hepatitis B and C, notably in settings with high viral hepatitis prevalence; indigenous populations and mobile and migrant populations from countries with higher prevalence; and key populations, including people who inject drugs, people in prisons and other closed settings, sex workers and men-who-have-sex-with-men, who may be disproportionately affected in different contexts.

As most people are unaware that they are infected with hepatitis B or C, access to hepatitis testing and treatment needs to be expanded beyond larger hospitals or referral centres. Testing and treatment must be accessible within the community delivered by primary health care facilities and general practitioners, close to where people live and work, and included as part of universal health coverage. Accelerated coverage of testing and treatment of hepatitis B and hepatitis C will reduce development of liver cirrhosis and cancer, and ultimately, death, she said.

It is important to keep the needs of people living with viral hepatitis at the centre of all efforts, and for all stakeholders, including the private sector, to work together at all levels  to reverse the current impact on health.

Results from several country investment case studies suggest that there is an estimated return on investment of US$ 2–3 for every dollar invested in the viral hepatitis response to reverse the increasing mortality and prevent large costs of cancer treatment and care.

"Viral hepatitis is a major public health challenge of this decade. With a public health approach and leveraging countries' investments in universal health coverage, elimination of viral hepatitis by 2030 is feasible," the Regional Director said. Taking action in 2024–2026, to expand equitable access to viral hepatitis interventions will enable countries to regain the trajectory to achieve the Sustainable Development Goals – saving lives; preventing a future generation of new infections, cancers and deaths; and reducing costs. "We have the collective responsibility to save lives today and protect the health of future generations. It's time for action", Wazed said.