The Pan American Health Organization (PAHO) is urging Caribbean countries to maintain essential prevention and treatment services for viral hepatitis during the coronavirus (COVID-19) pandemic so as not to jeopardize progress towards its elimination.
“In the midst of a pandemic, viral hepatitis continues to sicken and kill thousands of people,” said PAHO Director, Dr. Carissa F. Etienne, adding “services, including vaccination against hepatitis B, are essential and cannot be stopped. Care must continue safely for all those who need it.”
PAHO said that in the Americas, 3.9 million people live with chronic hepatitis B and 5.6 million live with hepatitis C.
However, a model developed by World Health Organization (WHO) estimates that 17 countries in the region have already managed to eliminate mother-to-child and early childhood transmission of hepatitis B and that the Americas as a whole has also achieved the goal of less than 0.1 percent prevalence of hepatitis B in children under the age of five.
The PAHO/WHO is recommending that all newborns are vaccinated against hepatitis B at birth and subsequently receive at least two additional doses to be protected for life.
“With universal vaccination, we are creating new generations free from hepatitis B and moving towards eliminating hepatitis as a public health problem,” said Dr. Etienne as the global community observers World Hepatitis Day on Tuesday under the theme “Hepatitis-free future” with the focus being on the prevention of mother-to-child transmission of hepatitis B.
PAHO said over 90 percent of new, chronic hepatitis B infections occur from mother-to-child transmission or between children during early childhood.
“It is therefore essential that newborns and infants are vaccinated against hepatitis B within the first 24 hours of life. In the Americas, 31 countries – representing over 95% of newborns – around 14 million – recommend universal vaccination at birth and all countries and territories of the Region (51) vaccinate against hepatitis B in their routine vaccination programs. Regional vaccination coverage is over 80 percent,” PAHO noted.
It said following the introduction of the hepatitis B vaccine more than two decades ago, the Americas is the Region of the world with the lowest prevalence of chronic infection.
“The progress achieved is exemplary,” said the Dominican-born Dr. Etienne.
PAHO estimates that in 30 years, the region managed to reduce the prevalence of hepatitis B in children under the age of five from 0.7 per cent to less than 0.1 per cent, compared to the global average of 0.9 per cent.
“These results would not be possible with the commitment of governments, health personnel and families to vaccinate,” said Dr .Etienne, warning that routine vaccination rates have recently decreased in some countries.
She emphasized that efforts should be made to ensure that vaccination of newborns against hepatitis B occurs during the first 24 hours of life and that vaccination coverage of children under the age of one must remain high.
Currently, there is no vaccine against hepatitis C, but antivirals can cure more than 95% of those infected. However, only 14 percent of infected people in Latin America and the Caribbean are diagnosed and less than one percent receive treatment due to its high cost.
Some countries in the region have accessed direct-acting antivirals (DAA)—which can cure hepatitis C in three months or less—through the PAHO Strategic Fund, a mechanism that ensures quality, affordable access to this medicine. However, few currently use it.
In 2019, PAHO launched its Elimination Initiative to end more than 30 infectious diseases in the Region by 2030, including viral hepatitis.
“To achieve this, health systems must ensure access to testing and treatment for all people with viral hepatitis for those who need it, as well as preventative measures such as vaccination,” PAHO added.