Ahead of World Hepatitis Day today (28 July), the World Hepatitis Alliance (WHA) has launched a white paper outlining the human impact of mother-to-child transmission of hepatitis B. The white paper highlights that 1.5m (1.1m-2.6m) people newly acquired hepatitis B in 20191. Most of these were as a result of mother-to-child transmission.
A safe and effective vaccine for hepatitis B has been available for more than four decades, but many countries have not yet harnessed its power effectively. More than half of infants worldwide still do not have access to the hepatitis B birth dose vaccine. In Africa, for example, only about 6% of infants receive timely birth dose vaccine2.
On World Hepatitis Day, the WHA and its global network of 320 members in 100 countries will come together with the global health community to highlight the need to accelerate the fight against viral hepatitis and the importance of testing and treatment for the real people who need it.
Ahead of the day, WHA’s white paper ‘Mothers and babies can’t wait – A call for action to end mother-to-child transmission of hepatitis B’, made policy recommendations, which, when carried out in addition to established guidelines, will ensure that prevention of mother to child transmission services are equitable, accessible, and available to all who need them.
Why is viral hepatitis important?
- WHO estimated that in 2019, 296m people were living with chronic hepatitis B3. Hepatitis B can cause liver scarring, liver failure and liver cancer
- By 2040, deaths from viral hepatitis are expected to exceed mortality from HIV, malaria, and tuberculosis combined4
- Approximately nine in 10 infected infants develop chronic hepatitis B, and around 25% of them will die of liver-related complications later in life
- The burden of hepatitis disproportionately affects the economically disadvantaged, with an estimated 197m of hepatitis B-positive people (~79%) living in low- and middle-income countries in the African and Western Pacific regions7
Mothers and babies can’t wait – A call for action to end mother-to-child transmission of hepatitis B:
Recommendations from the white paper include educational programmes and training to play a part in empowering and informing pregnant woman as a prenatal standard of care. These programmes must provide accurate information and share people’s experiences of living with hepatitis B and be made accessible to all, to combat the stigma and misinformation surrounding living with hepatitis.
Individuals living with hepatitis B often face challenges due to the stigma associated to the disease. This may hinder both health-seeking behaviours and public health efforts aimed at promoting hepatitis B testing and linkage to care. The paper recommends that health care professionals receive mandatory training to increase access to services and reduce hepatitis-related stigma in antenatal care.
Community-based organisations should be resourced and empowered to inform and support communities and play a recognised role in health care systems and hepatitis B elimination
Recommendations from the policy paper include funding and resources being provided to support WHO’s Triple Elimination Initiative and the implementation of known, cost-effective prevention of mother-to-child transmission of HIV, viral hepatitis and syphilis interventions.
WHO has combined the strategies for the elimination of mother-to-child transmission of hepatitis B, HIV and syphilis, within the context of the Triple Elimination Initiative. This strategy will address some of the discrepancies that currently exist between resourcing for hepatitis B, syphilis and HIV, as well as promoting integration.
Danjuma Adda, president, World Hepatitis Alliance says: “If we are to reach the 2030 hepatitis B elimination goals, we must address the systemic barriers to the prevention of mother-to-child transmission of hepatitis around the world and put the focus and attention on the needs of women. Because of gender and socioeconomic disparities, the women who are most likely to be affected by hepatitis B are often the ones least likely to have access to the healthcare needed to prevent passing it to their new-borns.”
Cary James, chief executive, World Hepatitis Alliance says: “Funding the prevention of mother-to-child transmission of hepatitis can help kickstart a rolling cycle of health improvement. This, in turn, will lead to greater health and quality of life for many. In this way, not only is the health of individual women improved, but that of whole communities.”
Alice, USA, lives with hepatitis B and is passionate about raising awareness of hepatitis B:
“I still feel a profound stigma because of how I was raised. I was ashamed to share my health status until 2018, when I was invited to participate in the storytelling campaign of the Hepatitis B Foundation. It was storytelling in a circle with people living with hepatitis B and family members, the circle time enabled me to open up.
“I could hear people sharing their story around me and I felt comfortable. Once I started talking and sharing my experience, I felt the trust and comfort in this circle of people. I thought, yes, I’m fine, I can share my information with everyone. It’s also a rewarding experience encouraging me to continue the outreach to promote hepatitis B prevention and vaccination.”
WHA’s full white paper: “Mothers and babies can’t wait – A call for action to end mother-to-child transmission of hepatitis B”, can be downloaded from here: www.worldhepatitisalliance.org/pmtct-report/
This report was supported by Kedrion Biopharma, with an unrestricted educational grant.
Issue by the The World Hepatitis Alliance