Commentary, News

Need for National Policy on Hepatitis

By Atta Kwadwo Nyarko Asiedu, Physician Assistant Med Student

Hepatitis and its devastating effects on individuals across the globe call for immediate action on education, prevention, diagnosis, and treatment, to save lives and improve health outcomes.

The World Health Organization, WHO, estimates that over 300 million people worldwide are living with viral hepatitis, yet, many of the infected persons do not know their status, nor are they aware of the risks associated with the silent killer. According to the World Health Organization, as of 2022, about 304 million people worldwide were living with chronic hepatitis B and C.

Out of the number, one point three million died of these two types of hepatitis. The WHO has therefore called on the international community for concerted efforts through education, advocacy and collective action to combat hepatitis, which is considered a public health crisis and to create a future where the viral disease can be well managed. Persons diagnosed of hepatitis have common signs and symptoms of jaundice, fatigue and weakness, nausea and vomiting, abdominal pain or discomfort and pale or clay coloured stools.

The advanced form of the disease include liver cancer, varices and ascites. The World Health Organization recommends the practice of safe sex and avoidance of sharing personal items, such as razors or blades, toothbrushes and nail clippers as preventive measures. There is also vaccination against the hepatitis virus. In Ghana, it is estimated that nine point one percent of the population is infected with hepatitis B, whilst the prevalence rate for hepatitis C is three point three percent. That notwithstanding, it appears policy makers of health and health practitioners in the country have relegated the interventions and public education on hepatitis to the background.

Whilst the state has invested much in HIV and AIDS prevention, malaria, childhood killer diseases and some communicable and non-communicable diseases, the same cannot be said of Hepatitis B and C. Yet, hundreds of Ghanaians are being infected daily, whilst others are silently dying of these. With the prevailing conditions, one can say that Ghana lacks the national data on Hepatitis B and C viruses to facilitate national planning on the disease. There are gaps in the surveillance and reporting systems for tracking incidents, mortality, as well as the number of persons tested and treated. Ghana is yet to establish a hepatitis elimination strategy, even though there are standard operating procedures to manage the disease in the country.

It is about time the Ghana Health Service and its partners come up with an updated policy, with specific hepatitis elimination goals. In spite of the fact that the Ghana National Policy on viral hepatitis was released in 2014, it does not specifically define the country’s goals for elimination. Integrating the vaccination against the viral disease at birth is not enough. The vaccination campaign against the disease must go beyond this and be intensified. Ghana needs to establish a sustainable and achievable national policy for the elimination of hepatitis B and C viruses to curb the devastating effects of the condition on the population. There should be intensive public education, research and programmes to clear some of the misconceptions about hepatitis. Some Ghanaians have the belief that hepatitis is contagious and can be spread through casual contact.

Again there is the misconception that only drug users and people with multiple sex partners can get hepatitis. Others however think the disease is a death sentence, since there is no treatment for it. Some are also of the view that infected people should be isolated. However, due to advancements in medical science, there are medications to curb the devastating effects of the viral disease.

The reality is, that whilst hepatitis B and C are primarily spread through blood-to-blood contacts, hepatitis A is spread through contaminated food and water. Again, it has been established that while sexual contact can transmit hepatitis B and C, other routes like blood transfusion, sharing of needles and mother-to-child transmissions during birth also occur. Moreover, with proper treatment and care, many people with hepatitis can manage their condition and lead active lives. Furthermore, anyone can get hepatitis regardless of the age, gender, position or lifestyle.

Truth is, despite the fact that millions of people are infected worldwide with many cases undiagnosed, hepatitis A and B vaccines are highly effective in preventing any infection. Therefore, people with hepatitis deserve respect, support and understanding and should not be stigmatized or isolated. With the commemoration of another World Hepatitis Day gone by, Ghana has to strategize to better deal with the devastating nature of the disease.

As the world recommits itself to eliminate hepatitis, we must remember the millions of lives lost to this silent epidemic. We are all at risk, but together, we can make a difference.