Why is there a WHO alert on viral hepatitis?

Subject: Science and tech

Section: Health

Context:

India accounted for 11.6% of the total viral hepatitis disease burden globally in 2022, making it the country with the second highest disease load after China, according to the World Health Organization’s (WHO) Global Hepatitis Report 2024 released recently.
Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation and Vietnam, collectively shoulder nearly two-thirds of the global burden of hepatitis B and C.

What does the report highlight?

The disease is the second leading infectious cause of death globally — with 1.3 million deaths per year, the same as tuberculosis, a top infectious killer.
New data from 187 countries show that the estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, 83% were caused by hepatitis B, and 17% by hepatitis C.
Every day, there are 3,500 people dying globally due to hepatitis B and C infections.
Half the burden of chronic hepatitis B and C infections is among people aged 30-54 years old, with 12% among children under 18 years of age. Men account for 58% of all cases.

Why is the report significant?

The report is significant as it is the first comprehensive WHO document consolidating global data on viral hepatitis, covering epidemiology, service coverage, and product access.
It provides the most recent estimates of disease burden and examines the coverage of essential services for viral hepatitis across 187 countries.
Key findings reveal low diagnosis and treatment rates: only 13% of those with chronic hepatitis B are diagnosed, with about 3% receiving antiviral therapy; for hepatitis C, 36% are diagnosed and 20% have received curative treatment.
These figures are substantially below the global targets of treating 80% of those with chronic hepatitis B and C by 2030.
Nonetheless, the report notes a modest but steady improvement in both diagnosis and treatment rates since the last estimation in 2019, marking some progress toward global hepatitis eradication goals.

What is Hepatitis?

Hepatitis is an inflammation of the liver that can be caused by various infectious viruses and non-infectious agents, leading to potentially fatal health issues.
There are five main types of the hepatitis virus—A, B, C, D, and E.
Each type causes liver disease but varies in transmission modes, illness severity, and geographic prevalence.
Types B and C are particularly significant as they often lead to chronic conditions and are the major causes of liver cirrhosis, liver cancer, and deaths related to viral hepatitis.

Why is India vulnerable?

India is particularly vulnerable to hepatitis due to multiple factors, including high population density, lack of awareness about the disease, insufficient screening and treatment options, and poor hygiene practices.
Mother to child transmission is responsible for most new infections.
The rise in non-viral hepatitis cases, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD), exacerbates the situation.
Urban lifestyles with higher alcohol consumption have increased ALD cases, while obesity, metabolic disorders, and sedentary habits have led to a surge in NAFLD cases across both urban and rural India.
These conditions can progress to severe liver diseases, adding to the hepatitis challenge.
Other risks include: infections from intravenous drug use, sharing injections, and risky sexual practices, contributing to higher transmission rates of hepatitis B and C among this group.

How can it be prevented?

Hepatitis B prevention is achievable through vaccination, which is emphasized for coverage enhancement.
Unlike Hepatitis B, Hepatitis C can be cured using specific medications.
Despite the severity of viral hepatitis, the mortality rates in India are not as high as those from tuberculosis, partly because the cost of hepatitis treatment is relatively low due to the availability of generic drugs in India.
The government’s viral hepatitis control program provides vaccines to high-risk adults, including healthcare workers, and offers treatment options for both hepatitis B and C.
Initially, the hepatitis B vaccine was rolled out in select cities and districts in 2002-2003, and by 2011-2012, the vaccine for Chronic Hepatitis B infection (HBV) was integrated into the childhood immunization program, expanding its reach and effectiveness in preventing the disease.

Source: TH