prevention and control of viral hepatitis infection: who framework for global action prevention and...
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Prevention and Control ofViral Hepatitis Infection:
WHO Framework for Global Action
Prevention and Control ofViral Hepatitis Infection:
WHO Framework for Global Action
Tim Nguyen
Technical Officer
1414thth International Symposium on Viral Hepatitis and Liver Disease International Symposium on Viral Hepatitis and Liver DiseaseShanghai 2012Shanghai 2012
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WHA63.18: Comprehensive Hepatitis Prevention and Control
WHA63.18: Comprehensive Hepatitis Prevention and Control
2010 World Health Assembly adopted resolution 63.18 as sponsored by Brazil, Columbia, and Indonesia calling for comprehensive approach to hepatitis prevention and control
World Hepatitis Day on July 28
Member State action
Secretariat action
Accountability to World Health Assembly
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Current challengesCurrent challenges
HBV– HepB vaccine at birth is still only administered in 92 Member
States and only 25% of infants have received this vaccine.
HBV / HCV– Millions of chronically infected persons do not have timely access
to testing, care and effective treatments.– Unsafe injections are still common in many developing countries. – On-going transmission is adding millions of people to the pool of
the chronically infected.
HAV / HEV– Unsafe water and sanitation are the norm for millions of people.
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Vision and GoalsVision and Goals
As of Dec 2011, WHO Global Hepatitis Programme
«A world where viral hepatitis transmission is stopped and all have access to safe and effective care and treatment»
Using a public health approach, the goal of the viral hepatitis programme is:
– to reduce the transmission of the various agents that cause viral hepatitis;
– to reduce the morbidity and mortality due to viral hepatitis and improve the care of patients with viral hepatitis;
– and to reduce the socio-economic impact of viral hepatitis at individual, community and population levels.
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Global Hepatitis FrameworkGlobal Hepatitis Framework
Axis 1: Partnerships, resource mobilization and communication
Axis 2: Data for policy and action
Axis 3: Prevention of virus transmission
Axis 4: Screening, care and treatment
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Axis 1: Increasing engagement through awareness, partnerships and mobilizing resources
Axis 1: Increasing engagement through awareness, partnerships and mobilizing resources
Increasing awareness among policy makers, health professionals, and the public about viral hepatitis
Support for World Hepatitis Day
Establish global network of collaborating centres and civil society for viral hepatitis prevention and control
Mobilize resources especially for countries with limited resources
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Axis 2: Evidence-based policy and data for action
Axis 2: Evidence-based policy and data for action
WHO is updating global prevalence and burden estimates for viral hepatitis.
Guidance on serological surveys to assess impact of prevention efforts
Guidelines and standards for infection and disease surveillance
Public Health Research Agenda for Viral Hepatitis
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Current estimates of Disease BurdenCurrent estimates of Disease Burden
HBV
1 of every 3 people has been infected by HBV
~240 million chronic carriers worldwide (3,7%)
~ 500 000 – 700 000 HBV related deaths per year, 94% chronic reasons
~4,5 million new cases/per year
HCV
130-170 millions of peopled
infected worldwide (2.2-3%)
>350 000 people die from HCV-related liver diseases each year
3–4 million people are infected with HCV each year
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WHO Public Health Research Agenda for Viral Hepatitis
WHO Public Health Research Agenda for Viral Hepatitis
The goal is to guide researchers in the direction of necessary research for generation of evidence needed to strengthen public health guidance and actions.
Examples of public health research questions:
What strategies are most useful in reaching high risk groups for Hepatitis B vaccination and increasing uptake?
What is the most cost-effective HCV screening strategy in settings with limited treatment resources?
Is it more cost-effective to focus on building infrastructure or to immunize children with the hepatitis A vaccine to reduce morbidity and mortality in low to middle income countries?
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Axis 3: Prevention of virus transmission
Axis 3: Prevention of virus transmission
Guidance and tools for immunization – Schedules and dosages – Protection of high risk groups including newborns and health-
care workers, especially against hepatitis B– Promote innovative approaches for the future
Safer sex, safe and rational use of injections and safe blood transfusion
– ensuring safe food and water for countries, and on proper disposal of sanitary waste
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Axis 4: Screening, care and treatment
Axis 4: Screening, care and treatment
Screening and counseling resource package
Diagnostic, care and treatment guidelines in resource-constrained settings
Training package for health care providers
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Global Hepatitis FrameworkGlobal Hepatitis Framework