Every year, the World Hepatitis Day is celebrated on 28th July and today, Rwanda joins the rest of the World to commemorate all the efforts that have been deployed in hepatitis prevention, care and treatment towards hepatitis B and C elimination. The global theme entitled ‘’It’s time for action’’ whereas the national theme is: “Sustain hepatitis elimination achievements (Dusigasire ibyagezweho mu kurandura hepatite)” to mark the progress made in hepatitis elimination and the next steps. As the World celebrates the Hepatitis Day, it is an opportunity to review and reflect on national and international progress towards Hepatitis elimination, and increase efforts to strengthen case finding strategies, inclusive access to testing and treatment services and reaffirm actions and engagement at all levels including leadership, partners, civil societies and communities, to ensure a comprehensive approach towards hepatitis elimination.
Hepatitis has become a global public health issue that causes a high global burden of morbidity and mortality. World Health Organization (WHO) estimates both viral hepatitis B and C to cause 1.3 million deaths every year (1 person dies every 30 seconds and 3.0 million new infections annually)1. More to the point, the epidemic of viral hepatitis B and C affects 304 million people globally and is 10 times larger than the global HIV epidemic. Every day 3,500 people die of viral hepatitis-related liver disease, liver failure and liver cancer2-3.
Additionally, in Africa, chronic viral hepatitis affects over 70 million Africans (60 million with hepatitis B and 10 million with hepatitis C). Dying from viral hepatitis in Africa is becoming a bigger threat than dying from HIV/AIDS, malaria or tuberculosis with at least 200,000 deaths a year1.
The Global Health Sector Strategy (GHSS) on viral hepatitis, approved by the World Health Assembly in 2016, has the vision of a world where transmission of viral hepatitis is halted and everyone living with viral hepatitis has access to safe, affordable and effective prevention, diagnosis, care and treatment. Its goal is to eliminate viral hepatitis as a major public health problem by 2030.
In Rwanda, a national plan for Viral Hepatitis C (HCV) elimination was launched in December 2018, with the goal to screen 7 million people aged 15 years and above and treat all positive cases, which aimed to reduce the HCV prevalence from 4% to 1% in less than 5 years. By launching the HCV national elimination plan, Rwanda is the first country in sub-Saharan Africa to have done so.
Throughout the years, Rwanda has made significant progress in implementing HIV and Viral Hepatitis Control measures, including early screening of blood supply, ensuring safe injections at health facilities, the establishment of a Hepatitis program in 2014, the subsequent publication of National Guidelines and the launch of viral hepatitis elimination in 2018. Major steps have been achieved in viral hepatitis management:
- Hepatitis services are free of charge for all the citizens and refugees residing in Rwanda.
- More than 8 million people aged 15 years and above have been tested for HCV and 60,000 people have been treated and cured for HCV and those who failed the first line treatment were introduced on the second line treatment.
- More than 5 million people have been tested for HBV and 8,000 people are on a lifelong HBV treatment and over 7,000,000 people including children and adults have been vaccinated for HBV from 2002.
- Hepatitis testing and treatment are decentralized and a task-shifting has been implemented to increase access of hepatitis services to the population in need. Hepatitis testing and treatment services are provided by medical doctors and nurses in all public health facilities, including hospitals and health centres.
- The prevalence of viral hepatitis B and C reduced from 3% and 4% in 2017 to 0.36% and 0.48% respectively in 20236
- Rwanda was selected by WHO among world top 7 countries with advanced hepatitis management services and was piloted for a pre-validation of viral hepatitis elimination
- Recently, Rwanda has received an award from the World Hepatitis Alliance for its outstanding contribution towards viral hepatitis elimination in Africa.
With the above-mentioned progress, the program is now sustaining the achievements towards viral hepatitis elimination through testing, treatment and vaccination.
Recent initiatives have also been introduced to eliminate Hepatitis B by preventing transmission from mother to child. This will be accomplished through routine screening and treatment of hepatitis B among all pregnant women as well as the introduction of a hepatitis B birth dose within 24 hours of life.
Through continued commitment, leadership support and strong partnerships, Rwanda through the Ministry of Health is committed to showcase that Hepatitis elimination is possible.
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For more information, please contact: Mr Julien Mahoro Niyingabira Rwanda Health Communication Centre Division Manager Rwanda Biomedical Centre Tel: (+250) 788606072
