A major new analysis published in The Lancet last week has shown that unprecedented progress has been made against the global burden of HIV, malaria and tuberculosis (TB), writes Charles Gore.
Much of this progress is attributable to the vast international collaborative effort against the diseases, the adoption of the sixth Millennium Development Goal and the creation of the Global Fund being two major contributors. This success should be celebrated but it should also be used as a spur in other areas.
While deaths from HIV/AIDS have been reduced from 1.7 million in 2005 to 1.3 million in 2013, deaths from viral hepatitis have increased by 50% in the last 20 years, and show no sign of slowing. It is now the leading cause of death from infectious disease, killing more than 1.4 million people every year. Inexplicably, the lessons learnt from tackling the enormous burden of other infectious diseases simply haven’t been applied to viral hepatitis, resulting in a spiralling epidemic.
The success with HIV/AIDS, TB and malaria has shown that a key element of addressing a global health threat is collaboration between civil society, governments and international agencies. All have worked together to implement policies and programmes, share best practices and put effective monitoring and surveillance in place. To find out to what extent that existed for viral hepatitis, the World Hepatitis Alliance launched a survey this year. The survey asked civil society organisations to respond to their government’s professed policies and programs as published in the World Health Organization (WHO) 2013 Global Policy Report on the Prevention and Control of Viral Hepatitis. Sadly, half of the civil society organisations thought their government had reported inaccurate information to the WHO. This indicates a lack of engagement and communication between governments and civil society about what is really happening and consequently the absence of a collaborative approach.
This disconnect between governments and civil society reveals how far behind the response to viral hepatitis is to what is happening in other communicable diseases. It also raises concerns about the extent to which new high-level commitments will turn into grassroots impact.
The recent resolution on viral hepatitis adopted at the World Health Assembly in May demonstrates the increased willingness of the global community to address viral hepatitis. The resolution asks all governments to implement national strategies and to strengthen prevention, diagnosis and treatment measures. In theory, this is a huge step forward for viral hepatitis, with every government in the world signing up to the asks of the resolution and more than a quarter of WHO Member States speaking out strongly in its support.
However, these actions must be accompanied by a shift in how the international community addresses viral hepatitis. Without 400 million people living with chronic viral hepatitis, it is a vast problem that is so far lacking any kind of global funding or indeed any prospect of it. In such an environment mobilising what resources there are and using them cleverly and effectively is going to require close collaboration between all stakeholders. Unfortunately, the recent Alliance report highlights a serious lack of such collaboration and engagement. Unless we make immediate efforts to change that, it is hard to see how progress against viral hepatitis will be possible. We need to learn from the success of other collaborative efforts.
World Hepatitis Day is a crucial time to build these networks. This year on the 28th July around 200 events will be taking place across the world, often featuring new partnerships and fresh ideas for cooperation. These are all opportunities to begin discussions around the resolution and how best to implement new policies. We have seen how well this can work. Let’s ensure this happens for viral hepatitis.
Charles Gore is President of the World Hepatitis Alliance
Find out more about World Hepatitis Day at www.worldhepatitisday.org
The World Hepatitis Alliance report will be available at http://global-report.worldhepatitisalliance.org/en/ from the 28th July.