Kevin Fenton, MD, PhD, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC), and Kevin M. De Cock, MD, director of the Center for Global Health, also at the CDC, have issued the following statement:
On this first World Health Organization (WHO)-sponsored World Hepatitis Day, July 28, 2011, the Centers for Disease Control and Prevention (CDC) joins the world in reflecting on the remarkable successes and enormous challenges in the global effort to prevent and control viral hepatitis.
These successes and challenges are amplified because viral hepatitis is not a single disease. Hepatitis is caused by at least five viruses—including two spread by water or food contaminated with feces(hepatitis A and E) and three transmitted by blood and body fluids (hepatitis B, D, and C) during childbirth (from infected mother to child); through injecting drug use, needle sticks, or transfusions; or through sexual contact. Hepatitis B and C infections can cause cirrhosis of the liver and lead to liver cancer.
Today, more than 500 million persons worldwide are living with viral hepatitis and do not have adequate access to care—increasing their risk for premature death from liver cirrhosis and liver cancer. Each year, more than 1 million people die from viral hepatitis and millions of new infections add to this global burden of disease and death.
This first World Hepatitis Day honors the man who achieved one of the greatest and earliest successes in viral hepatitis prevention—Dr. Baruch Blumberg, discoverer of the hepatitis B virus in 1967. He later developed an effective vaccine and won the Nobel Prize for his efforts. His discoveries were the first in a series of tools developed to combat viral hepatitis: diagnostic tests, new therapies and vaccines.
Vaccines are clearly making a difference today. The hepatitis B vaccine is now offered to children in 178 countries worldwide, providing a level of protection that prevents more than 700,000 deaths from cirrhosis and liver cancer in each new generation. And because hepatitis D requires the presence of hepatitis B virus to cause infection, hepatitis B vaccination eliminates the risk of contracting hepatitis D. A vaccine that prevents hepatitis A has been effectively used since the 1990s. In development are promising new vaccines against hepatitis E, a common cause of water- borne hepatitis in Asia and Africa that disproportionately kills pregnant women. Unfortunately, vaccines against hepatitis C infection remain elusive.
Besides effective vaccines, tests for viral hepatitis have made the blood supply safer by dramatically lowering the risk for transfusion-associated hepatitis B and C infections. And for persons living with hepatitis B and C, improved access to screening and referral for treatment can reduce disease and death. Today, new therapies for hepatitis C can eliminate the virus in 3 out of 4 persons treated, essentially curing their infection.
While we celebrate these gains, we have much more to do. In the United States, many if not most people living with hepatitis are not aware of their infection, and thus cannot benefit from the effective treatments that are available. Lack of progress in countries with fewer resources has been directly related to the inability to implement what works—providing clean water and guaranteeing a safe food supply, routinely offering the birth dose of hepatitis B vaccine and ensuring that every child receives 3 doses, educating health care providers and at-risk people about the importance of being tested, improving infection control procedures in health care facilities, and raising awareness of risk among injection drug users. We must redouble our commitment to ensure these effective tools are fully utilized to benefit all people at risk for viral hepatitis.
To this end, in 2010 the World Health Assembly passed a resolution urging member states to comprehensively address viral hepatitis. In the United States, the Department of Health and Human Services has developed an action plan to speed our progress: Combating the Silent Epidemic of Viral Hepatitis: Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. CDC will play a key role in U.S. efforts to implement and ensure the success of this comprehensive plan and will assist other countries in raising public and provider awareness; implementing interventions tailored for a country’s individual hepatitis burden; and convincing policymakers worldwide to support the best systems for prevention, care, and treatment.
To honor Dr. Blumberg’s legacy, let us use all the tools at our disposal to stop the suffering caused by viral hepatitis. In the words of the WHO’s 2010 report to the World Health Assembly, "the time is right" and "[t]he impact of these efforts on mortality and morbidity will be significant because of the tremendous burden of disease."