Hong Kong, 11-12 Juli 2023
On 11-12 July 2023, Peduli Hati Bangsa attended the Hep Can’t Wait Asia Workshop in Hong Kong organized by the World Hepatitis Alliance in collaboration with Gilead Sciences.
The Asia Workshop was attended by 22 community-based organizations and 11 clinical experts from 11 countries in the Asia Pacific region to share ideas and new approaches to eliminate hepatitis. In addition to sharing experiences, this workshop also provides up-to-date information regarding WHO plans to simplify Hepatitis B treatment algorithms.
Innovations to eliminate Hepatitis B are deemed necessary to achieve the target of ≥ 90% HBV vaccine coverage, ≥ 90% of people with HBV diagnosed, and ≥80% of people with HBV who are diagnosed and eligible for treatment to receive treatment. If the target is reached, it is expected to reduce HBV incidence by 95% and reduce 65% of HBV-related mortality.
Currently, the situation is still not ideal where out of the estimated number of people with Hepatitis B, only 13% of them are diagnosed and 25% of people are being treated.
By looking at each country in the Asia region, only a few countries have achieved a prevalence of <0.1% for children aged ≤5 years, namely Japan, mainland China and Hong Kong, South Korea, Taiwan, and Singapore. These countries achieved this target as early as 2015 to 2022.
Countries that achieve the targets above are also more likely to achieve the target of 90% diagnosis and 80% treatment between 2030-2050. Of all countries, only Japan will achieve the target of 65% reduction in HBV mortality before 2030.
Supporting factors for achieving each country’s targets include government commitment and provision of resources (e.g., distribution and coverage of vaccinations and treatment borne by the government), including efforts to reach groups in the “grey area”. The grey area or zones are referred to people who were born before the government implemented mass vaccination and screening program.
In addition, another supporting factor is the simplification of the treatment flow, especially in the East Asia region. Experts in the East Asia region suggest the following to simplify treatment requirements for non-cirrhotic cases from 2020:
1. HBV virus count ≥2000 (compared to >20,000 by most consensus)
2. Total normal ALT or SGPT value ≥1x (compared to ≥2x by most consensus), or if normal SGPT <1x but aged 40 years and over, has a family history of death from cirrhosis or liver cancer
3. Have liver fibrosis level ≥F2 and/or A2
As for Indonesia, plenty has to be done to eliminate Hepatitis. This effort needs to be carried out with the cooperation of various including the government, community, academia, private sector, health care facilities, and also the media.