World Hepatitis Day: Over 18m Nigerians infected with hepatitis— Health minister

The Minister of Health, Dr Osagie Ehanire says 18.2million Nigerians are infected with viral hepatitis, as awareness, reporting, diagnosis and treatment of Hepatitis B and C remain  low in the country.

Ehanire said this while addressing journalists on Wednesday in Abuja in commemoration of the 2021 World Hepatitis Day with the theme: “Hepatitis Can’t Wait!”

Hepatitis is the inflammation of the liver, showing five common viral hepatitis strains as A, B, C, D, and E, but with a hepatitis G virus identified recently.

Hepatitis A and E are transmitted through contaminated food, water, poor hygiene and close contact with carriers of the virus, while Hepatitis B, C and D are transmitted through blood, sexual intercourse, bodily fluids, kissing, sharing syringes and blades and touching wounds of infected persons.

Hepatitis G being the newly discovered viral hepatitis’ route of transmission is no different from that of B, C and D.

Studies revealed that hepatitis A and E were acute; last for a short time – less than six months – while hepatitis B, C, D and G may progress to chronic, lasting more than six months.

Symptoms of viral hepatitis start from asymptomatic, absence of symptoms, to mild or moderate features such as jaundice, a yellowish discoloration of the skin and eyes, poor appetite, malaise and progressing to chronic liver failure.

The minister stressed that Hepatitis remained a disease of public health importance, with the mortality rate from both infections still alarming, in spite of global progress made in addressing the disease.

He stated that 16 million Nigerians were estimated to be infected with Hepatitis B and 2.2 million with Hepatitis C, which represented an estimated prevalence rates of 8.1 per cent and 1.1 per cent respectively.

“In 2019, 3.8 per cent of the world’s population was living with Chronic Hepatitis B virus infection and 0.75 per cent with Hepatitis C infection,” he added.

The minister described the 2021 theme as apt, while calling for continuous efforts to manage and mitigate hepatitis in Nigeria.

“We adopted the national sub-theme ‘National ownership and financing for viral hepatitis elimination’ as a clarion call to action by all stakeholders and acknowledged the need to increase engagement to realise the desired changes,”  he said.

Ehanire also said that the ministry introduced policy documents and guidance for action with partner support, but regretted that ensuring optimal access to services remained a challenge, while out-of-pocket payment was still the main source for financing treatment.

“The government recognises the urgent need to address out-of-pocket payments and improve sustainable financing, to be on course to the elimination targets,”  he added.

In view of Nigeria’s commitment to the 2030 viral Hepatitis elimination plan, the minister said it was essential to improve community engagement, political leadership, testing and treatment and scale up high-impact interventions.

He called on all Nigerians to work together to eliminate the ‘silent killer,’ viral hepatitis by visiting a health facility for screening.

The WHO representative to Nigeria, Dr Walter Mulombo said the 2021 theme ‘hepatitis can’t wait’ emphasised the urgent need for countries to rapidly improve access to services to prevent, diagnose and treat viral hepatitis.

“In Africa, including Nigeria, hepatitis is a silent epidemic: More than 90 million people are living with hepatitis in the region, accounting for 26 per cent of the global total.

“Around 4.5 million African children under five years, are infected with chronic hepatitis B, reflecting an enormous 70 per cent of the global burden in this age group.

“The global target of less than 1 per cent incidence of Hepatitis B in children under 5 years has been reached, but the African Region is still lagging at 2.5 per cent,” Mulombo said.

He noted that most of the cases could be prevented by eliminating mother-to-child transmission of the disease, during or shortly after birth and in early childhood.

“Key interventions against hepatitis B include vaccination at birth and in early childhood, screening pregnant women, and providing timely treatment.

“With the launch of the first global strategy on Hepatitis in 2016, along with increased advocacy in recent years, political will is starting to translate into action,” he added.

He noted that Nigeria had developed policy and guidance documents to prevent and treat viral hepatitis across the five core intervention areas “vaccination, prevention of mother to child transmission (PMTCT) blood and injection safety, harm reduction and hepatitis B and C testing and treatment.

“Although the birth dose and pentavalent hepatitis vaccine is provided free for all under 5 children, the health system is challenged with ensuring access and availability for infants and children, testing and treatment for pregnant women and mothers.

“Nine out of 10 people who are infected, have never been tested,” he said.

He urged all stakeholders in maternal and child health to consider integrating Hepatitis B interventions into antenatal care services together with the HIV and Syphilis PMTCT programme.

He added that in collaboration with other key partners, the organisation could step-up action in supporting the FMOH to mobilise the needed domestic and international resources required for viral hepatitis control in the country.

“As a follow up to the commitment of the African Heads of States to address viral hepatitis as a public health threat in the Cairo Declaration in February 2020, we advocate the creation of a viral hepatitis budget line at the national and state levels to the programme for the disease.

“Similarly, the inclusion of testing and treatment services within the National Health Insurance Scheme (NHIS) will facilitate the much-needed access for the people that need it.”

He pledged commitment to continuing partnership with FMoH/National AIDS and STI Control Programme (NASCP) National Primary Health Care and Development Agency (NPHCDA) and the National Blood Transfusion Services (NBTS).

“Also, with the National Harm Reduction Programme and other departments, partners and stakeholders working on viral Hepatitis, through provision of technical support and innovations toward the attainment of the set targets,” Mulombo further said.