SEATTLE—At least 1.4 million people die each year from hepatitis. The World Health Organization (WHO) wants to decrease this number, so it took a look at innovative methods to increase hepatitis treatment around the world. The Borgen Project had the opportunity to interview Dr. Lisa Fair, HIV program manager for the Free Medical Clinic of Greater Cleveland, about treatment options.
Hepatitis is a group of viral infections (A, B, C, D, E) that can develop into short (acute) or long-term (chronic) liver disease. Differences between each strain of the virus include mode of transmission, the population they affect and the health outcomes. If left unchecked, hepatitis B and C are particularly deadly, as they can develop into cirrhosis or liver cancer.
WHO embraced a philosophy of looking for global “unprecedented opportunities” to combat hepatitis last April. Some countries offer large-scale, inexpensive childhood hepatitis B vaccinations, and a birth-dose vaccination prevents mother-to-child transmission of hepatitis B. New oral hepatitis C medicine provides hope as well.
To address the disease on a global scale, a multi-faceted approach is necessary. WHO partnered with the Social Entrepreneurship for Sexual Health (SESH), an organization that creates participatory contests to engage the community, and promote creative ideas to put together a contest. The contest, called #HepTestContest Innovation Contest, searched for approaches to hepatitis treatment that would work in multiple global contexts.
One of the two top-five finalists in the WHO-SESH contest is a community network organization in India. It focused on raising awareness, provided frequent, voluntary testing for over a month and also gave post-test counseling and treatment to people who tested positive.
WHO said that the key to the community network’s success was the strong community involvement and the strategic partnerships the organization formed. Together, these factors created enough leverage to obtain a reduced treatment price.
Lisa Fair, the Free Medical Clinic of Greater Cleveland’s HIV program manager, said that hepatitis treatment is too expensive for some people. Even if they’re able to take the initial diagnostic blood test, the following confirmatory test is even more expensive.
Fair said that the people who get tested usually know their status beforehand. The major reason people in this situation don’t get tested is avoidant behavior. Understandably, they don’t always want to deal with the reality of their status.
Education, however, may help with this behavior, as people will be more aware of their options post-diagnosis.
In the Netherlands, an online hepatitis awareness campaign educates people on hepatitis risk factors and the likelihood that they’ve contracted the disease. Through various social media platforms and a highly visible public communications campaign, people were encouraged to take an anonymous risk assessment test.
Without risk assessment, it’s possible people would have little indication of their status. According to WHO, 95 percent of people don’t know they have hepatitis B or C.
This is in part because, other than liver problems, symptoms remain normal enough to indicate other diseases. They include fever, fatigue, loss of appetite and vomiting.
Knowledge can prevent at-risk populations from ever needing hepatitis treatment, though. At The Free Clinic, a syringe-exchange program provides harm reduction services for intravenous drug users.
Fair noted that hepatitis C can live a long time since it doesn’t die when exposed to air, like HIV. This means it can live in unsanitized needles from, for example, using drugs or getting a tattoo in an uncontrolled environment.
When giving people harm-reduction kits, The Free Clinic insists that they share nothing, not even cotton balls, to ensure minimal risk of contracting any type of disease.
Amongst those utilizing The Free Clinic’s syringe exchange program, Fair said she has seen no rise in hepatitis infections. WHO itself recommended that organizations take advantage of the opportunities harm-reduction services offer, as they provide preventative training for multiple other diseases as well.
– Anastazia Vanisko