“Silent disease” outed at African Hepatitis Convention

By Liezl Human, via GroundUp

• The African Viral Hepatitis Convention this past week has put a spotlight on the need for eliminating hepatitis B and C, a disease which has infected millions of South Africans and can cause liver cancer if left untreated.
• The convention, hosted by the Gastroenterology and Hepatology Association of Sub-Saharan Africa, adopted a declaration that African countries prioritise national hepatitis elimination plans.
• South Africa’s national health department deputy director-general conceded that there were gaps in the government’s programme.

The African Viral Hepatitis Convention, held in Cape Town, has put a spotlight on the need to eliminate from the African continent hepatitis B and C, the “silent disease”.

The World Health Organisation(WHO) says Africa “accounts for 63% of new hepatitis B infections, and yet only 18% of newborns in the region receive the hepatitis B birth-dose vaccination”.

In South Africa, 2.8-million people are infected with hepatitis B and 240,000 have chronic hepatitis C. Of those with hepatitis B, only about 23% have been diagnosed.

The convention, hosted by The Gastroenterology and Hepatology Association of sub-Saharan Africa (GHASSA) in conjunction with the International Hepato-Pancreato Biliary Association (IHPBA), took place over several days.

On the last day, a declaration was adopted, demanding the “immediate prioritisation of national elimination plans”, allocation of resources domestically, and the political commitment to eliminate hepatitis.

“As a community of people living with viral hepatitis, advocates for those living with viral hepatitis, healthcare workers, academics and those who simply care, we say no more … All the tools to eliminate viral hepatitis are available and are uncomplicated interventions,” the declaration read.

The convention follows a WHO 2024 global hepatitis report that says globally deaths are on the rise and that 1.3 million people died of viral hepatitis in 2022, with hepatitis B causing 83% and hepatitis C causing 17% of deaths.

In Africa, 300,000 people died from hepatitis B and C. This is despite having the “knowledge and tools to prevent, diagnose and treat viral hepatitis”.

There are vaccines available for hepatitis B, and hepatitis C can be cured with medication. Hepatitis B is spread through blood and bodily fluids.

Hepatitis-related liver cancer rates and deaths are also on the rise, according to the WHO report.

At the convention Mark Sonderup, a hepatologist at Groote Schuur Hospital, said, “Inaction now results in a bigger problem later.”

Danjuma Adda, former president of the World Hepatitis Alliance, spoke about stigma as barriers to receiving care.

“Because of high stigma we have low testing because people are not motivated to be tested … We need to change the narrative,” he said.

Anban Pillay, the deputy director-general of the National Department of Health, said that at a national level, guidelines around hepatitis education and treatment can be created, but there “has to be advocacy at a local level” too. He also stressed the importance that voices of patients on the challenges they face be heard at a national and provincial level.

Pillay said that the conference had highlighted “gaps in our programme” and that it will identify and implement interventions that have worked in other countries.

At the end of the last session of the hepatitis convention, the declaration was read and signed by those in attendance.