hepinion: The African Union must provide leadership for hepatitis elimination

21 Feb 2020 Lucy Ferrier

By Dr Alioune Coulibaly, WHA Board Member for the AFRO Region

In February the African Union met and the Presidency of the Union handed over from Egypt to South Africa. During Egypt’s presidency there has been a concerted effort to ensure hepatitis elimination is on the Union’s agenda, including the creation of the African Union Declaration on Hepatitis which committed African Union members to creating and financing hepatitis elimination programmes as part of the Universal Health Coverage framework.

Egypt has been a leading example of countries that are making vigorous efforts to eliminate hepatitis. Through their mass screening and treatment programme, the country has committed to finding and treating over one million people living with hepatitis C. This created momentum in the African Union. Countries including Chad, Eritrea and South Sudan are receiving support from Egypt and other agencies to catalyse their hepatitis elimination work.

However, now the Presidency moves to South Africa, a country which is less focused on hepatitis elimination, we need to ensure that momentum is not lost and that the promise to eliminate hepatitis by 2030 is met.

If we do not eliminate viral hepatitis in Africa, it will have consequences that reach far beyond health. I myself have seen the impact of viral hepatitis on the productivity and development of my country, Mali, and others. If people are sick, they may not be able to work, to complete their education, or to live the fulfilling life that every person deserves. If people do not know they are sick – which is very common with viral hepatitis – they cannot seek treatment, and they cannot adequately protect their loved ones from infection.

Despite challenges of climate and conflict in some countries, Africa is booming in so many ways – but if viral hepatitis is not addressed, it will continue to prevent many African nations from achieving their potential.

WHA attended the African Union meeting in February where WHA Past President Michael Ninburg moderated a session on viral hepatitis and met some members of the Organisation of African First Ladies for Development, a group with considerable influence on policy in Africa. We must continue to seize these opportunities to meet with and advocate to individuals of influence. Hepatitis advocates have a vital role to play to ensure that people living with viral hepatitis are heard and their voices are included on the health agenda, and hepatitis elimination will not happen in Africa if we do not speak up.

"Key to any elimination strategy in Africa will be the elimination of mother-to-child transmission of hepatitis B through screening all pregnant women, linking them to care and ensuring that babies receive the hepatitis B birth dose vaccine."

Key to any elimination strategy in Africa will be the elimination of mother-to-child transmission of hepatitis B through screening all pregnant women, linking them to care and ensuring that babies receive the hepatitis B birth dose vaccine. We must ensure that this tool is used to prevent mother-to-child transmission of this deadly disease. The vaccine can be administered easily and countries can obtain it at low cost. With it we can at least ensure that the next generation does not have the same burden of hepatitis B. We also need to raise so much awareness about this disease. It needs to be spoken about and the stigmas and myths, which are prevalent in some communities in Africa, dispelled.

We have been presented with a once in a lifetime opportunity to eliminate viral hepatitis in Africa. We have the tools. Civil society must play a key role in the journey. We need buy-in of and influence from our leaders and decision makers, including – and perhaps especially – the government of South Africa, as they take on the presidency of the African Union.

While there are many challenges to overcome, including financing, an upscale of diagnosis and testing, and political will, we must fight to ensure that we seize the opportunity and eliminate the disease to help every country in the African Union prosper.

"We must fight to ensure that we seize the opportunity and eliminate the disease to help every country in the African Union prosper."