JULY/AUGUST 2020: Vol 46 oice hep YourV magazine from the World Alliance WHA members shine on

World Hepatitis Day reaches millions

hepinion: Why we need World Hepatitis Day now more than ever

WALL OF STORIES “Today, my hepatitis is a friend. It reminds me that I have to live each day intensely.” hep Voice JULY/AUGUST 2020 1 NOTE FROM OUR CEO Contents Stay connected www.worldhepatitisalliance.org Welcome to hepVoice. Regulars I hope you are well and that, despite the ongoing [email protected] COVID-19 pandemic, you found World Hepatitis Day www.facebook.com/worldhepalliance (WHD) successful for raising awareness and reaching 4 hepHeadlines new people. @Hep_Alliance I have really enjoyed keeping up with members' and 8 Dates for the diary WHD supporters' activities on social media and, as @worldhepatitisalliance ever, have been so inspired by your creativity and your Features commitment to supporting your communities. We have included a tiny snapshot of your many brilliant WHD events and activities on page 14, and I look forward to 10 World Hepatitis Day message 22 WHO: fast-tracking the hearing about many more. from WHA President elimination of among mothers and children To help us build a better picture of the impact of WHD Don’t this year, how it was affected by COVID-19, and how 12 World Hepatitis Day impact miss out we can work to make future WHDs even better, I invite 26 - receive welcomes four new members you to complete the 2020 World Hepatitis Day survey. 13 Thousands sign NOhep's hepVoice open letter straight This World Hepatitis Day, I especially enjoyed watching 28 Investment in to your the first-ever WHD global relay travel across the 14 WHA members shine on World elimination in Punjab will inbox! world, marking the start of WHD from New Zealand to Hepatitis Day save money and lives Hawai'i; you can find out more about it on page 16. 16 #WHDRelay passes through 37 30 New funding looks to support In this packed edition of hepVoice, we also bring you some of the major news countries on WHD catalytic efforts to tackle and releases from WHD. These include the World Health Organization (WHO)'s plans to fast-track the elimination of hepatitis B among mothers and children, the 18 hepinion: Why we need announcement of new grants that aim to provide catalytic funding for hepatitis World Hepatitis Day now more 32 Find the missing Millions: programmes, and a new report that reveals that more than half a million lives than ever inspiration from Nigeria could be saved in Punjab state, India, with increased investment in hepatitis C elimination. 34 Wall of Stories: Juana's story

I also explore why World Hepatitis Day 2020 was more important than ever; read my hepinion on page 18. Want to contribute? Congratulations to everyone who helped make World Hepatitis Day a global success this year, even in the face of a global health pandemic. We welcome your contributions so please get in touch at [email protected] to have your news and stories included in future issues and feel free to share this magazine with your network.

2 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 3 Cary James hep headlines Hepatitis is regularly making the news thanks to the efforts of WHA members. Here are a few highlights.

Scottish health NHS Tayside developed Nigeria aims to trust claims to a new approach reduce chronic have “effectively to testing for and hepatitis B Sarwar Foundation and University of Health Sciences eliminated” treating hepatitis C in prevalence to less Lahore sign a memorandum of understanding 2012, which focuses hepatitis C than two per cent in The government also Perveen Sarwar, on people who inject Hepatitis Free children under five announced that it Vice-Chair of Sarwar drugs (PWID). Unlike Pakistan campaign has made significant Foundation, said that previous programmes, launched progress towards the organisations had this new approach increasing access made a joint pledge to does not restrict access to the hepatitis B test and treat a million to curative therapy birth dose vaccine people across Pakistan until a person enters a through domestic by 2021. A health board in recovery programme or contribution to Scotland, UK, claims stops using drugs. financing Sarwar Foundation, to be the first region in At an event held in collaboration Professor John programmes. the world to effectively to mark World with UHSL and 14 Dillon, consultant Sarwar Foundation, a eliminate hepatitis C. Hepatitis Day (WHD) At the event, other organisations, hepatologist and Pakistan-based NGO, 2020, the Nigerian health minister Dr. will hold hepatitis The National Health gastroenterologist, and the University Federal Government Osagie Ehanire also awareness and Service (NHS)’s Tayside said this approach of Health Sciences announced that it is launched a new policy screening camps in Trust says it has challenged previous Lahore (UHSL) signed working on a number document: “Road Map both rural and urban reached elimination thinking that the lives a memorandum of of interventions to Set Up a State Viral areas. There will four years ahead of of PWIDs were too understanding (MOU) that will reduce the Hepatitis Program”. also be a particular Scotland’s national chaotic to allow on World Hepatitis Day prevalence of hepatitis focus on reaching target, and 10 years for sustained and have announced B among children aged Read more here. people who could ahead of the 2030 hepatitis C treatment. their intention to under five to below not otherwise afford goals laid out by provide free testing two per cent. testing or treatment. the World Health Read more here. and treatment for hepatitis in Pakistan. Organization (WHO).

4 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 5 Mrs Sarwar said: reduction services in health challenge of Professor Ed Gane hepatitis by 2030 at out in February. “Unfortunately, a large Hawai‘i - launched the viral hepatitis.” has called for better risk, according to the number of patients in state’s first hepatitis awareness of the Indonesian Ministry She said: "There’s Pakistan cannot afford elimination strategy, Find out more and read condition and has of Health. nothing [patients] can to get themselves “Hep Free 2030”. the full strategy here. urged family doctors do apart from wait. tested, let alone the and community health According to ministry Those in early stages treatment. Our aim This new, community- Leading doctor providers to data, there was a 41 of hepatitis C can wait, is to reach out to driven strategy is the calls for mass increase testing. per cent decline in the but those in late stages those who are result of extensive hepatitis B testing number of pregnant just can't. We are racing financially challenged. consultation with for Māori, Asian and He said: “Hepatitis B is women undergoing against time and representatives from Pacific Island adults still a big problem in early detection for losing lives." “We will hold free more than 50 agencies New Zealand, 33 years hepatitis B between camps in various cities and with people after we had a vaccine. January and June Wiendra Waworuntu, of Pakistan where we affected by or living 2020 compared to the Prevention and will provide free testing with viral hepatitis “Most people don’t same period in 2019. Control Director, said: facilities and those who in Hawai’i. know they have it until The number of people "The pandemic will test positive will be they get a complication undergoing early certainly disrupt our given free medication.” Mazie Hirona, United and develop liver detection for hepatitis targets surrounding States Senator, said: failure or cancer. C among at-risk hepatitis elimination Read more here “The launch of ‘Hep A leading doctor in New communities fell by 60 [...] We'll look into how "We need more testing Free 2030: The Hawai’i Zealand has called for per cent in the we can catch up with of adults. Māori, Pacific Hawai’i launches viral Hepatitis Elimination mass hepatitis B testing same period. programs [we might hepatitis elimination Strategy 2020- for all adult Māori, and Asian adults have missed]." strategy 2030’ represents Asian and Pacific should all be tested." As well as interrupting an aggressive and Island people. screening and early Read more here Read more here. comprehensive effort to dectection programmes Māori, Asian and make Hawai’i the first COVID-19 threatens and vaccination drives, state in the nation Pacific Island people the pandemic has Indonesia's hepatitis to eliminate are disproportionately also disrupted the elimination progress viral hepatitis. affected by viral supply chain of hepatitis, with imported drugs. On World Hepatitis "This groundbreaking hepatitis B causing Day, Hep Free endeavour will help 50 per cent of liver Caroline Thomas from Hawai’i - a coalition save thousands of lives cancer deaths among hepatitis support group of over 90 local, across our state and these communities Peduli Hati Bangsa national, and global serve as a model for compared to only 10 revealed that stocks of The COVID-19 partners dedicated to other states to address per cent for people of daclatasvir — a curative pandemic has put increasing awareness the serious public European heritage. therapy for hepatitis C Indonesia's target of and access to viral which is provided by the of eliminating viral hepatitis and harm government — had run

6 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 7 Participating in a hepatitis related activity or have an event planned?

Email us on [email protected] or contact us on social media. 19 - 26 september Global Goals Week

Dates for the Diary The countries of the United Nations made a universal promise to leave Upcoming events and activities taking place in the no one behind in achieving a peaceful and prosperous world by 2030. Global Goals Week is a shared commitment of partnership between coming months. civil society, business, academia and the UN system to push action on the Sustainable Development Goals (SDGs), especially during the . It is also an opportunity to speak 27 - 29 august UN General Assembly High-level Week out as one voice, and share ideas and transformative solutions in the The Digital International Liver Congress fight to build back better from global challenges. Find out more here. Given the continuing impact of the COVID-19 pandemic and resulting restrictions, the European Association for the Study of the Liver (EASL) 13- 16 november has decided to transition the onsite International Liver Congress The Liver Meeting Digital Experience 2020, planned for 25–28 August, to a digital event –The Digital International Liver Congress 2020, which will be held between The American Association for the Study of Liver (AASLD)'s 27–29 August 2020. Liver Meeting is going digital!

The Digital International Liver Congress 2020 will be an innovative The Liver Meeting Digital Experience will bring together attendees and engaging digital event for the liver community to connect and from around the world to exchange the latest research, discuss new learn via cutting-edge content. Find out more here. developments in treatment outcomes, and network with other experts in the field. Find out more here 10- 12 september Conference on Liver Disease in Africa (COLDA) 2020

The Conference on Liver Disease in Africa (COLDA) is going virtual!

COLDA 2020 aims at empowering African healthcare professionals (HCPs) to diagnose, prevent, treat, and achieve a cure for liver diseases for the benefit of patients in Africa.

Please visit the meeting website for more information on abstract submission and discounted registration fees: www.COLDA.org How did you mark World Hepatitis Day? Did COVID-19 impact your plans? What do you think our focus for WHD 2021 should be? Please tell us by filling in our 2020 World Hepatitis Day survey. Your answers will help us build the WHD global impact report.

Click here to complete the survey. 8 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 9 World Hepatitis Day message from WHA President, Dr. Su Wang

World Hepatitis Day 2020 is an World Hepatitis Day is our day world enters a period with a difficult important landmark for the hepatitis to speak in a united voice and to financial outlook. It will be far too community. We are now just ten years celebrate how far we have come easy for governments to do nothing, away from the 2030 elimination towards eliminating viral hepatitis. however investing in hepatitis targets set out by WHO in 2016. With It also gives us time to pause and elimination now will save money, concerted effort over the next decade reflect on the countless lives that strengthen health systems and avert we can eliminate this global killer have been lost to these diseases over seven million deaths. and save millions of lives. Sadly, despite there being a vaccine and transmission to their infants and also 2020 is also the year the COVID-19 effective treatment for hepatitis B One of the easiest and most for their own health. Countries must pandemic gripped the world. The and a cure for hepatitis C. cost-effective interventions is integrate hepatitis into maternal crisis has had a significant impact on the Prevention of Mother to Child and child health services in order to the viral hepatitis community, with This year on World Hepatitis Day, Transmission (PMTCT). On World protect their next generation. This prevention, testing and treatment the World Hepatitis Alliance and Hepatitis Day, the World Health must also be seen as a woman’s services affected and many people the NOhep movement are calling on Organization released new guidelines health issue because elimination living with viral hepatitis facing policy makers to keep the promise on PMTCT, an issue which is will not be achieved without difficulties in obtaining the care and they made to eliminate viral hepatitis particularly close to my heart. As gender equality. medications they need. by 2030. Viral hepatitis is a global someone living with hepatitis B and health crisis, but one that a mother, one of the most important “It is my sincerest wish that “I know the resilience of can be overcome. milestones in my life was seeing that World Hepatitis Day 2020 our community in the face the PMTCT interventions worked, and is a catalyst for action, Progress is being made. Over 124 my children all tested immune and of adversity” countries have developed or are they are hepatitis B free. I do not even in the face of the developing elimination strategies. have to live with the burden of having COVID-19 pandemic.” I am acutely aware of how the However, many of these strategies do passed on this lifelong to pandemic has affected the global not have funding. On World Hepatitis my children. It is unconscionable that It is my sincerest wish that World hepatitis community and your plans Day, WHA released a new report with the tools we have available, Hepatitis Day 2020 is a catalyst for World Hepatitis Day. But I know from India Punjab State which lays there are still many children infected for action, even in the face of the the resilience of our community in the out the financial case for hepatitis every year with hepatitis B. We COVID-19 pandemic. Let us raise our face of adversity, and I have full faith C elimination. It shows that scaling must ensure that birth dose is given collective voices and work together to that the hepatitis community utilised up their response to ensure they to all children. But that alone is eliminate hepatitis. every opportunity to raise awareness reach elimination by 2030 is not only not enough - all pregnant women on 28 July. achievable but is cost saving. These must be screened for hepatitis B so Thank you for your commitment, and financial cases are imperative as the that we can identify those who may I hope you had a highly successful need antiviral treatment to prevent World Hepatitis Day.

10 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 11 World Hepatitis Day: Thousands of people and the results are in! organisations sign NOhep’s Thank you to everyone who helped make it a success! World Hepatitis Day open letter

More than 2,500 people and 300 organisations from around the world signed NOhep’s World Hepatitis Day open letter, which urges governments worldwide to keep their promise to eliminate viral hepatitis by 2030.

The people and organisations who have backed NOhep’s global call-to-action come from more than 100 countries, which shows that viral hepatitis is a truly global issue and that people all over the world want their leaders to take urgent action to tackle it.

NOhep will soon be sending this letter to every ministry of health in the world. For updates on this campaign and to get involved with NOhep‘s future work, join the movement here.

12 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 13

Monuments all over the world were lit up green, purple or yellow to mark World Hepatitis Day! What a great way to raise awareness even if there are WHA members shine on World Hepatitis Day restrictions on face-to-face events! Undaunted by the ongoing COVID-19 pandemic, WHA members all over the world came together to mark World Hepatitis Day and raise awareness to help #FindTheMissingMillions

Nigeria North Macedonia United States of America Philippines United Kingdom Australia

Bangladesh United Kingdom Turkey Uganda Australia

Turkey United Kingdom Indonesia Australia

From TV interviews to testing events, WHA members all over the world unleashed their 14 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 15 creativity on World Hepatitis Day! Australia #WHDRelay passes through 37 countries on World Hepatitis Day

The COVID-19 pandemic may have meant that many planned World Hepatitis Day events and activities couldn’t go ahead. However, it didn’t stop World Hepatitis Alliance members, policymakers, and World Hepatitis Day supporters from all over the world from uniting to take part in the first ever WHD virtual video relay! The #WHDRelay passed through 37 countries across every timezone, marking the start of World Hepatitis Day from New Zealand to Hawai’i. You can relive the relay by watching regional highlights - click on each of the images on this page to watch the corresponding regional video!

16 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 17 Why We Need World Hepatitis Day Now hepinion More Than Ever By Cary James, CEO World Hepatitis Alliance

In 2016, every government in the Eliminating hepatitis isn’t just losing their jobs and opportunities world committed to achieving the about eradicating an illness — for study. People are denied even World Health Organization’s target it’s about achieving social justice basic rights — all because of their of eliminating viral hepatitis by and human rights. People living hepatitis diagnosis. 2030. However, with just 10 years with hepatitis regularly face to go, only a handful of countries stigmas and discrimination that Not only this, but the people and are on track to reach this goal. impact their health, work, and communities most affected by viral relationships. People are cast out hepatitis are also often those most Despite a lack of global progress, from their communities and fear underserved by health systems. there is hope. There is a cure for Continued on next page hepatitis C. There is an affordable vaccine and effective treatments for hepatitis B. We have the tools A lack of specific symptoms to reach elimination and transform means 9 in 10 people people’s health, but we must living with viral hepatitis make our resources available to are completely unaware everyone who needs them. they have it. Undiagnosed, We must also find the millions hepatitis B and C can cause of people who are unaware they cirrhosis, liver cancer, are living with viral hepatitis. and premature death, yet Otherwise, millions will continue to die as a result of a preventable, public awareness of these treatable, and — in the case of so-called “silent killers” hepatitis C — curable condition. remains worryingly and life- threateningly low. “Eliminating hepatitis isn’t This is a key year in the journey just about eradicating toward eliminating viral hepatitis an illness — it’s about as a global threat. achieving social justice and human rights.”

18 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 19 With COVID-19 restricting people’s “The elimination of viral access to hepatitis prevention, testing, and treatment — and hepatitis is within our reach potentially impeding global — we must not allow it to progress toward hepatitis slip from our grasp. Join us elimination — World Hepatitis Day has never been more important. and we can win this fight together.” Even during a pandemic, it is critical that we leverage World The elimination of viral hepatitis Hepatitis Day to raise awareness is within our reach — we must not of viral hepatitis online and, allow it to slip from our grasp. where safe and possible, in our Join us and we can win communities. We must also carry this fight together. on the momentum of World Hepatitis Day and continue this vital work throughout the year. of lives lost. It is an opportunity “We cannot stand by and to increase awareness among the allow these injustices public, and advocate for to continue.” greater political action and financial investment. We cannot stand by and allow these injustices to continue. By “With COVID-19 achieving elimination, we will create a more equal world, and restricting people’s protect the health and rights access to hepatitis of some of the world’s most prevention, testing, vulnerable people. and treatment — and The global community comes potentially impeding together each year on 28 July to global progress mark World Hepatitis Day. It is a day to acknowledge the progress toward hepatitis that has been made toward elimination — World eliminating viral hepatitis, and to Hepatitis Day has pause and reflect on the millions never been more important.”

20 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 21 World Health Organization: fast-tracking the elimination of hepatitis B among mothers and children

The proportion of children under On World Hepatitis Day 2020, WHO five years of age living with chronic is calling for united and stepped-up hepatitis B virus dropped to just action to build on this achievement under one per cent in 2019 down through intensified efforts to prevent from around five per cent in the mother-to-child transmission of pre-vaccine era (the period between the hepatitis B virus through testing the 1980s and the early 2000s), pregnant women and provision according to new estimates from the of antiviral prophylaxis to those World Health Organization (WHO). who need it and maintaining and expanding access to hepatitis B This marks the achievement of one immunisation and birth dose vaccine. of the milestone targets to eliminate viral hepatitis in the Sustainable Globally, more than 250 million Development Goals - to reach under people are living with chronic 1 per cent prevalence of hepatitis B in hepatitis B. Infants are especially children under five years vulnerable: about 90 per cent of of age by 2020. children who contract hepatitis B in their first year of life become chronic “No infant should grow up only to hepatitis B carriers. The hepatitis B die of hepatitis B because they were virus attacks the liver and claims the The scale-up of hepatitis B vaccine dose is 43 per cent but this drops not vaccinated - today’s milestone lives of nearly 900,000 people worldwide over the last two decades, to 34 per cent in the WHO Eastern means that we have dramatically each year. reduced the number of cases of which has been in large part due Mediterranean Region and only 6 per to the support provided by Gavi, cent in the WHO African Region. liver damage and liver cancer in Preventing hepatitis B future generations,” said Dr Tedros the Vaccine Alliance, has been a great public health success story “Expanding access to a timely birth Adhanom Ghebreyesus. “Preventing Infants can be protected from and contributed to the decrease dose of the hepatitis B vaccine is mother-to-child transmission of hepatitis B through a safe and in hepatitis B among children. In the cornerstone of efforts to prevent hepatitis B is the most important effective vaccine that provides over 2019, coverage of three doses of the mother-to-children transmission of strategy for controlling the disease 95 per cent protection against hepatitis B vaccine during childhood hepatitis B. For countries especially in and saving lives. Even in the midst infection. WHO recommends that reached 85 per cent worldwide, up regions such as sub-Saharan Africa, of the COVID-19 pandemic, we must all infants receive a first dose of from around 30 per cent in 2000. where the birth dose of hepatitis B ensure that mothers and newborns the hepatitis B vaccine as soon as However, access to the first critical vaccine has not yet been introduced, have access to life-saving services possible after birth – preferably dose within 24 hours of birth remains it is a priority to assure that including hepatitis B .” within 24 hours – followed by at uneven. Global coverage of this birth protection as early as possible,” said least 2 additional doses.

22 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 23 Dr Meg Doherty, Director of Global need is an additional opportunity to per cent for one year respectively), children born between 2020 and HIV, Hepatitis and STI Programmes. prevent onward transmission from as well as a delay and slow recovery 2030 and one million additional mother to child. in the expansion of the vaccination hepatitis B-related deaths among An additional way to protect children programme towards the planned those children later on. Thus, is to provide pregnant women “Stopping vertical transmission of 2030 WHO-targets in the post missed opportunities now to with antiviral treatment to reduce hepatitis B is a key pillar of the COVID-19 period, there would be prevent new hepatitis B mother-to-child transmission global ‘triple elimination’ initiative, a projected 5.3 million additional will have a long-lasting and of hepatitis B. WHO already which seeks to eliminate mother- chronic hepatitis B infections among life-impacting effect. recommends routine testing of all to-child transmission of three pregnant women for hepatitis B, as infections that are prevalent in low- well as HIV and syphilis as early as and middle-income countries: HIV, World Health Organization possible in their pregnancy. In view syphilis and hepatitis B virus,” added launches new guidelines of new evidence on the safety and Dr Doherty. efficacy of antiviral prophylaxis in for the prevention pregnant women and their children, Eliminating mother-to-child of mother-to-child WHO is issuing today two transmission of hepatitis B is also an transmission of hepatitis B new recommendations: important stepping stone for reaching the targets of WHO’s global hepatitis Elimination of hepatitis B as a 1) Pregnant women who test positive strategy, which aims to reduce new public health threat requires a for hepatitis B and have a high level hepatitis infections by 90 per cent reduction in the prevalence of of the virus in the blood (known and deaths by 65per cent, compared hepatitis B surface antigen (HBsAg) as HBV viral load) should receive to 2015 levels. to below 0.1% in children five preventive antiviral therapy with years of age. This can be achieved tenofovir from the 28th week of The COVID-19 pandemic through universal immunisation pregnancy until birth. The antiviral jeopardizes future progress of newborns against hepatitis B drug, tenofovir is available at low and other interventions to prevent cost in many countries of the world COVID-19 threatens to hamper mother-to-child transmission of for less than US$3 per month. progress in eliminating hepatitis the hepatitis B virus. B. According to a new modelling 2) In settings where HBV viral study conducted by Imperial College The World Health Organization’s load testing is not available, WHO London in collaboration with newly-published guidelines recommends the use of an alternative WHO, disruptions to the hepatitis |provide evidence-based guidance low cost test (HBeAg) to determine B vaccination programme due to on the use of peripartum antiviral whether a woman is eligible for the pandemic could have a serious prophylaxis in HBsAg-positive preventive antiviral therapy. impact on efforts to reach the targets pregnant women for the prevention of the global strategy. of mother-to-child transmission In countries that have already of hepatitis B. achieved high coverage of hepatitis B Under a worst-case scenario, with immunisation, including timely birth high levels of disruptions of both Click here to download dose, routine testing for hepatitis the birth dose and childhood HBV B among pregnant women and immunization (by 60 per cent and 20 the guidelines antiviral prophylaxis for those in

24 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 25 WHA welcomes four new members Rights and Development for All – RADFA WHA has recently welcomed four new members to the Based in Pakistan, RADFA is dedicated to promoting diversity and organisation, which now cultivating women and youth leadership in tribal areas to achieve gender equality. Health is one of the many pillars that form the represents 303 members infrastructure of their organisation. across 98 countries. Through their work they have discovered how hepatitis rates are Manluku Youth Development growing in the tribal communities of Pakistan. In 2018, RADFA arranged for 10 doctors to deliver awareness-raising sessions on viral hepatitis Based in Tanzania, Manluku Youth Development's main aim is to to over 1,000 people in tribal areas. These people were encouraged to improve the lives and living standards of young people in rural go on and deliver further training in the surrounding communities, with areas of Tanzania. the aim that everybody becomes aware of viral hepatitis. These same doctors are also attempting to identify those living with chronic viral They have a broad range of objectives linked to their mission, including hepatitis so they can put them on the pathway to treatment. the delivery of sexual and reproductive health and rights education to young people both in and out of school. Follow them on Facebook here and Twitter here.

Their key hepatitis activities focus on raising awareness of hepatitis B and promoting the need for testing and vaccinations.

Follow them on Facebook here and Twitter here. Meson de la Misericordia Divina, A.C.

Mexico-based Meson de la Misericordia Divina, A.C. work to integrate viral hepatitis programmes with existing HIV and sexual health services through Universal Health Coverage. Organization For Medical Outreach To Communities (OMOC) They provide basic information on hepatitis B and C, and encourage rapid testing for timely hepatitis diagnosis and referral to hepatitis B vaccination Organization For Medical Outreach To Communities (OMOC) are for people who test negative. They provide advice for integrating hepatitis based in Tanzania. They aim to expand access to quality, affordable programmes into health services for monoinfection or coinfection, including health care and health education, especially for people experiencing sexually transmitted infections such as syphilis and HIV. poverty. They also work towards micro-elimination within key populations, and work They have six key focuses around hepatitis: education; advocacy; especially with men who have sex with men (MSM) and people living screening and linkage to care or vaccination; raising awareness; with HIV/AIDS (PLHIV). expanding Tanzania's one dedicated hepatitis clinic; and research. Follow them on Facebook here Follow them on Facebook here and Instagram here.

26 hep Voice JULY/AUGUSTJULY/AUGUST 20202020 hep hep V V oice oice JULY/AUGUSTJULY/AUGUST 2020 2020 27 27 New report reveals investment in hepatitis C elimination in Punjab State could save more than 500,000 lives

On World Hepatitis Day (28 MAKING THE INVESTMENT CASE FOR To help address this, the World Hepatitis the different financing options required July) 2020, the World Hepatitis HEPATITIS C ELIMINATION Alliance’s financing for viral hepatitis to fully fund national viral hepatitis programme works in partnership elimination plans — in 2017 in Nigeria. Alliance (WHA), in partnership To develop the investment case for with Ministries of Health, civil society WHA worked with the Ministry of Health with the Ministry of Health hepatitis C elimination in Punjab state, organisations and other partners to in Nigeria, WHA members in the country, in India Punjab State and the WHA partnered with the SVHMU, WHA take a strategic approach to financing a and the Clinton Health Access Initiative Clinton Health Access Initiative members, CHAI and other stakeholders. comprehensive hepatitis C response. (CHAI), to cost, create the investment case and explore financing options for (CHAI), released a new report: The aim of this work was to give the SVHMU a robust tool to help in their WHA launched this pioneering Nigeria’s hepatitis C programme. The Developing an HCV Investment efforts to obtain increased domestic programme — which looks beyond just full report can be accessed here. Case for Punjab (India) investment in hepatitis elimination making the investment case to explore services. Launched on World GLOBAL LEADER Day (28 July) 2020, you can read the full report here. India’s Punjab State is a global leader in the hepatitis response. Since 2016, During the development of the Punjab State has provided free hepatitis investment case, two scenarios were C treatment to all residents, treating costed using a bottom-up approach: 69,684 people between 2016 and status quo and elimination. While August 2019. It is the first state in India the status quo scenario does not to launch such a programme. reach elimination, the elimination scenario achieves elimination by Despite the progress made in Punjab 2030 and was found to be not only State to date, the State Viral Hepatitis cost-effective but cost-saving. In Management Unit (SVHMU) within the fact, if an additional ~US$37 million Punjab State government identified (US$3.4 million per year) is invested that, without a scale-up of their in Punjab for hepatitis C in the next current interventions and roll out of 11 years, Punjab will not only reach new interventions — including increased elimination, but will save a staggering awareness-raising, workforce training, 550,000 lives and US$188 million. and decentralisation of the response to primary and community health care ABOUT WHA’S STRATEGIC FINANCING centres—, they would fail to reach PROGRAMME elimination. Financing continues to be a major In order to achieve hepatitis elimination, barrier to the elimination of further funding and a viable financing viral hepatitis. plan would be required.

28 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 29 New funding looks to support catalytic efforts to tackle viral hepatitis globally ●● Expand public engagement ●● Support efforts to maintain the On announcing the grants Mr. in hepatitis B/hepatitis C and momentum for a global campaign to Wangsheng Li, President of The Hepatitis crowdsource to spur needed policy eliminate viral hepatitis. Fund, highlighted: changes. ●● Implement a decentralized and “Hepatitis is the most neglected ●● Demonstrate an integrated viral integrated strategy through a On World Hepatitis Day infectious diseases relative to its hepatitis strategy to increase access national capacity building training 2020, The Hepatitis Fund burden globally. The Hepatitis Fund to diagnostic and treatment services programme in Sub-Saharan Africa. is solely dedicated to supporting viral in major urban areas with high announced a series of Wangsheng Li continued, “We’re grateful hepatitis elimination. The grants are prevalence in East Asia. to ZeShan Foundation, our seed funder, grants which will accelerate intended to have a sustainable impact, ●● Support a regional approach to for its visionary leadership and its improving health systems and saving efforts to eliminate viral hepatitis policy change in the Andean steadfast commitment to our cause lives whilst providing evidence of the region. since the inception of this project.” hepatitisas a global health opportunity and feasibility to accelerate hepatitis elimination. This funding will threat as articulated by the ●● Strengthen capacity for national The Hepatitis Fund has ambitious enhance countries’ efforts to build WHO Global Health Sector hepatitis planning across the world. plans to step up the funding available effective elimination strategies within to tackle hepatitis globally; and is Strategy. the framework of Universal Health ●● Develop a monitoring and evaluation calling on more institutional donors Coverage.” logframe for viral hepatitis catalytic In 2016, at the World Health Assembly, funding. and like-minded philanthropists to join all 194 member states of the World its campaign to raise US $ 1 billion to The programmes funded through The ●● Demonstrate how to effectively Health Organization adopted a tackle hepatitis in low- and middle- Hepatitis Fund are innovative projects increase hepatitis C screening and resolution committing to the elimination income countries by 2030. that are scalable and replicable and will treatment by mobilizing rural health of viral hepatitis by 2030. However, this look to tackle a key barrier to hepatitis centres in high prevalence settings in ambitious but achievable goal has been Progress on each grant will be posted elimination. South Asia. by and large an unfunded mandate, regularly on the fund’s website. resulting in very few countries being on The grants totalling over US$3 track to reach this goal. The Hepatitis Fund aims to accelerate the global million will: efforts by providing catalytic funding. ●● Produce data analytics which will be used to inform policy formulation, national planning and “Hepatitis is the most implementation in Sub-Saharan neglected infectious Africa. ●● Develop and roll-out an operational diseases relative to its guide to assist countries in performing burden globally." monitoring and evaluation in the WPRO and SEARO regions.

30 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 31 Inspiration from around the world

awareness on hepatitis as a public health concern in Gombe state. Inspiration from To help address this, during World Hepatitis Day (WHD) 2019, SCDI conducted a range of awareness- around the raising and advocacy activities in collaboration with the state ministry world - Nigeria of health and other CSOs. Key activities included a sensitisation Through the Find the Missing rally, stakeholder engagement, a Millions campaign, we are press briefing and free hepatitis highlighting best practice and screening. We offered free hepatitis B innovations in screening and testing screening to over 500 people across so that other organisations can three locations, including the Emir’s learn and develop their national Palace and the state offices of the Nigeria Security and Civil Defence activities. This month, we hear from Council and Gombe State Agency for Sufabel Community Development the Control of AIDS. Initiative from Gombe State, Participants during the for example the Society for Women Nigeria. Importantly, we also used this commemorative event on WHD Development & Empowerment of opportunity to increase the included: representatives of the Nigeria, Network of People Living with It is estimated by the Gombe State awareness and understanding of the State Ministry of Health, Gombe HIV/AIDS and members of three key Ministry of Health that the prevalence public by sharing flyers containing State Agency for the Control of AIDS population-led community-based of hepatitis B in the state is information about the signs, (GomSACA), State AIDS & STI Control organisations in the state. 11 per cent. symptoms, prevention and treatment program (SASCP) and other CSOs, of hepatitis. The inclusion of images As a community-based organisation, showing the progression of hepatitis SCDI conducted a routine assessment Keys to our success and a damaged liver on the flyers to determine the knowledge of viral incited shock amongst the public and hepatitis among beneficiaries of its ●● We built good working relationships with other organisations and local it was clear that many of them had funded (TB) programme authorities: the strong presence of SCDI and its good working relationship never heard about the disease. for Nomads (the Koninklijke with CSOs and key actors in the state health sector made it easier to Nederlandse Centrale Vereniging SCDI also conducted an advocacy visit mobilise partners for awareness raising and testing activities on WHD. tot bestrijding der Tuberculose). to the Permanent Secretary, Gombe This assessment revealed a lack State Ministry of Health, urging ●● We employed a robust networking strategy: SCDI created a WhatsApp of awareness of the diseases. More the creation of a unit to coordinate group and used it to mobilise CSOs and interest groups. so, feedback from civil society hepatitis intervention across ●● We targeted key populations: SCDI, through its TB projects, targeted the organisations (CSOs) implementing the state. HIV/AIDS programmes for general most underserved communities (Fulani Nomads) and have developed and key populations provided further increased knowledge of the state’s population dynamics. evidence which supported the lack of

32 hep Voice JULY/AUGUST 2020 Click here to read more Find the Missing Millions case studies from around the world hep Voice JULY/AUGUST 2020 33 “Today, my hepatitis Wall of Stories: Juana is a friend. It reminds me that I have to live Together, our stories can That was the jolt I needed to revive I was also motivated to spend a lot of my life. my time on other altruistic tasks. All each day intensely.” change the way the world these activities helped me, especially sees viral hepatitis. At first, I was scared of what was to during the treatments which caused Today, my hepatitis is a friend. It come. I spent a lot of time looking me some depression. That is why I reminds me that I have to live each Each month we share the story of at studies and familiarising myself always suggest to other patients that day intensely. At the same time, it someone whose life has been affected and my family with hepatitis and the they find an occupation, a hobby, reminds me that if it hadn’t been for by viral hepatitis. This month, we impact it would have on something that they are passionate the condition, I would have grown old hear from Juana from Mexico, who our lives. about, something that — although it without reinventing myself. Without contracted both hepatitis B and C is difficult for them to get up — makes it, I would never remember my son, from a blood transfusion. I started the first treatment in 1999, them feel motivated and makes them the one I never knew and the one who and for 14 months — sometimes forget about the condition I discovered that I had both hepatitis gave me a new life... with more desire than strength — and discomfort. B and C a few months before my my family, my doctors and I fought. 50th birthday. Unfortunately, treatment was not If you have a positive attitude, I successful. However, a lot of changes believe it will definitely help your I didn’t have any symptoms at all. were coming to hepatitis treatments. medications work! I had never been a particularly There were new protocols and sick person, but I did have some new hopes, so I spent the next two problems with my pregnancies. And years regaining weight, hair, and that’s where my hepatitis came strength. In 2003, we started another, from. My last pregnancy was ectopic newer treatment with far fewer (outside the uterus) and nearly cost uncomfortable side effects. me my life; the doctors gave me a blood transfusion, and with it, both By Christmas of that year I had hepatitis B and C. successfully completed the treatment “The doctors gave me and had rediscovered myself. I was invited to join Fundación para a blood transfusion, la Salud Hepática, A.C (FundHepa), and with it, both a patient organisation, where I talk with other patients about what they hepatitis B and C.” are going to face. I also tell people about the many ways hepatitis can The doctor explained that if the be transmitted, and what they can do treatment did not work, he could to reduce the risk of contracting offer me a good quality of life for the condition. six years, and that in that time the medicines could improve. See more stories and submit your own at www.worldhepatitisalliance.org/wall-stories 34 hep Voice JULY/AUGUST 2020 hep Voice JULY/AUGUST 2020 35 hep Voice

www.worldhepatitisalliance.org

36 hep Voice JULY/AUGUST 2020