MAY/JUNE 2020: Vol 45 oice hep YourV magazine from the World Hepatitis Alliance WHA members inspire during COVID-19 pandemic

hepinion: What COVID-19 teaches us about infectious and what we can learn from viral hepatitis

World Hepatitis Day website and campaign materials launched

WALL OF STORIES “My passion for preventing will live on even after I die” hep Voice MAY/JUNE 2020 1 NOTE FROM OUR CEO Contents Stay connected www.worldhepatitisalliance.org Welcome to hepVoice. Regulars [email protected] I hope that you and your loved ones continue to remain safe and well during the ongoing 4 hepHeadlines www.facebook.com/worldhepalliance COVID-19 pandemic. The pandemic has had an unprecedented impact on all of us, as well as 8 Dates for the diary @Hep_Alliance the many vital services delivered by hepatitis organisations around the world. However civil Features @worldhepatitisalliance society and community-led organisations are remarkably resilient, and I have been inspired by 10 WHA members inspire the ways in which many of you have adapted to during COVID-19 pandemic continue serving your communities at an incredibly challenging time. You can read about some of our 12 NOhep launches World Want to contribute? members’ recent activities on page 10. This is purely Hepatitis Day open letter a snapshot of the brilliant work that has been We welcome your contributions taking place around the world. I am sure all of so please get in touch at 14 WHA hosts COVID-19 webinars you have been doing all you can to support your [email protected] communities. to have your news and stories 16 : What COVID-19 hepinion included in future issues and (WHD) is now just around the teaches us about infectious diseases and what we can learn feel free to share this magazine corner. While there is no doubt that this year’s from viral hepatitis with your network. WHD will be very different to those of the past, it is as important as ever that we raise our voices Don’t 20 World Hepatitis Day: time to and join together to find the missing millions. miss out #FindTheMissingMillions - receive Read more about our new open letter, which will hepVoice be sent to every Ministry of Health in the world New estimates highlight straight after World Hepatitis Day, on page 12. You can also 22 need to step up response to to your find out more about the many other ways you hepatitis D inbox! can get involved and make the most of the day on page 20. I look forward to hearing about your WHD 24 Find the Missing Millions activities soon; please let us know what you have in-country programme update planned by getting in touch. 26 Find the Missing Millions: inspiration from Egypt

28 Wall of stories: Alice’s story

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

Inventor of hepatitis the virus the advancement of C cure wins from reproducing, in medicine on prestigious award 2007 and the drug every front. was approved for use in 2013. It is thought “The Cameron Prize that more than 95 per for Therapeutics cent of people living recognizes how with the most common science has been form of hepatitis C able to solve critical Infant immune percentage of babies Study author Niklas can be cured by the medical challenges system may be able who contract hepatitis Björkström said: “The treatment. for the betterment of to fight off hepatitis C B from their mothers immune system of the mankind, and it is for in the womb during pregnancy healthy babies shows Expressing his deep this recognition that I or birth. similar changes to honour for being am truly appreciative.” A new study conducted that in babies infected selected for the by researchers in Researchers compared with hepatitis C. This Dr Sofia’s focus is Dr Michael J Sofia, the award, Dr Sofia said: Sweden indicates that the immune systems of could suggest that now on discovering, medicinal chemist who “It is humbling to be the immune systems of babies born to mothers the immune cells developing a cure for devised the antiviral counted among those babies born to mothers with hepatitis C who have encountered the chronic hepatitis B. drug sofosbuvir, has who have transformed living with hepatitis had not themselves virus in the womb and medicine over contracted the virus to managed to eliminate been awarded the Read more here. C may be able to kill prestigious University the years. off the virus during the immune systems of it before birth.” of Edinburgh Cameron gestation. This could babies who had. Both “Today, as we are Prize for Therapeutics. explain why only five sets of babies had Researchers are faced with the spectre per cent of infants born adaptations in their B hopeful that this of a global pandemic, Dr Sofia developed to mothers who have lymphocytes, immune discovery could lead we are reminded that sofosbuvir, which hepatitis C contract cells that produce to improvements in we must continue to works by stopping the virus, a relatively antibodies that can hepatitis C treatment commit ourselves to small proportion identify and root out and prevention. compared to the foreign pathogens. Read more here.

4 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 5 Spike in hepatitis E and multifaceted examines the lived deaths in Namibia response to contain the experience of people NOhep launches . Most informal diagnosed with chronic settlements in the hepatitis B has revealed country are at risk of the extent to which new website outbreaks of the virus living with the virus due to poor sanitation impacts them. and a lack of access to safe drinking water. From fear and anxiety to stigma and Informal settlements Efforts to improve discrimination, the in Namibia have been sanitation and water paper highlights the hit by a sharp increase facilities, including psychosocial impact of in hepatitis E cases health education on chronic hepatitis B on and deaths, with more hand washing and the patients. than 7,500 suspected use of alcohol-based . sanitisers, have been The paper also intensified. Shangula spotlights the roles that Describing the is hopeful that such the research community outbreak, Namibian efforts will not only can play in taking into health minister help combat hepatitis account and mitigating Kalumbi Shangula E, but also COVID-19. these factors, and said: “The cumulative highlights how to NOhep, the global The site is packed with total of hepatitis E Read more here. the development of movement to eliminate information, materials, cases currently stands a cure for chronic viral hepatitis by 2030, top tips and case New paper highlights hepatitis B could go at 7,587, of which has a brand new website studies to help you raise 1,937 are laboratory- impact of chronic a long way towards confirmed, while hepatitis B on people alleviating many of the to help you kick-start your awareness and advocate 4,410 are epidemic- living with the virus psychosocial impacts of journey towards helping for the elimination of viral linked, and 1,240 are the virus. achieve NOhep and hepatitis in your country. still being treated as suspected cases. Read more here. saving lives. To date hepatitis E deaths stand at 65, of Visit the site now at www.nohep.org which 26 are maternal deaths.”

Shangula said that the government is looking A new collaborative at a multisectoral research paper which

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

Email us on [email protected] or contact us on social media. 27 - 29 august The Digital International Liver Congress Given the continuing impact of the COVID-19 pandemic and Dates for the Diary resulting restrictions, the European Association for the Study of the Liver (EASL) has decided to transition the onsite International Upcoming events and activities taking place in the Liver Congress 2020, planned for 25–28 August, to a digital event coming months. –The Digital International Liver Congress 2020, which will be held between 27–29 August 2020.

28 july The Digital International Liver Congress2020 will be an innovative and engaging digital event for the liver community to connect World Hepatitis Day and learn via cutting-edge content. Find out more here. 28 July is the biggest day in the hepatitis calendar - it’s World Hepatitis Day! Worldwide, 290 million people are living with september viral hepatitis unaware. Without finding the undiagnosed and 10- 12 linking them to care, millions will continue to suffer, and lives Conference on Liver Disease in Africa (COLDA) 2020 will be lost. On World Hepatitis Day we call on people from The Conference on Liver Disease in Africa (COLDA) is going virtual! across the world to take action and raise awareness to find the COLDA 2020 aims at empowering African healthcare “missing millions”. professionals (HCPs) to diagnose, prevent, treat, and achieve a Visit the World Hepatitis Day website to find out more and cure for liver diseases for the benefit of patients in Africa. learn how you can get involved. Don’t forget to use Please visit the meeting website for more information on abstract #WorldHepatitisDay on social media to help us reach as many submission and discounted registration fees: www.COLDA.org people as possible!

9 august International Day of the World’s Indigenous Peoples There are an estimated 370 million indigenous people in the world, living across 90 countries. They make up less than five per cent of the world’s population, but account for 15 per cent of the poorest. Indigenous peoples are also disproportionately affected by viral hepatitis, and may be up to 10 times more The World Hepatitis Alliance has launched a COVID-19 resource hub for likely to be living with viral hepatitis than the general people living with viral hepatitis. The hub will be updated regularly with population in their respective countries. Use #IndigenousDay to relevant information about COVID-19 and emerging news about how it raise awareness and to call for no one - including indigenous specifically impacts people living with viral hepatitis. peoples - to be left behind in the race to eliminate viral hepatitis. Visit the hub by clicking here or visiting www.worldhepatitisalliance.org/COVID-19

8 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 9 WHA members inspire Providing testing during COVID-19 pandemic

World Hepatitis Alliance members around the world have been working tirelessly to support their communities during the COVID-19 pandemic. Below is a tiny snapshot of activity - if you would like to tell us about your activities South Africa - TB HIV Care North Macedonia - Hepar Centar Bitola please email us on [email protected]. provided HIV and COVID-19 continued to provide hepatitis testing testing to the community. during European Testing Week.

Keeping medicines accessible Raising awareness of COVID-19

UK - The Hepatitis C Trust Uganda - Great Lakes Peace have been using their testing Center have been delivering Sierra Leone - Knowhep Pakistan - Back to the Life Sierra Leone delivered a and outreach van to deliver hepatitis medication on foot, Australia - Hepatitis Foundation held a COVID-19 COVID-19 and hepatitis hepatitis C medication. by bicycle and by motorbike. Australia have been awareness workshop and B sensitisation and providing information about distributed face masks and prevention session to helplines and have produced gloves for free. people who use drugs. a fact sheet for people living Providing essentials to the community with viral hepatitis.

Ensuring harm reduction

Switzerland - USA - Hep Education Arud Zentrum fur Project have been Suchtmedizin have continuing essential been delivering harm reduction clinics, India - RANN Foundation have USA - Berkeley Free Clinic’s opioids to patients taking new precautions been delivering essential supplies outreach team have been and continuing some to protect staff and including food and sanitary items installing hand hygiene facilities adjusted face-to- clients from COVID-19. to vulnerable people. and other essentials to people face services. experiencing homelessness. 10 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 11 10 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 11 NOhep launches open letter urging governments to keep their promise to eliminate hepatitis

In 2016, every government in the world made a commitment to eliminate viral hepatitis by 2030. With less than 10 years to go, only a handful of countries are on track to eliminate hepatitis C, and progress towards eliminating hepatitis B is lagging globally.

Now, it’s up to us to hold our governments to account and urge them to keep their promise to eliminate viral hepatitis.

That’s why NOhep, the global movement to eliminate viral hepatitis by 2030, has launched a new open letter, which will be sent to every Ministry of Health in the world after World Hepatitis Day. Now, we need YOU to add your voice to our call for action.

It’s really easy to get involved; simply visit the NOhep website, add your name and email address and click “Add your name”. Then, share the campaign on social media and encourage your friends, family, colleagues and networks to support it!

Together, we CAN make the elimination of viral hepatitis a reality!

You can read the full letter and add your name here. Urge your government to keep their promise to Sign the letter now eliminate hepatitis

12 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 13 WHA hosts COVID-19 webinars To answer some of the most The first webinar brought together World Hepatitis Day common questions people living medical professionals to examine with viral hepatitis have about the clinical aspects of COVID-19 and Digital programme what it means for people living with COVID-19 and to explore the viral hepatitis. The global town hall impact of the pandemic on brought together WHA members, hepatitis services worldwide, civil society organisations and WHA hosted a webinar and a global health experts to discuss and global town hall meeting. share experiences of the impact of COVID-19 on hepatitis services. Watch the webinars at www.worldhepatitisalliance.org/COVID-19

We have a series of informative and engaging webinars and virtual events planned, including:

Watch the COVID-19 and viral hepatitis webinar with ●● An in-depth look at the impact of COVID-19 on medical professionals harm reduction services and people who inject drugs ●● The prevention of mother-to-child transmission ●● The impact of COVID-19 on progress towards hepatitis elimination Want to be the first to know when further details about these events are released? Sign up to the World Hepatitis Day mailing list and you’ll receive full details closer to the time. We will also be publishing details of the events on Watch the COVID-19 and viral hepatitis global town hall our Facebook and Twitter profiles.

14 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 15 What COVID-19 teaches us about infectious diseases and what we can learn from viral hepatitis hepinion By Dr Su Wang, hepatitis B patient and WHA President

Many are already all too familiar course, and effective treatments hepatitis C, effective medications with the devastating impact of or vaccines. for hepatitis B, and research is global infectious diseases. For ongoing for a hepatitis B cure. example, viral hepatitis is the In contrast, we know how viral Effective, safe, and affordable world’s second deadliest infectious hepatitis is transmitted and have vaccines for hepatitis B are game- disease, affecting more than 325 the diagnostic tools to identify changers and have dramatically million people worldwide and patients accurately with ease and reduced rates of transmission. claiming 1.4 million lives each at low cost. We also have cures for year – more than HIV and combined. Yet unlike COVID-19, public awareness is shockingly low and the global response is paltry. COVID-19 has spread across “Many are already all continents and countries. We are seeing unprecedented too familiar with the global attention focused devastating impact of on one disease, leading to infectious diseases.” drastic actions to limit its spread and reduce its death The strategies being used for toll. COVID-19 are already the same for many other diseases, including Too many lives will still be lost viral hepatitis — identification and the effects of the pandemic (screening), containment will be visible for years. What’s (prevention), and treatment. But remarkable is the singular focus it is the urgency of action that of governments, scientists, and makes COVID-19 stand out, due to the healthcare sector to combat the nature of the many unknowns COVID-19 and the about its transmission, natural overwhelming response. Like COVID-19, viral hepatitis is a global health problem, but awareness is low

16 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 17 experiencing. You live with guilt innovations that can change the and self-stigma, and a constant trajectory of a disease. worry that you could transmit the disease to loved ones. While we learn lessons for combatting COVID-19, let us join together in this battle against Sharing stories infectious diseases. I have since learned that telling my story and the stories of others “As we advocate affected by hepatitis (many of for testing, care, whom feel they have no voice) is critical for increasing awareness, and treatment for and this is a key lesson for the COVID-19, let us not COVID-19 response. The stories of those impacted by COVID-19 are forget that these same painfully familiar to the global interventions exist hepatitis-affected community. COVID-19 has received unprecedented global attention and response for many diseases, Not having access to testing, including viral hepatitis, feeling alone and isolated, not A global goal “Why do we remain knowing where to go for help, yet remain out of reach With all these tools, viral apathetic to the many and not being able to obtain for many.” hepatitis can be eliminated. In potentially life-saving therapies lives lost to hepatitis, are all barriers that resonate 2016, countries were tasked with As we advocate for testing, care, developing national plans to meet when these deaths are with us. We ache when we hear stories of people facing stigma and and treatment for COVID-19, let the World Health Organization’s entirely preventable?” us not forget that these same goal of eliminating viral hepatitis discrimination, because many of us When I was diagnosed with hide out of that fear as well. interventions exist for many by 2030. While some plans exist, diseases, including viral hepatitis, they are often not supported with hepatitis B in college, I was afraid These stories must be shared, and yet remain out of reach for many. funding or resources, and only to tell anybody. I went through the patient voice elevated. The As we witness how life-saving five countries are on target for medical school and residency only human impact is what compels these can be, let us ensure these elimination. Why do we remain letting a few of my closest friends decision makers to remove barriers interventions reach the 325 million apathetic to the many lives lost to know. Living with an infectious to testing, care, and treatment. living with viral hepatitis hepatitis, when these deaths are disease is very different from living It is what drives development of among us. entirely preventable? with a non-infectious disease, as many with COVID-19 are now This article was originally featured in Media Planet’s Infectious Diseases campaign. Click here to view the campaign.

18 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 19 World Hepatitis Day: time to #FindTheMissingMillions New 2020 campaign website and materials launched

own messaging, background, and logo to the materials. What do you have planned?

World Hepatitis Day We know how creative our members in light of COVID-19 are, and we are sure that many of you have come up with innovative We understand that, in light of solutions and activities to mark COVID-19, you may not be able World Hepatitis Day. We’d love to to hold some of the events and hear more about them, so please activities you were planning for World contact us and let us know what you The World Hepatitis Campaign materials Hepatitis Day this year. have planned. Alliance (WHA) is pleased to share with you the brand Based on feedback from our To ensure that World Hepatitis Day is World Hepatitis Day will be different 2019 World Hepatitis Day survey still impactful and engaging, we are this year. But, together, we can make new World Hepatitis Day and consultations with you, our planning a series of virtual events it a success. website and 2020 campaign members, we have designed a new and a range of digital activities materials. suite of materials to help you raise you can participate in. You’ll find a Visit the website at awareness this World Hepatitis Day. programme of virtual events www.worldhepatitisday.org While COVID-19 is understandably on page 15. dominating the headlines, it is The materials are available to important that we try our best and download in Arabic, Chinese, English, make the most of World Hepatitis French, Portuguese, Russian and Day to raise life-saving awareness Spanish, or you can customise any Click here to visit the and find the missing millions who are of the materials into your language unaware they are living with using our new customisation tool. World Hepatitis Day website viral hepatitis. You can also use this tool to add your

20 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 21 New estimates highlight need to step up

sex workers. Dr Doherty points out, is focused on developing improved “This information helps in identifying prevention strategies.” response to hepatitis D the groups with hepatitis B among whom we should be looking for Professor Geretti concludes, In a study published in the Journal of hepatitis D : in Mongolia, the hepatitis D.” “Hepatitis D has long been neglected, Hepatology, Professor Anna Maria Republic of Moldova, and countries in because for decades the prevalence Geretti and Dr Alexander Stockdale Western and Hepatitis D (formerly known as the of infection remained uncertain and from the University of Liverpool Middle Africa.” Delta agent) is a small virus – one effective treatment was lacking. (United Kingdom), in collaboration of the smallest that is known to Mapping the epidemiology of the with researchers from the World “We have identified cause disease in humans – and can infection is just the first step. More Health Organization (WHO) and the several geographical replicate only in the presence of efforts are needed to reduce the International Agency for Research hepatitis B, from which hepatitis D global burden of chronic hepatitis B on Cancer (IARC), estimate that hotspots of high borrows some of its structures. and develop medicines that are safe worldwide, hepatitis D virus affects prevalence of hepatitis and effective against hepatitis D and nearly 5 per cent of people who have Compared with people with hepatitis are affordable enough to be deployed a chronic infection with hepatitis D infection: in Mongolia, B infection alone, those who have a on a large scale to those who are B virus and that hepatitis D co- chronic infection with both hepatitis most in need.” infection could explain about one in the Republic of Moldova, B and hepatitis D have a much higher five cases of liver disease and liver and countries in Western risk of developing disease in the form Read more on the World Health cancer in people living with chronic of cirrhosis and liver cancer. Organization website hepatitis B. and Middle Africa.” “Hepatitis D is a significant To map the epidemiology of hepatitis “Although it is less common contributor to severe liver disease D infection in the world, Professor than hepatitis B, hepatitis D is a and liver cancer,” says IARC scientist Geretti and Dr Stockdale joined serious disease that often affects Dr Catherine de Martel. “The forces with the WHO Global Hepatitis underprivileged and vulnerable findings from this study inform our Programme and IARC, alongside populations,” says Dr Meg Doherty, work on the association between investigators in Germany, Malawi, Director of the WHO Global viral infections and cancer, which and the United Kingdom. Hepatitis Programme. “Hepatitis D has “Infection with hepatitis D occurs Those who are more likely to have in about one in 22 cases of chronic hepatitis B and hepatitis D co- long been neglected, hepatitis B infection in the world,” infection include people who inject because for decades the Dr Stockdale says. “More high- drugs and people with hepatitis C quality data are needed, but we virus or HIV infection. The risk of co- prevalence of infection have identified several geographical infection also appears to be higher in remained uncertain and hotspots of high prevalence of recipients of haemodialysis, men who have sex with men, and commercial effective treatment was lacking.”

22 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 23 Inspiration from around the world

Indonesia

Caroline Thomas from Yayasan Koalisi Satu Hati (YKSH) in Indonesia aims to increase community involvement and capacity to undertake advocacy, and increase the national budget for hepatitis C elimination in Indonesia through better In-country programme update policy and practices. YKSH is currently developing basic hepatitis and advocacy modules for online Zoom classes and has successfully advocated to the Indonesian Made up of five WHA member countries across the world – Armenia, government to make viral hepatitis one of the main focuses of the 2020-2024 Bangladesh, Ghana, Indonesia and Jamaica – the Find the Missing Millions National Medium Term Development Plan. YKSH also carries out work in health (FMM) In-country Programme aims to support members to develop and centres but some health care centres have turned into COVID-19 response centres implement effective action plans which advocate for policy makers within which makes patients uneasy about visiting them. their individual countries to take action to increase hepatitis diagnosis rates. Bangladesh Ghana Zunaid Paiker from National Liver Foundation of Bangladesh aims to share the message of the importance of viral hepatitis testing, create awareness among Charles Ampong Adjei from the Hepatitis Alliance of Ghana (HAG) aims to focus on students, decentralise awareness campaigns to reach underserved communities, the three main barriers to diagnosis of hepatitis in Ghana. HAG’s objectives to help and minimise myths and misconceptions about viral hepatitis. National Liver overcome these barriers include increasing political will, increasing the knowledge Foundation of Bangladesh has carried out a number of awareness events, of health care providers, and increasing awareness in selected communities. HAG including a hepatitis awareness and screening session at Bondhushava Jatiya has made a lot of progress towards the aims and objectives set, for example, Bondhu Somabesh’s national members’ conference, testing 582 people for collaborating with religious groups to offer hepatitis B education to 1,200 people hepatitis B and C for free. Plans for future awareness and screening sessions and carrying out free hepatitis B testing. The COVID-19 pandemic has affected HAG’s have been postponed due to the pandemic and a nationwide lockdown. work as movement is restricted and this prevents any large group gatherings.

Jamaica Armenia Shelly-Ann Myrie from Caribbean Hepatitis C Alliance in Jamaica aims to Anahit Harutyunyan from Positive People Armenian Network (PPAN) aims to advocate increase knowledge of hepatitis C through public awareness and sensitisation for combination testing to be implemented at the National Centre for AIDS Prevention programmes, establish a national response to the virus, and integrate hepatitis (NCAP) and for the micro-elimination of hepatitis C amongst those living with HIV. C screening with HIV services. Caribbean Hepatitis C Alliance has been able to PPAN has been successful in carrying out events to provide hepatitis education meet with Ministry of Health officials concerning the development of a national during European Testing Week, alongside the Ministry of Health and NCAP. They have hepatitis plan, and has raised hepatitis awareness among healthcare workers. also produced a powerful patient video with the message: ‘Get tested on time! Get There were also plans to hold further sensitisation lectures among healthcare treatment on time! And live life fully!’. Unfortunately, PPAN’s work has been halted workers at healthcare centres, but due to COVID-19, this has been postponed by the government of Armenia’s decision to merge NCAP with the NORK Infectious until further notice. Disease Hospital, a decision which has been met with protest.

Each participant has made progress and created many ways to address barriers to diagnosis. Each aim has been tailored to suit participants’ individual country’s needs. Positive progress has been made and many goals have been achieved, however, due to the current COVID-19 pandemic, each participant has been affected or challenged in some way. They are all working towards making alternative plans to make sure they are still able to carry out the project effectively in uncertain times.

24 hep Voice MAY/JUNE 2020 hep Voice MAY/JUNE 2020 25 Inspiration from around the world

worked with the community to 3) Fundraising design and provide on-the-ground community-based activities, has As some of the villagers were Inspiration from led to a social movement in Egypt from low income households, and can be replicated in other a strategy was implemented communities with a similar context. calling for funds via public around the donation to pay for the Al-Othmanya was chosen as the first treatment of villagers. The world - Egypt village for this programme because campaign was mostly funded the village’s community leaders by ELRIAH but funds were Through the Find the Missing had approached the Egyptian Liver also raised by using Zakat, Millions campaign, we are Research Institute and Hospital an Islamic way to address highlighting best practice and (ELRIAH) to assist with treating barriers. Individuals from innovations in screening and testing hepatitis C in the village. higher income households village were eligible for testing. All so that other organisations can were able to pay for the treatment of hepatitis C virus antibody-positive To implement this project, we applied those from lower income households. participants were linked with care learn and develop their national four distinct activities: activities. This month, we are for a confirmatory viral load testing, 4) Testing, diagnosis, and highlighting a unique initiative and over 90 per cent of those 1) Community mobilisation and treatment confirmed to be living with hepatitis C to micro-eliminate hepatitis C in establishment of partnership underwent treatment. Egyptian villages. A comprehensive testing, diagnosis To mobilise the community, and treatment strategy was adopted. Due to the success of this project in By Professor Doctor Ammal Mokhtar we engaged individuals from Between 6 June 2015, and 9 June the Al-Othmanya village, we now Metwally, National Research Centre of community-based organisations and 2016, approximately 67 per cent of hope to introduce the project to other Egypt Community Medicine Research 60 local volunteer village promoters, those who lived in Al-Othmanya villages across Egypt. Department,-Medical Division who were also villagers, to create a culture of community participation, Hepatitis C is a major local ownership and accountability burden in Egypt, with a prevalence to support a range of community and Keys to our success that is one of the highest in the educational activities. world. Based on data reported from ●● We used a comprehensive and integrated approach to the elimination of hepatitis C at a community level, incorporating both preventive approaches to reduce Egypt Demographic Health Surveys 2) An educational campaign to in 2015, it was estimated that transmission and new infections, and testing and treatment to reduce both the raise awareness and promote burden of disease and associated morbidity. seroprevalence among people aged behavioural changes 15–59 years was 10 per cent, and 0·4 ●● Being a patient focused initiative, testing at a household level ensured high uptake per cent for those younger than 15. The key objective of the educational of testing and access to individuals regardless of sex, age, income or stage of In order for Egypt to achieve hepatitis campaign was to increase awareness disease. C elimination by 2030, an innovative and knowledge about hepatitis C, ●● We used a wide range of complementary promotional educational tools to raise model which would increase access not only in the local community, awareness. to testing and treatment needed to but also among local barbers and be implemented. healthcare providers, encouraging ●● The strong community engagement, empowerment, and commitment to safe practices in barbers and places implementing the project activities through community-based associations and 60 Our initiative, through which we where healthcare was provided. village promoters was a crucial component.

26 hep Voice MAY/JUNE 2020 Click here to read more Find the Missing Millions case studies from around the world hep Voice MAY/JUNE 2020 27 Wall of Stories: Alice Together, our stories can completed the three doses Later, when change the way the world afterwards. they left home for university, sees viral hepatitis. When they were tested at age one, they continued and then again at age two, the Each month we share the story of doing hepatitis tests came back negative. someone whose life has been affected B outreach on by viral hepatitis. This month, we their own. I did But my doctor told me that, hear from Alice, who did not find out too. because I have chronic hepatitis that she had hepatitis B until she was pregnant with her first child. B, I have a 25 per cent chance of I remember getting liver cancer. my son coming I remember my mom always telling home during a me “don’t ask, don’t tell” in regards “Would I be able to school break to illness. For my Chinese family, and saying being sick is a taboo so we never see my children grow “hepatitis B is talked about it. a silent killer. up to adulthood? Will Testing is so When I became pregnant with I have to leave them important, and my first child, I found out I have can hepatitis B. I was very shocked. too early? ” prevent the Only then did I learn from my mom infection.” I told Would I be able to see my children that she also has chronic hepatitis him “you got it! grow up to adulthood? Will I have B virus, and that I probably got it I am so proud to leave them too early? from her. of you”. I know the transmission wasn’t her I chose to be very open with my I used to think my passion fault and yet I wish she had told children about the virus and I “I used to think my passion for preventing hepatitis me sooner. I decided I wanted to started reaching out to Asian for preventing hepatitis B B would live in me until I do motherhood differently. I was communities too. die. Now I think it will live blessed because my obstetrician- would live in me until I die. longer than that. gynaecologist knew what to screen When my children attended for and took precautions to prevent Chinese-language school, I set up Now I think it will live Thank you to The Hepatitis transmission from mother to child. a hepatitis education booth for longer than that. ” B Foundation for allowing us parents. My children manned the to share Alice’s story. Read My two children were given booth with me and talked to their other stories from their #justB vaccines at birth and then friends about vaccination. See more stories and submit your own at storytelling campaign here. www.worldhepatitisalliance.org/wall-stories

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www.worldhepatitisalliance.org

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