HEPATITIS B

Hepatitis is a disease that causes an inflammation of the liver. It is caused by hepatitis A, B, C, D, and E viruses. These group of viruses have the potential of causing permanent and significant irreversible damage to the liver. The hepatitis B and C viruses are the most dangerous. It is 100% times infectious than HIV/AIDS.

This is because the hepatitis B virus can be isolated in almost all body fluids. It spreads by mother to child transmission, unprotected sex, sharing of toilet articles and other sharps. The hepatitis B virus is also known to be asymptomatic so those affected end up sharing the virus freely with those around them. As reported by the World Hepatitis Alliance 290 million people living with hepatitis are unaware. Presently, over two billion people worldwide are affected with 1.34 million deaths occurring every single year. Sub-Sahara Africa and Asia are the worst hit areas.

(Ott et al 2012)
REGIONAL DISTRIBUTION ACROSS THE GLOBE
Sub Saharan Africa: 8%-12%
Asia: 5%-8.2%
Japan and Mediterranean Countries:4.3%-5.4%
North America & Western Europe:1.6%-5%

Burden of Hepatitis B&C according to regions of the world

PREVALENCE AMERICAS REGION EUROPEAN REGION EASTERN MEDITERRANEAN REGION SOUTH EAST ASIA REGION AFRICAN REGION WESTERN PACIFIC
HEPATITIS B 7 MILLION 15 MILLION 21 MILLION 39 MILLION 60 MILLION 115 MILLION
HEPATITIS C 7 MILLION 14 MILLION 15 MILLION 10 MILLION 11 MILLION 14 MILLION

(World Hepatitis Advocacy tool kit,2018)

Even though it has been established that hepatitis kill more people than Malaria, HIV/AIDS and TB put together, the Global Fund has unaccountably excluded hepatitis. Lack of fund coupled with poor global leadership are the prime reasons for this disaster. In spite of the fact that Hepatitis B is a vaccine preventable illness it has been allowed by world leaders to cause much devastation to humanity. The World Health Organization whose oversight responsibility is to tackle the worsening condition has failed woefully in my opinion. They failed to mobilize resources on a scale similar to that of HIV/AIDS, TB and Malaria and also unable to engage effectively with the global leaders in dealing with the devastation. In sub Saharan Africa where the disease is most prevalent the World Health Organization has not been able to use the two regional bodies such as ECOWAS and Africa Union in this regard. Though 2030 has been set to be the elimination target for hepatitis this to me may be a mirage and a lip service simply because the target has no financial support. This appalling and lukewarm attitude by world leaders is a gross violation of the fundamental human rights of those affected and those yet to be affected. It is purely criminal and dehumanizing to set back and watch millions of our children, mothers, brothers and sisters perish in such a gruesome manner. There is no justification what so ever for our action because hepatitis B is preventable and treatable while hepatitis c is absolutely curable.

In Africa the condition is worsening. It is estimated that over 60 million Africans are currently affected. What is worrying is that while other developed countries like Brazil are poised towards elimination of the disease most African leaders appeared to be suffering from apathy, weak political commitment and no money syndrome. Most of them are still in the state of delusion and fail to realize the realities of donor fatigue. The days of hiding behind such programs to amass wealth through corrupt practices is over. Though Africa is the richest continent endowed with so many natural resources yet is the poorest continent that is plague with poverty and disease. Politicians in Africa appear to be interested in votes of their citizens and not their health and wellbeing. Politics is rather the virus that is killing the over 60million people in Africa and not hepatitis. The earlier we tackle the political chaos the better.

In Ghana however, the condition is deteriorating especially among the youth. Even though Ghana has a policy on hepatitis and hepatitis focal person in the Ministry of Health, nothing significant seems to be happening. Presently, there are no awareness campaigns, no vaccines available in our hospitals, and no treatment guidelines to tackle the disease. Those affected are left to die silently at the mercy of herbalist. Babies who acquired the virus from their parents have no treatment likewise their parents. Evidence available suggests that the future of our youth are in jeopardy. A recent survey conducted by Atakli (2017) in the School of Public Health University of Ghana revealed that 14 out of every 100 students in one of the senior high schools in Krachi West district are hepatitis B positive.. This finding corroborated a similar finding by Avege in 2012 which reported that the prevalence of hepatitis B is 12.1% among junior high students in Navrongo. The rising prevalence in my view can be attributed to the introduction of the childhood immunization program by WHO in 2002 without any catch up program for the vast number of the youth who were born before 2002. They are left to bear the full brunt of the heat by dying prematurely. As publish by Atakli (2017) in the School of Public Health University of Ghana the average age of the affected student is 17±2years standard deviation. It is therefore not surprising why most of the obituaries of late often read gone too soon, what a shock among several others indicating the age of prematurity.

Hepatitis –B is indeed hyper endemic in Ghana. A recent systematic and metal-analysis of prevalence in Ghana from 1995-2016 also reported that HBV prevalence was 10.8%, 12.7% and 13.1% among voluntary blood, replacement blood donors and pregnant women respectively (Ofori A. et al, 2016). According to the systematic review the regional HBV prevalence is as follows: Ashanti 13.1%, Greater Accra 10.6%, Eastern 13.6% , Northern 13.1% ,Central 11.5%, and Brong Ahanfo 13.7% region. As pointed out by Ofori “the prevalence for Volta, Western, Upper East and Upper West regions could not be determined for lack of aggregate data”. The highest prevalence was found among those within the 16 to 39 year group.

Sadly several petition and appeal to both past and successive governments have yielded no significant results. Even a latest appeal by Long Life Africa (A Health NGO) to the presidency has fallen on death ears.

HBV Prevalence by Regions in Ghana
HBV Prevalence by Regions in Ghana

Source: Ofori-Asenso & Agyeman BMC Infectious Disease (2016)

Before l conclude l wish to appeal to the world health organization and more especially United Nations organization, and the rest of the world leaders to wake up to the realities of the gargantuan danger that confront us. The time to kill the global apathy and the politics that fuel the awful existence of this dreadful disease is now. Posterity will judge us all if we continue to sleep and allow the over two billion people affected to be consumed by such a vaccine preventable illness. I further wish to appeal to all African leaders to scrub off the nuisance taxes on the importation of hepatitis B vaccines, drugs, test kits and diagnostics to allow access to care.

In conclusion, l wish to appeal to the parliamentary select committee on health, chiefs, civil society organizations and all well-meaning Ghanaians to wake up to the realities of the devastation that is about to strike the nation. Frankly our youth are in danger. We cannot crucify the future of our youth on the altar of no money. Let us set our priorities right. Let’s tackle the issue of pervasive corruption and greed which is killing the nation with all seriousness. Let’s channel moneys that we pump into useless ventures like Miss Ghana and other expensive entertainment programs into vaccinating the youth in our senior high schools. We appeal to our parliamentarians and other honorable ministers of states to sacrifice some of their expensive allowances and other useless and unnecessary privileges to support this just cause. Let’s doll out taxation policies that support hepatitis B immunization programs. Let’s reorganize the proceeds from our petroleum products and other rich mineral resources we are blessed with in this direction. Health after all is a right and not an offer from any politician. This injustice against humanity must not be allow to continue.
As part of the solution Long Life Africa is organizing a national dialogue on hepatitis this 25th July in Accra Ghana. We hereby appeal to all and sundry to donate generously in support of this program through the MTN number 0243824387. God richly bless you.

Author:
Atakli Alex
Executive Director
Long Life Africa (Health NGO)
Public Health Specialist
+233(0)202853761
ataklialex@gmail.com

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