1. Prevention and Control of Viral Hepatitis Infection: WHO Framework for Global Action Prevention and Control of Viral Hepatitis Infection: WHO Framework for Global Action Tim Nguyen Technical Officer 14 th International Symposium on Viral Hepatitis and Liver Disease Shanghai 2012

2. ISVHLD 2012 I Shanghai, 23 June 2012 I 2 | WHA63.18: Comprehensive Hepatitis Prevention and Control 2010 World Health Assembly adopted resolution 63.18 as sponsored by Brazil, Columbia, and Indonesia calling for comprehensive approach to hepatitis prevention and control World Hepatitis Day on July 28 Member State action Secretariat action Accountability to World Health Assembly

3. ISVHLD 2012 I Shanghai, 23 June 2012 I 3 | Current challenges HBV –HepB vaccine at birth is still only administered in 92 Member States and only 25% of infants have received this vaccine. HBV / HCV –Millions of chronically infected persons do not have timely access to testing, care and effective treatments. –Unsafe injections are still common in many developing countries. –On-going transmission is adding millions of people to the pool of the chronically infected. HAV / HEV – Unsafe water and sanitation are the norm for millions of people.

4. ISVHLD 2012 I Shanghai, 23 June 2012 I 4 | Vision and Goals As of Dec 2011, WHO Global Hepatitis Programme «A world where viral hepatitis transmission is stopped and all have access to safe and effective care and treatment» Using a public health approach, the goal of the viral hepatitis programme is: –to reduce the transmission of the various agents that cause viral hepatitis; –to reduce the morbidity and mortality due to viral hepatitis and improve the care of patients with viral hepatitis; –and to reduce the socio-economic impact of viral hepatitis at individual, community and population levels.

5. ISVHLD 2012 I Shanghai, 23 June 2012 I 5 | Global Hepatitis Framework Axis 1: Partnerships, resource mobilization and communication Axis 2: Data for policy and action Axis 3: Prevention of virus transmission Axis 4: Screening, care and treatment

6. ISVHLD 2012 I Shanghai, 23 June 2012 I 6 | Axis 1: Increasing engagement through awareness, partnerships and mobilizing resources Increasing awareness among policy makers, health professionals, and the public about viral hepatitis Support for World Hepatitis Day Establish global network of collaborating centres and civil society for viral hepatitis prevention and control Mobilize resources especially for countries with limited resources

7. ISVHLD 2012 I Shanghai, 23 June 2012 I 7 |

8. ISVHLD 2012 I Shanghai, 23 June 2012 I 8 | Axis 2: Evidence-based policy and data for action WHO is updating global prevalence and burden estimates for viral hepatitis. Guidance on serological surveys to assess impact of prevention efforts Guidelines and standards for infection and disease surveillance Public Health Research Agenda for Viral Hepatitis

9. ISVHLD 2012 I Shanghai, 23 June 2012 I 9 | Current estimates of Disease Burden HBV 1 of every 3 people has been infected by HBV ~240 million chronic carriers worldwide (3,7%) ~ 500 000 – 700 000 HBV related deaths per year, 94% chronic reasons ~4,5 million new cases/per year HCV 130-170 millions of people d infected worldwide (2.2-3%) >350 000 people die from HCV-related liver diseases each year 3–4 million people are infected with HCV each year

10. ISVHLD 2012 I Shanghai, 23 June 2012 I 10 | WHO Public Health Research Agenda for Viral Hepatitis The goal is to guide researchers in the direction of necessary research for generation of evidence needed to strengthen public health guidance and actions. Examples of public health research questions: What strategies are most useful in reaching high risk groups for Hepatitis B vaccination and increasing uptake? What is the most cost-effective HCV screening strategy in settings with limited treatment resources? Is it more cost-effective to focus on building infrastructure or to immunize children with the hepatitis A vaccine to reduce morbidity and mortality in low to middle income countries?

11. ISVHLD 2012 I Shanghai, 23 June 2012 I 11 | Axis 3: Prevention of virus transmission Guidance and tools for immunization –Schedules and dosages –Protection of high risk groups including newborns and health- care workers, especially against hepatitis B –Promote innovative approaches for the future Safer sex, safe and rational use of injections and safe blood transfusion –ensuring safe food and water for countries, and on proper disposal of sanitary waste

12. ISVHLD 2012 I Shanghai, 23 June 2012 I 12 | Axis 4: Screening, care and treatment Screening and counseling resource package Diagnostic, care and treatment guidelines in resource-constrained settings Training package for health care providers

13. ISVHLD 2012 I Shanghai, 23 June 2012 I 13 | Global Hepatitis Framework