19 WORLD GASTROENTEROLOGY NEWS OCTOBER 2014 Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events WHO’s Initiative May Change Global Viral Hepatitis Prevalence Drastically Cihan Yurdaydin, MD Chief of the Hepatology Institute, The University of Ankara Professor of Gastroenterology, Gastroenterology Department University of Ankara Medical School Ankara, Turkey Secretary General, WGO The World Health Organization (WHO) Global Partners Meeting took place on March 27 and 28, 2014, in Geneva, Switzerland with 120 registered participants. Both the number of participants and the global distribution of organizations they represent or they work for, was impressive and probably a reflection of WHO’s determination for eradica-tion of viral hepatitis. The meeting was important and may be considered even historic as it highlighted a change in the ap-praisal of viral hepatitis by WHO. It appears that the breakthrough came in 2010, at which time the World Health Assembly adopted resolution WHA63.18 which acknowledged viral hepatitis as a global public health problem. WHO then established the Global Hepatitis Program (GHP) with the vision to stop viral hepatitis transmission, and to provide access to safe and effective care and treatment for ALL IN NEED. GHP covers all five hepatotropic viruses although special attention is paid to hepatitis B virus (HBV) and to hepatitis C virus infection in terms of their greatest public health significance. Recent promising developments in hepatitis treatment and prevention reminiscent to the many innovations witnessed with HIV some 15 years ago, have triggered a rethinking of how hepatitis is framed within WHO. As a consequence, the secretariat of the GHP has been strategically moved from the Pandemic and Epidemic Department to the cluster responsible for HIV, tuberculosis, malaria and neglected tropical diseases. This will enable the GHP, it is considered, to interact more closely with other com-municable disease programs, especial-ly with regard to the experience of the HIV department in scaling up access to treatment. Figure 1: HCV Prevalence Rates in Egypt. Besides these strategic develop-ments within WHO, the stars of the meeting were the Egyptians, who are running a very successful hepatitis C treatment program financially covered by their government and through unbelievable price negotiations with pharma. Information on the program was given by Dr. Wahid Doss from the National Hepatology and Tropical Medicine Research Institute of the Ministry of Health in Egypt. They worked with Roche and Merck for Pegylated Interferon+Ribavirin, and now they are negotiating with Gilead for sofosbuvir aiming 100% SVR in those treated. They are treating 45,000 to 50,000 chronic hepatitis C cases, annually, although Dr. Doss underlined that in Egypt more than 100,000 new cases still are encoun-tered yearly. Another aim of the Egyptians is to create a huge database, the National Network for Treatment Centers with more than 300,000 patients. Dr. Doss mentioned that besides Gilead, price negotiations with AbbVie are also proceeding. Their ambitious aim is to treat 250,000 to 300,000 annually in the next 10 years, with more than 90% of governmental funding, and to decrease HCV preva-lence in the country from its current prevalence of around 14% (see Figure 1) to less than 2% in 10 years. Their efforts need to be congratulated. The achievements they have reached so far, despite the bleak economic situa-tion of the country and the political turmoil they are going through, is impressive. Similar initiatives are needed in other areas of the world where viral hepatitis treatment is not affordable such as sub-Saharan Africa. There is great hope that WHO can and will make a difference, and that we will witness a change in paradigm towards eradication of viral hepatitis globally.
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