National Liver Foundation of Bangladesh, World Hepatitis Alliance and London School of Hygiene and Tropical Medicine jointly organized Global Hep Contest Meeting on “What can be done to eliminate viral hepatitis in Bangladesh” at The Daily Star Center, Dhaka on Friday, 25 March 2022.
It was participated by renowned hepatologists, Gastroenterologists, representative of Communicable Disease Control (CDC), Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare, Govt. of Bangladesh, experts from World Hepatitis Alliance (WHA) & London School of Hygiene and Tropical Medicine. (LSHTM)
In 2016, WHO's Global Health Sector Strategy outlined plans to eliminate viral hepatitis as a threat to public health, setting a target of a 90% reduction in new infections and a 65% reduction in viral hepatitis-related mortality by 2030. It is estimated to save more than 7 million lives, including 1.5 million liver cancer deaths.
About 10 million people in Bangladesh are living with viral hepatitis, causing 20,000 deaths annually. Hepatitis B & C are the major cause of liver cancer, the 3rd leading cause of cancer death in Bangladesh.
The key interventional areas of viral hepatitis elimination in Bangladesh were the focal points of the meeting. Elimination of each focal areas individually, will collectively eliminate viral hepatitis in the nation.
Distinguished speakers from home & abroad spoke on the vital elimination strategies. Topics include: Overview of the Global Hepatitis Open Call, Viral hepatitis: Bangladesh Perspective, Viral Hepatitis Control Strategy in Bangladesh, Prevention of Mother-to-Child Transmission of HBV, Testing & Vaccination of HBV & HCV, Treatment of Hepatitis B & C in Bangladesh, Blood Transfusion and Surgical Safety, Injection Safety and harm reduction, stigma & discrimination were the focusses.
Transmission from hepatitis B infected mother to child (most important way HBV transmission) Unsafe blood transfusion, hazardous uses of medical equipment, sharing injection needles, unprotected sex are major risk factors for spreading hepatitis B &C in Bangladesh, experts viewed at the discussion.
Major obstacles to eliminating the viral hepatitis are Inadequate HepB birth dose vaccination, deficient alertness about testing of viral hepatitis during pregnancy, short of awareness about hepatitis & its testing, limited access to treatment among mass people.
In addition, misinformation, traditional treatment, stigmatization and discrimination against infected people are additional factors, which compound the elimination strategy, the speakers said. The situation is more complex in rural Bangladesh where majority people (> 64%) people of the nation are residing. Most of them are unaware about hepatitis B & C and its consequences.
All infants at birth, all children, dialysis patients, blood donors, surgical & dental stuff, nurses, people engaged in hazardous work coming contact with blood & blood products, sex workers & risk groups must be prioritized in awareness &vaccination
A Study of National Liver Foundation of Bangladesh found that I in 5 Rohingya refugees in Bangladesh infected with Hepatitis C, which is 18 times higher than host community.
Out of 50,000 pregnant Rohingya women, 8% of them found positive with Hepatitis C virus. It is a serious concern for them & for the host community, Bangladesh. The study recently published in a well circulated international journal. Government & international organizations should come forward to control this high prevalence of HBV & HCV among Rohingya refugees.
Story of two recipients of Zakat Fund programme of NLFB, Muslima Kader Mili (Hepatitis C survivor), listed in the top ten winners & Mahfuzur Rahman (Hepatitis B Carrier) listed in the top thirty winners of global “Nohep stories contest 2021” of Nohep movement of WHA & LSHTM. Videos of their stories of getting infection, long suffering, discrimination, receive of successful treatment & their messages displayed.
Major interventions for achieving elimination goals in Bangladesh are incorporation of HepB birth dose vaccination, compulsory child hood vaccination under 5 yrs.(to achieve <0.1% goal), catch up vaccination, scale up of mass awareness & testing of pregnant woman (Prevention of mother to child transmission of HBV), Grass root activation (especially commoners at rural Bangladesh), Population-wide testing , treatment facilities, free treatment for underprivileged, unreachable communities to be reached, easy availability of anti-viral drugs, vaccine & immunoglobulins, Investigations at affordable cost, harm reduction, stigma & discrimination should be dealt. Scale up of existing interventions. Global fund allocation.
National Liver Foundation of Bangladesh (NLFB) is involved to control every elimination strategy in Bangladesh from long time. Closely working with WHA since its inception. Engaged in addressing the core interventional areas in rural and urban Bangladesh. Working to support every endeavor of the Govt. to achieve elimination 2030 goals.
Different Associations & Societies affiliated with Liver & Gastrointestinal diseases in Bangladesh also involved & working for control of viral hepatitis in Bangladesh.
Government of Bangladesh is committed & engaged in fulfilment elimination goals. Activities of Govt. aim at reducing 90% of viral hepatitis-related morbidity and mortality in Bangladesh by 2030
We firmly believe that together we can eliminate viral hepatitis as a public health threat in Bangladesh by 2030.
Participants from Bangladesh:
Prof. Mohammad Ali, Founder, National Liver Foundation of Bangladesh,
Dr. Afsana Alamgir Khan, Assistant Director. Communicable Disease Control (CDC), Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare, Govt. of Bangladesh.
Prof. M Anisur Rahman, former Professor and Head, Dept. of Gastro intestinal Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM General Hospital, Dhaka & Joint Secretary General, National Liver Foundation of Bangladesh,
Prof. Salimur Rahman, Former Professor of Hepatology, Bangabandhu Sheikh Mujib Medical University and President, Association for the Study of the Liver Diseases, Bangladesh.
Maj Gen. Rabiul Hossain (Retd.) Former Director General, Medical Services, Bangladesh Armed Forces,
Prof. Faruque Ahmed, Director, Sheikh Russel Gastro Liver Research Institute and Hospital & General Secretary, Bangladesh Gastroenterology Society.
Prof. Md. Abu Sayeed, Former Head, Dept. of Medicine, Chittagong Medical College and Vice President, Hepatology Society, Dhaka, Bangladesh
Prof. Dr. Md. Shahinul Alam, Professor, Dept. of Hepatology, Bangabandhu Sheikh Mujib Medical University & General Secretary, Hepatology Society, Dhaka, Bangladesh,
Dr. Golam Azam, Associate Professor, Dept. of Gastro intestinal Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM General Hospital, Dhaka
Dr. Faruque Ahmed, Head, Dept. of Hepatology. Dhaka Medical College & Hospital.
Prof. Syed Alamgir Safwath, Professor & head, Dept. of Gastroenterology, Jalalabad Ragib-Rabeya Medical College, Sylhet, Bangladesh.
Tasnia Noor President, Bangladesh Medical Student Society.
Participants from abroad:
Jessica Hicks & Cynthia Pokuah of World Hepatitis Alliance (WHA).
Eneyi Kpokiri , Dan Wu & Joseph Tucker of London School of Hygiene and Tropical Medicine
Doctors, Medical students, members of youth club, print & electronic media personals attended.