On July 28 every year, Rwanda joins the rest of the world in marking World Hepatitis Day. This is done through different campaigns which aim at encouraging the public to reach designated health facilities for early check-up, screening and if found positive, early treatment. Augustin Manirakiza, former immediate vice president of the Rwanda Pharmaceutical Students Association (RPSA), says this is to help the healthcare system ensure that the community is accessing hepatitis services, including vaccination. However, due to Covid-19, this year, RPSA chose to use different online platforms such as WhatsApp, Twitter and Facebook, to share information concerning hepatitis. “The online campaign was about creating awareness on the pros of the early testing of hepatitis, mode of transmission and the role of vaccination to prevent viral hepatitis and related complications,” he says. Manirakiza says this was also to raise awareness of viral hepatitis, an inflammation of the liver that causes severe liver disease including cirrhosis and hepatocellular carcinoma. This year’s World Hepatitis Day was celebrated under the theme “Hepatitis Can’t Wait”. With a person dying every 30 seconds from hepatitis-related illness–even in the current COVID-19 crisis— there is a need to act on viral hepatitis. Hepatitis is a deadly yet preventable disease, where everyone can take initiative to its elimination in our community. Emanuel Niyonsenga, RPSA public health officer, says there are five main types of the hepatitis virus; A, B, C, D, and E. He also notes that it has been established that hepatitis B and C are the most common which result in 1.1million deaths and 3 million new infections per year globally. Almost 90 per cent of people living with viral hepatitis are unaware they have it. Meanwhile, viral Hepatitis is still a global health threat causing 1,100,000 deaths with a person dying every 30 seconds from a hepatitis-related illness. Despite the current pandemic, hepatitis remains challenging and continues to cause preventable deaths. According to Dr Janvier Serumondo, Director of Viral Hepatitis and STI at Rwanda Biomedical Center (RBC), it’s clear that having complicated hepatitis B or C can worsen the outcome of patients infected by the Covid-19 virus. He says this means people with complicated viral hepatitis B or C (those with advanced liver fibrosis, cirrhosis or liver cancer) can be attacked more severely by the Covid-19. Efforts to help curb the disease in Rwanda have been deployed. Serumondo says a national plan for Viral Hepatitis C (HCV) elimination was launched in December 2018, with the goal to screen seven million people aged 15 and above and treat all positive cases, to reduce the HCV prevalence from four per cent to one per cent in less than five years. By launching the HCV national elimination plan, Rwanda is the first country in sub-Saharan Africa to do so. Throughout the years, Serumondo says the country has also made significant progress in implementing HCV control measures, including early screening of blood supply, training and enforcement of safe injection practices. Following the launch of HCV elimination, the country has simplified the diagnostics and treatment methodology by the introduction of Rapid Diagnostic Tests (RDTs), as well as Direct Acting Antiretrovirals (DAAs) for a 3-month HCV treatment course with less or no side effects, and a cure rate of more than 90 per cent. Dr Serumondo says there has been also the decentralisation of hepatitis services from four facilities in 2016 to all public health facilities (all public hospitals and health centres) in 2019 to date. “In the same framework, a task shifting has been put in place to increase access to services and general practitioners and nurses have been trained to support specialists in hepatitis management. “Therefore, over 1000 healthcare workers are trained and available to provide hepatitis services across the country,” he says. Based on the above said efforts in the management of viral hepatitis B and C, about 4,000,000 people have been tested for Hepatitis B (HBV) and over 5,000 people are on a lifelong HBV treatment. In addition to that, over 7,000,000 people, including children and adults, have been vaccinated for HBV. For HCV, over 5,000,000 people have been tested and more than 50,000 people have been treated and cured.
