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In 2016, deaths caused by viral hepatitis have surpbaded all chronic infectious diseases, including HIV / AIDS, malaria and tuberculosis, according to a study conducted globally. The prevalence of hepatitis B in Uganda is 4.1%, which means that 1.75 million people are infected. According to a study conducted by the Ministry of Health in partnership with the Center for Disease Control (CDC) and the World Health Organization (WHO).
We do not have representative national data on hepatitis C, but we have an estimate of 1.5%. However, these data come from blood banks, which are very restrictive as to the blood donors they use, so this probably does not give a faithful picture.
In 2005, the prevalence of hepatitis B was 10%, so the situation improves. However, nothing clearly indicates why this figure has decreased. these factors must be explored by research. A milestone was reached in 2014 when the government committed $ 3 million a year for the hepatitis response. Most of it is used for interventions against hepatitis B. There is still much to be done on hepatitis C, especially in terms of awareness, even among health workers.
Patients with viral hepatitis face a lot of stigma and discrimination due to the lack of knowledge of the general public. We must also mobilize the community to respond positively to hepatitis eradication programs.
An organization, the National Organization for People Living with Hepatitis B (NOPLHB), was created in 2012 by a group of people living with HIV for hepatitis B, including myself. We decided to dedicate our whole lives to advocating for the inclusion of hepatitis in the national health program. When we started, the Ministry of Health did not yet exist in the hepatitis program, but today there are offices specializing in hepatitis B and hepatitis C.
Civil society groups, like my organization, have done a lot of advocacy to mobilize communities and cultural leaders to hold the government accountable for the damage caused by hepatitis in Uganda. The damage does not only result from infections, but also from other problems that the high prevalence of this virus has caused, such as domestic violence and health complications, such as cirrhosis of the liver, the liver cancer and liver failure.
It is thanks to the commitments of civil society groups that the Ministry of Health has developed programs to raise awareness of hepatitis and to allocate funds for the fight against the disease.
We have trained more than 5,000 health workers with support from sponsors such as Gilead Sciences. Our training is very basic. We provide them with general knowledge to detect hepatitis and determine appropriate therapeutic interventions for patients eligible for treatment of hepatitis B.
The private sector has generally been silent about hepatitis, but recently we have begun to see private companies integrating the hepatitis B virus screenings into their health programs, and even drug companies have been found to be inactive. insurance now include the treatment of hepatitis B in their coverage.
The majority of the Ugandan population lives in rural areas where access to health care is limited. Therefore, as an organization, we organize awareness campaigns. Most people in these areas do not like going to public health facilities because they often find that services and medications are not available.
So, we go to these communities and offer free screenings of hepatitis B and affordable vaccines. I think this is the best way to help us find the "millions of missing people" because many people living with hepatitis do not know their status.
We have not yet managed to raise enough funds to reach this goal, but our ambition is that these outreach initiatives provide a single window for all hepatitis B and C services, such as the screening and liaison to care, with clear follow-up. monitoring mechanism.
We have just organized the first African Hepatitis Summit in Kampala from 18 to 20 June, and the government has exceptionally supported this event. The summit was important because it brought together high-level stakeholders, such as health ministry officials from different countries, WHO representatives, pharmaceutical companies and other strategic organizations.
In total, we welcomed more than 500 delegates from Africa and beyond. Our ambition for the next two years is for all African member countries of WHO to have their own plans of action for the elimination of hepatitis and for some countries to fund them at the national level.
Representatives of hepatitis patients also signed a statement inviting WHO to provide technical support for the development of national plans and strategies for the elimination of hepatitis. It also calls on African governments to provide national funding and calls on the African Union to badume political leadership and recognize hepatitis as one of the continent's most pressing challenges.
We will continue to involve all Program Managers who attended the Summit on the actions they undertake in their respective countries. We also wish to organize this event every two years and continue to bring together the countries that have shown interest and review our progress in the elimination of hepatitis on the continent.
Uganda must continue to involve patient communities in all programs, as ultimately these programs are intended to improve the lives of patients. We need to develop testing services in rural communities and create a clear referral system for linking HIV-positive people to the Hepatitis B test for proper care and management.
If we want to reduce the burden of hepatitis B in this country and more generally in Africa, our countries must introduce birth vaccination against hepatitis B for all newborns in order to avoid transmission of the virus from mother to child, which is a major route of transmission. If we do it quickly, we will have truly protected the younger generation of hepatitis B and have helped the country / continent for many years.
Mr. Kabagambe is the founding executive director of the National Organization for People Living with Hepatitis B.
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