GENEVA, Switzerland (CMC) — The World Health Organization (WHO) is urging Caribbean and other countries to take rapid action to improve knowledge about viral hepatitis, and to increase access to testing and treatment services.

Yesterday, which was recognised as World Hepatitis Day, the WHO said only one in 20 people with viral hepatitis know they have it, and that just one in 100 with the disease is being treated.

Around the world, WHO said 400 million people are infected with hepatitis B and C, more than 10 times the number of people living with HIV.

An estimated 1.45 million people died of the disease in 2013 – up from less than a million in 1990, the WHO said.

In the Americas, including the Caribbean, more than 125,000 deaths each year are associated with viral hepatitis, 99 per cent of them due to hepatitis B and C.

According to the WHO, an estimated 7.2 million people are living with chronic hepatitis C in the region, and only 25 per cent have been diagnosed and of those only 300,000 are receiving treatment.

Due to the availability of new treatments, the WHO said about 90 per cent of those infected with Hepatitis C can be cured, reducing the risk of death due to liver cancer or cirrhosis.

“Viral hepatitis continues to be a silent epidemic because the majority of people who have Hepatitis B or C don’t know that they have it, since the infections take years to appear,” said Massimo Ghidinelli, chief of the HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections unit at the Pan American Health Organization (PAHO).

“That’s why it’s important for the countries to increase their efforts to widen access to diagnosis and treatment because those measures can save many lives,” he added. “It’s also important to inform people about these diseases and ways to prevent them.”

According to PAHO, in May 2016, at the World Health Assembly, 194 governments adopted the first-ever Global Health Sector Strategy on viral hepatitis and agreed to the first-ever global targets.

It said the strategy included a target to treat eight million people for hepatitis B or C by 2020.

PAHO said the longer-term aim is to reduce new viral hepatitis infections by 90 per cent and to reduce the number of deaths due to viral hepatitis by 65 per cent by 2030 from 2016 figures.

Ministers of health from the Americas in 2015 approved a series of measures to prevent and control viral hepatitis infection, with emphasis on hepatitis B and C, as part of the Plan of Action for the Prevention and Control of Viral Hepatitis 2016-2019, PAHO said.

It said the plan asked countries to create national plans to fight hepatitis, to extend vaccination against Hepatitis B to all children under one-year-old and target high-risk and vulnerable population groups, to raise public awareness through information campaigns, and to pursue options to expand access to medicines.

Hepatitis is an inflammation of the liver, most commonly caused by a viral infection by one of the five main hepatitis viruses (types A, B, C, D and E), said PAHO, adding that it can result in acute infections and lead to chronic disease liver cirrhosis, cancer or even death.

PAHO said Hepatitis B and C infections are transmitted through contaminated blood, as well as through contaminated needles and syringes, and among people who inject drugs.

The viruses can also be transmitted through unsafe sex and from an infected mother to her newborn child. The vaccine for hepatitis B has been available since 1982, and PAHO says that all the countries of Latin America and the Caribbean have adopted the vaccine in their national immunisation programmes, with coverage rates averaging 90 per cent.

In addition, PAHO said more than 99 per cent of blood units collected in these countries is screened for hepatitis B and C.

As of 2014, 84 countries vaccinate infants against hepatitis B as part of their vaccination schedules and 82 per cent of children in these states received the hepatitis B vaccine.

This is a major increase compared with 31 countries in 1992, the year that the World Health Assembly passed a resolution to recommend global vaccination against hepatitis B.

PAHO says, in addition, it has implemented blood safety strategies, including quality-assured screening of all donated blood and blood components used for transfusion, can help prevent transmission of hepatitis B and C.

“Harm reduction services for people who inject drugs are critical to reduce hepatitis in this population,” it said. “Safer sex practices, including minimising the number of partners and using barrier protective measures (condoms), also protect against transmission.”

However, PAHO said some countries are finding ways to get services to the people who need them, stating that these efforts are made easier by the declining price of hepatitis C medicines.

The health organisation said prices are now dropping, particularly in countries that have access to generic drugs.

In 2015, a preliminary analysis estimated that 300 000 people living in low-and middle-income countries had received hepatitis C treatment based on the new direct-acting antivirals.

“Early detection and access to quality medicines at accessible prices could prevent many complications such as cirrhosis and liver cancer, saving many lives and increasing the quality of life for people,” Ghidinelli said. “This is the first time that we can cure a chronic viral infection since we have new medicaments with high cure rates and few adverse effects. But they are still very expensive”.