Experts identify major disruptions to hepatitis elimination efforts caused by COVID-19

It is now just over a decade since 28 July was designated as World Hepatitis Day by the WHO

The Coalition to Eradicate Viral Hepatitis in Asia Pacific, Hepatitis, Burnet Institute, WHO, Professor Rosmawati Mohamed, World Hepatitis Day

On 24 July 2020, the Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP) co-hosted a webinar with Burnet Institute, in collaboration with World Health Organization (WHO) Western Pacific Region and WHO South East Asia Region, inviting health experts to discuss how people living with hepatitis, and the services they access, are affected by the COVID-19 pandemic and the implications this may have on the goal to eliminate viral hepatitis as a public health threat by 2030.

It is now just over a decade since 28 July was designated as World Hepatitis Day by the WHO. Each year, the health sector comes together to bring worldwide attention to the huge unmet need in the area of viral hepatitis, to share work experiences of those living and combatting the virus, and identify what still needs to be done to achieve the goal of eliminating viral hepatitis as a public health threat by 2030.

This year, however, they came together on a World Hepatitis Day like no other, with the COVID-19 pandemic having thrown us new scenarios and challenges that impact the lives of people working and living with hepatitis in many ways. Last week's webinar, titled #HepFree Future in Asia and Pacific: Hepatitis elimination in the time of COVID-19, heard from various speakers from the region who presented perspectives from a range of countries including Vietnam, Thailand, Pakistan, China, Indonesia, Malaysia and Australia.

CEVHAP Co-chair, Professor Rosmawati Mohamed of the University of Malaya, presented results of the World Health Organization survey "Disruption in HIV, Hepatitis and STI services due to COVID-19" carried out by from April to June 2020, noting the highest levels of disruption being reported in the Western Pacific Region. These disruptions included:
• Diversion of health services to combat COVID-19
• Travel and transport restrictions limiting access to hepatitis services
• Reductions on continuity of hepatitis treatment
• Drug stock outages

An alarming reduction in cancer services was also highlighted, with 80% of countries reporting disruption occurring in services for cancer and other non-communicable diseases with disruption being highest in countries with the most severe transmission phase of COVID-19. With implications for the longer-term development of new therapies, a significant reduction of an average of 65% in enrolment in clinical trials has been observed causing some trials to be suspended or abandoned altogether.

However, while many disruptions were reported by speakers, there was also a number of potential opportunities noted that could assist the hepatitis elimination effort as a result of the extensive changes and innovations occurring in healthcare systems due to COVID-19.

Professor Mohamed said, "There are some positives that may come from this pandemic for example, a number of governments are using multi-month dispensing (3-6 month) and changing community delivery services, offering benefits over the long term and at the same time promote innovation in people-centred service delivery."

Associate Professor Joe Doyle of the Burnet Institute spoke of the further challenges facing vulnerable and hard-to-reach groups in the community and expressed the view that the current pandemic presents us with a number of solutions and opportunities. These include the opportunity now for us to focus on patient-centred healthcare, with Professor Doyle saying that "new models of outreach to deal with COVID-19 really should also be applied to hepatitis."