Making Hepatitis C History

The Collaborative Centre for the Elimination of Viral Hepatitis of the World Health Organisation was opened last month in Tbilisi.

The National Centre for Disease Control and Public Health — the national agency tasked with protecting the public’s health against dangerous diseases — was granted the status of a Collaborative Centre, meaning that, according to the WHO, it will contribute to the developing, revising and monitoring of national hepatitis elimination plans, improve viral hepatitis testing strategies and strengthen diagnostic laboratory capacity in the Region. It will act as a demonstration platform for the WHO European Region and share experiences in hepatitis elimination with WHO Member States. 

At the opening, Georgian Minister of Health Zurab Azarashvili said, “The opening of the WHO Collaborating Centre on Viral Hepatitis Elimination in Georgia is a recognition of the significant success of the national Hepatitis C Elimination Programme and the strong support from international partners.”

VIRAL HEPATITIS - A WORLDWIDE THREAT

Hepatitis C is a blood-borne virus that causes inflammation of the liver. The infection can range in severity from mild illness to one which can last a lifetime and cause liver cirrhosis and cancer. Although antiviral medicines can prove effective in most cases, diagnosis remains a challenge.

The disease is a major concern for the World Health Organisation, which estimates that more than 58 million people worldwide suffer from chronic hepatitis C infection and that the condition is rising at the rate of 1.5 million new infections yearly. For most, testing and treatment remain beyond reach. The WHO statistics show that in 2019 alone, approximately 290,000 people succumbed to hepatitis C virus infection. In terms of mortality worldwide, hepatitis B and Hepatitis C are on a par with HIV, malaria and TB in making up the top four global infectious diseases. 

In 2016, a commitment to eliminating viral hepatitis as a public health threat by 2030 was made by the 194 WHO Member States. The aim is to reduce new hepatitis infections by 90% and deaths by 65% in that period through vaccination, testing, medicines and education campaigns.

GEORGIA, HOWEVER WAS AHEAD OF THE CURVE

having launched the unprecedented Hepatitis C Elimination Programme focused on testing and treating people with HCV in 2015. According to the WHO, at the time, more than 5% of the adult population were chronically infected with HCV — two-thirds of those were entirely unaware that they were infected. 

The Georgian elimination programme, strongly supported by the WHO and the US CDC, focused on testing and treating all HCV patients with effective direct-acting antivirals, which have a cure rate of over 99%. Biopharmaceutical company Gilead Sciences, for example, supplied Harvoni — a hepatitis C cure — to Georgia for free. (In the US, a course of treatment could cost as much as $1,100 a pill.) In total, more than 2.8 million people were screened and 80,000 treated. 

The achievements of the Georgia Hepatitis C Elimination Programme and also Hepatitis B vaccination programme have been critical in developing Georgia’s current public health capacity.

Speaking at the opening of the Tbilisi Collaborative Centre, Dr. Nino Berdzuli, Director of the Division of Country Health Programmes at the WHO/Europe, said, “Georgia has done much towards eliminating viral hepatitis. From designing health services that are centred around people’s needs to decentralizing and integrating viral hepatitis services in primary care settings, Georgia has been showing the way forward. This provides an opportunity for other countries to gain a practical understanding of how to overcome barriers in implementation and to turn strategy into reality.”

COREX Country Head in Georgia, Nana Pekhmashvili, agrees with Georgian Minister of Health Zurab Azarashvili who said, “Georgia will make an even greater contribution to the elimination of viral hepatitis in the European Region and to reducing the disease burden globally.”

“I AM EXTREMELY PROUD OF HOW GEORGIA HAS TACKLED THE PRESSING ISSUE OF DEALING WITH VIRAL HEPATITIS,” says Nana. “That this collaborative centre is in Tbilisi is a testament to how our country has tackled this chronic condition so far. Georgia can truly be a world leader in showing how to deal with this potentially fatal illness that so often goes undetected until it’s too late. My hope is that we can look back in 2030 and see that we have successfully eliminated it as a public health threat.”

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