The Western Pacific presents the highest estimates of Hepatitis B Virus (HBV) prevalence globally. Despite early gains achieved in some national immunisation programs of the birth HBV dose, around 115 million people are still living with chronic hepatitis B across the region. Without treatment, up to a quarter of these individuals will die from cirrhosis and hepatocellular carcinoma. Countries in the Pacific have requested support from WHO and development partners to develop and establish a comprehensive prevention and control response for viral hepatitis in the region. 

 

The Regional Action Plan for Viral Hepatitis in the Western Pacific Region 2016-2020 was approved for action by Member States in 2015. It was intended to guide Member States in developing country-specific national hepatitis responses based on the needs and priorities of people living with hepatitis or at risk for viral hepatitis, as well as build the capacity of the national health sector to address these needs.

 

This led to ASHM International, in collaboration with the WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute, carrying out a scoping mission to assess the response to viral hepatitis in Fiji, Kiribati, the Solomon Islands and Vanuatu in 2019. The aim of the scoping visit was to support comprehensive and multi-sectoral action to address the emerging public health threat of viral hepatitis in Pacific Island countries. Recommendations arising from the scoping visit included the strengthening of data collection systems, updating the essential medicines list to incorporate medications for hepatitis B, the development of testing and treatment guidelines for viral hepatitis, broadening the availability of diagnostic testing, integrating the response to hepatitis B into all levels of health service provision, and building health worker confidence and competence in the delivery of high quality health services for hepatitis B.

 

In response to the identified need for clinical workforce development, ASHM International has developed the ‘Hepatitis B in Health Settings’ training package. The overall aim is to increase the knowledge, skills, and confidence of the health workforce in the Pacific, both in prevention of new hepatitis B infections (safe injections, blood safety, prevention of mother to child transmission and vaccinations programs) and in the care and treatment of people living with hepatitis B. The first training will be delivered in Honiara in May 2021 by Dr Nicole Allard from the Victorian Infectious Diseases Laboratory at the Doherty Institute, and Professor Gail Matthews from the UNSW Kirby Institute. Participants will include medical officers from the Solomon Islands OBS/GYN and paediatric teams, physicians, pharmacists, lab technicians, and representatives from the Solomon Islands National Hepatitis Program. The training package is delivered over three days and is designed to be modified in collaboration with local partners and identified needs in local health system across the Asia and Pacific region.

 

2021 will also see ASHM International, in collaboration with WHO Western Pacific Regional Office, deliver the on-demand session “Constructing the Cascade: Addressing Hepatitis B in the Pacific” at the 2021 Australasian Viral Hepatitis Conference. This session will focus on recent achievements gained within Pacific Island Countries in development and implementation of hepatitis B responses. Bringing together policy makers, health workers and people with hepatitis B, it will highlight the challenges and talk through the change and innovation required for integrated HBV programming in Pacific health systems.