New Case Studies on Hepatitis Elimination in Rwanda and Nigeria Released by The Economist
The Economist Intelligence Unit has published two articles on the battle against hepatitis in Rwanda and Nigeria, providing key insights into successful viral hepatitis elimination and management campaigns. This build upon similar pieces by The Economist on hepatitis elimination strategies in Egypt, Uganda, and Pakistan.
Following in the footsteps of Egypt’s 2018/19 success in addressing its hepatitis C prevalence, Rwanda is emerging as another case study of a successful viral hepatitis elimination campaign.
In terms of testing, Rwanda first introduced HCV screening in 1999 and then scaled up its capacity by using existing HIV programs and labs. All adults in Rwanda are recommended to get tested for HCV at least once in their lifetimes and at-risk populations are suggested to undergo testing annually. To combat HBV, the hepatitis B vaccine was introduced in 2000 and Rwanda has plans to introduce an HBV birth-dose immunization program in 2021 as well.
In efforts to increase access, the Rwandan government has repeatedly negotiated price reductions for rapid diagnostic tests and treatments and advocated for the inclusion of hepatitis-related care in private and public health insurance policies. A national mutual health insurance scheme currently covers 95% of the Rwandan population.
Rwanda’s efforts have led to the mass screening of 700,000 people for HCV and for 10,000 to be cured with treatment. In 2018, the nation set a goal to eliminate hepatitis C by 2024, six years before the 2030 global target set by the World Health Organization (WHO).
In contrast, Nigeria has put in place several strong measures to combat hepatitis B and C but hasn’t yet realized the same nation-wide results as Rwanda. Despite having free HBV vaccinations available through a childhood immunization program, vaccine coverage in the nation is only estimated to be around 51%. Also, mass screening of the population for HBV and HCV has proven to be difficult due to a lack of annual health checkups and conflict in Northern Nigeria. This is only exacerbated by the lack of inclusion of viral hepatitis as a part of national health coverage, pricing many Nigerians out of necessary vaccines, testing, and treatments.
Due to Nigeria’s slow implementation of hepatitis elimination and management strategies, the state government of Nasarawa launched its own viral hepatitis elimination program in 2015 and in February 2020, and announced its own 5-year HCV elimination plan. They aim to screen over 2.4 million individuals and treat 124,000 people by 2024, six years ahead of the WHO’s 2030 target. So far Nasarawa has screened over 85,000 people and cured 1,300. Success in Nasarawa can serve as a template to be adapted across Nigeria and eventually other areas of Sub-Saharan Africa.
This series of articles in The Economist outlines the plans, strategies, and guidelines that countries across the world have put in place to combat viral hepatitis. They each demonstrate the necessity for further political and financial commitment by policymakers and funders to continue on the path of eliminating the burden of hepatitis.
This series was made possible by the support of Abbott Laboratories.