Health Promotion and Policy Report: World Hepatitis Alliance Analysis

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This report analyzes the health promotion and policy strategies of the World Hepatitis Alliance (WHA) concerning Hepatitis B and C in India. The report begins with an introduction to the WHA, its mission, and its global efforts to raise awareness and advocate for improved health outcomes. It then focuses on the prevalence of Hepatitis B and C in India, particularly among children and marginalized populations, highlighting risk factors and modes of transmission. The report explores the impact of the disease, including the need for liver transplants. The report provides recommendations for the WHA to control and reduce the spread of the virus in India, including implementing vaccination programs, offering protection in medical care through syringe programs, and promoting comprehensive drug treatments. The report emphasizes the importance of screening, especially for pregnant women and those with chronic diseases, and the role of government in supporting these initiatives.
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Running Head: HEALTH PROMOTION AND POLICY
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Health promotion and policy
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HEALTH PROMOTION AND POLICY Q 1
Introduction
World Hepatitis Alliance is known as one of the most known international non-government
organization which is dedicated to advocating and raises awareness related to expanding of
hepatitis on the global level. At present this organization includes almost 249 members and is
spread in almost 84 countries all over the world. Growing number of hepatitis case on the global
platform has motivated this organization to work for improving health situation on the global
level. This organization came into existence when numbers of people who were suffering from
hepatitis started making people aware of this disease in 2006 (Ward, Averhoff and Koh, 2011).
This gave them an idea of starting an organization which will be dedicated towards this issue of
Hepatitis B and C. In 2007, this WHA was established to give this effort a correct direction in
order to improve the health situation of the individuals. This organization has one objective in
their mind which is to reduce the percentage of hepatitis without generating any earning through
their operations (Perz et al., 2008). WHA has organized a meeting at World Health Assembly on
the behalf of Brazil to discuss on spreading of Hepatitis disease. This discussion came into
positive end, when Egypt agreed to become volunteer for this program by agreeing to draft novel
resolution in 2013.
Hepatitis B and Cand C in children and marginalized population in India
From many years Hepatitis B and Cis considered as one of the common diseases on the global
level and according to the study it has been found that over 2 billion of the world populations are
being exposed by Hepatitis B and C virus, among which 350 million are very critical. Indian is
among one of the countries which are suffering from disease burden of around 50 million. As per
the study it has been found that Hepatitis B and Cis mostly found in tribal areas of India because
they follow intercaste marriage, traditional customs which are connected with the poor situation
linked with healthcare situations.
As per the study, it has been found that Hepatitis B and C have become chronic health disease in
India and is expanding predominantly in children's as well youths which are living remote areas
(Lahariya, Subramanya and Sosler, 2013). In addition, it has been explored that horizontal
transmission mode is not yet explored properly but it can be assumed that it mainly occurs due to
contact of skin or tissue membranes which when to tear which come in contact with any injury
(Gower et al., 2014). In addition to can be spread when an infected person shares their using
materials with another member of the family such as toothbrushes. It has been seen that patient
mostly comes in contact with this type of disease in their early age. As per the study, around 30%
of children who are in the age group of 2-5 years suffer from this hepatitis B, while in adults this
percentage is below 5%. Another concept behind spreading of this disease transmission from
parenteral end when they come in contact with the factors which promote this disease like
infected blood use, infected injection or some kind of occupational injuries which carrying some
health-related procedures. According to research, it has been seen that passing of disease
happens in three natural phases (Meena, Jindal and Hazarika, 2011). One is immunotolerant
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HEALTH PROMOTION AND POLICY Q 2
which is linked with e+ve along with normal enzymes loaded with high DNA, another is immune
active which is linked with Hepatitis B and Ce antigen and another is HBe antibody linked with
the inactive carrier. It has been seen that risk factors are increasing day by day related to
Hepatitis B and Cin people living outside the city because they people are continuously in touch
with dirt and another infected environment which is full of diseases (Shyamala, 2014). It has
been observed that the percentage of Chronic liver disease related to HBV is more in India
especially in children and people living in remote areas (Mehta et al., 2013). As a result of this
patient has to go through liver plantation. But with the help of LT program India is trying to
bring a decrease in the percentage of Hepatitis B and C in children as well as in adults. In
addition, they have also discovered some procedure to fight with such kind of disease which is
being chronic in nature.
Occurrence of HBV is found to be more as compared to high-risk chronic kidney disease which
forced the patient to go for dialysis, haemophilia or in some cases where it is linked with cancer
go for chemotherapy. It has been found that almost two-thirds of load related to the disease is
linked with this Hapitias B in which main target is children because their immune system is not
stronger as compared to adult (Jain et al., 2013). But it has been found in adults also because
they are also under the influence of this disease. These diseases make use of viral loads which
transfer naturally within the contact group. While the government has introduced vaccination for
this disease in order to stop their expanding. At some point, government has been able to reduce
the percentage of HBV but it not able to finish this disease completely (Setia et al., 2013). In this
situation, people must be screened in proper context in order to offer prevention against this
chronic disease, especially in the case of pregnant women and people suffering from other
chronic diseases like HIV and cancer.
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HEALTH PROMOTION AND POLICY Q 3
According to the latest research carried out in India, it has been found that Hepatitis B and Cis
spread by DNA virus which is known as deoxyribonucleic acid. It is also known as the family
member of Hepadnaviridae. This member usually focuses on adding various types of disease in
the host body and tries to reduce their immune system. Remote areas of India are continuously
affected by this HBV virus (Puri, 2014). This disease is self-limited along with its chronic face.
Most of the children and adults are being treated for this chronic Hepatitis B and Cby providing
them injections with can protect them for the time duration of six months. As per research
carried in India, it has been found that this disease has a direct link with the age because these
diseases are found common and chronic in children as compared to adulthood (Messina et al.,
2015). Research explored that chronicity in neonates are around 90 %, while children who are in
the age group2-5 percentage decrease up to 20% and in adults chronicity is less than 5%. This
survey explored that in some cases this disease does not do serious damage to the patient while
in some cases it has led to fibrosis and finally stop the liver to work properly (Saraswati et al.,
2015). In India, it has been found that most cases of Hepatitis B and C was spread in the body of
patient in the form of hepatocellular form which is difficult to control. On the global platform,, it
has been found that India is contributing around 5% of this disease burden on the global world as
compared to other developed countries (Sarin et al., 2016). Same kinds of percentages are
common in all other Asian countries with almost same kind of patterns. In recent years some
decrease has been seen in the percentage of this disease but still, it has stronger roots in the
remote areas of India. Earlier it was believed that this disease gets spread due to lack of
education among the people (Solomon et al., 2015). But recent studies proved that this disease
has nothing to do with the education because Hepatitis B and C were also found common in the
areas of Kerala which is considered as most education state in India with a literacy rate of 99%.
Recommendation
One of the best options which can help World Hepatitis Alliance organization to control or
reduce viral of hepatitis B and C is to implement two vaccine programs which are specially
developed to fight with the virus of Hepatitis family. This program was very successful in
Australia and in fact, it has decreased the percentage of this inflection to a very low level. In this
program, WHA was first to focus on universal vaccination which includes dose quantity of three
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HEALTH PROMOTION AND POLICY Q 4
or four within the regular program and this process will be mainly working on adults which are
living in remote areas of India (Komatsu, 2014). Another element of this program will be
selective vaccination in which the team will identify the population which is at risk due to the
influence of this virus in both children as well as adults in India which will be based on their
occupation and living standards. In addition, WHA will take help of government to promote this
program to every corner of the countries in order to fight with this disease (Aggarwal et al.,
2017). This program will also focus on one of the most important section of the population
which is always come under risks such as pregnant women and newborn babies which mainly
face issue linked with HBsAg-positive. In this section with the help of government WHA will try
to reduce the cost associated with this process so that a protection environment can be offered to
this section of the population. But before this process, WHA will try to put pregnant patient in
screening process.
(Source: Haruki Komatsu, 2014)
Second option for WHA for reduces influence of Hepatitis B and C in India is to offer the
environment of protection in medical care. This syringe program was followed by the United
States in their country to lower down the increase rate of this infection in the country and it really
helped the United States in reducing the percentage of people getting infected with this virus.
Under this syringe program, WHA will take care of syringe of the needle and offer proper
mentoring related to the possible issues connected with this inflection (Saxena et al., 2014). In
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HEALTH PROMOTION AND POLICY Q 5
addition, additional information will be offered to the public related to this program with the help
of various advertising tools. This will help in bringing awareness about their own health and will
try to explore all the necessary steps which were explained in this Syringe program (NCB, 2017).
This program will mainly focus on youth which belongs to remote areas of India. These sections
of people are under continuous contact with injuries due to bad infrastructure of the area and
therefore this kind of program will help them in taking care of their own health (Sunbul, 2014).
In addition, it will reduce the transmission of Hepatitis B among youths and will also cover the
children section under this program. Syringe for injection will automatically lower down the
possibility of spreading this disease by offering protected injunction. This program will offer the
same result as it offered in case of New York and San Francisco.
Third best option for WHA organization to stop spreading of Hepatitis B and C in India is to
make use of comprehensive drug instead of injection because population which is under the
influence of this virus are mainly connected with the rural areas of India. Therefore it will not be
possible to offer protection against this kind of virus through the medium of injection due to the
poor condition of the areas and environment linked with the areas (Zibbell et al., 2018). This
program was successfully carried in the remote parts of the United States and has offered
positive results in reducing the spread of this infection in remote areas of US. It has been seen
that injection are very common in rural areas and this strategy will automatically lower down the
cause of influence related to this virus.
Conclusion
Rising in Hepatitis B and C disease has truly become one of the most important concerns in
India, especially children and youths which belong to remote areas of India. In addition to this
govern has put their effort but is not successful in eliminating this infection completely in India.
Still, rural areas of India are continuously struggling from this disease. In this situation, WHA
can act as hope which can help in reducing the percentage of this disease before it becomes very
chronic for the common public.
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HEALTH PROMOTION AND POLICY Q 6
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HEALTH PROMOTION AND POLICY Q 7
References
Aggarwal, R., Chen, Q., Goel, A., Seguy, N., Pendse, R., Ayer, T. and Chhatwal, J. (2017) Cost-
effectiveness of hepatitis C treatment using generic direct-acting antivirals available in
India. PloS one, 12(5), p. Shyamala, V., 2014. Factors in enhancing blood safety by nucleic acid
technology testing for human immunodeficiency virus, hepatitis C virus and hepatitis B
virus. Asian journal of transfusion science, 8(1), p.13.0176503.
Gower, E., Estes, C., Blach, S., Razavi-Shearer, K. and Razavi, H. (2014) Global epidemiology
and genotype distribution of the hepatitis C virus infection. Journal of hepatology, 61(1), pp.45-
S57.
Jain, P., Prakash, S., Gupta, S., Singh, K.P., Shrivastava, S., Singh, D.D., Singh, J. and Jain, A.
(2013) Prevalence of hepatitis A virus, hepatitis B virus, hepatitis C virus, hepatitis D virus and
hepatitis E virus as causes of acute viral hepatitis in North India: A hospital based study. Indian
journal of medical microbiology, 31(3), p.261.
Komatsu, H. (2014) Hepatitis B virus: Where do we stand and what is the next step for
eradication? [online]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112872/
[Accessed 23/5/19].
Lahariya, C., Subramanya, B.P. and Sosler, S. (2013) An assessment of hepatitis B vaccine
introduction in India: Lessons for roll out and scale up of new vaccines in immunization
programs. Indian journal of public health, 57(1), p.8.
Meena, M., Jindal, T. and Hazarika, A. (2011) Prevalence of hepatitis B virus and hepatitis C
virus among blood donors at a tertiary care hospital in India: a fiveyear
study. Transfusion, 51(1), pp.198-202.
Mehta, K.D., Antala, S., Mistry, M. and Goswami, Y. (2013) Seropositivity of hepatitis B,
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Messina, J.P., Humphreys, I., Flaxman, A., Brown, A., Cooke, G.S., Pybus, O.G. and Barnes, E.
(2015) Global distribution and prevalence of hepatitis C virus genotypes. Hepatology, 61(1),
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HEALTH PROMOTION AND POLICY Q 8
NCB. (2017) Eliminating the Public Health Problem of Hepatitis B and C in the United States:
Phase One Report [online]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK368067/
[Accessed 23/5/19].
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worldwide. Journal of hepatology, 45(4), pp.529-538.
Puri, P. (2014) Tackling the hepatitis B disease burden in India. Journal of clinical and
experimental hepatology, 4(4), pp.312-319.
Saraswati, L.R., Sarna, A., Sebastian, M.P., Sharma, V., Madan, I., Thior, I., Pulerwitz, J. and
Tun, W. (2015) HIV, Hepatitis B and C among people who inject drugs: high prevalence of HIV
and Hepatitis C RNA positive infections observed in Delhi, India. BMC Public Health, 15(1),
p.726.
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Setia, S., Gambhir, R.S., Kapoor, V., Jindal, G. and Garg, S. (2013) Attitudes and Awareness
Regarding Hepatitis B and Hepatitis C Amongst Health. care Workers of a Tertiary Hospital in
India. Annals of medical and health sciences research, 3(3), pp.551-558.
Shyamala, V. (2014) Factors in enhancing blood safety by nucleic acid technology testing for
human immunodeficiency virus, hepatitis C virus and hepatitis B virus. Asian journal of
transfusion science, 8(1), p.13.
Solomon, S.S., Mehta, S.H., Srikrishnan, A.K., Solomon, S., McFall, A.M., Laeyendecker, O.,
Celentano, D.D., Iqbal, S.H., Anand, S., Vasudevan, C.K. and Saravanan, S. (2015) Burden of
hepatitis C virus disease and access to hepatitis C virus services in people who inject drugs in
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Sunbul, M. (2014) Hepatitis B virus genotypes: global distribution and clinical
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Ward, J.W., Averhoff, F.M. and Koh, H.K. (2011) World Hepatitis Day: a new era for hepatitis
control. The Lancet, 378(9791), pp.552-553.
Zibbell, J.E., Asher, A.K., Patel, R.C., Kupronis, B., Iqbal, K., Ward, J.W. and Holtzman, D.
(2018) Increases in acute hepatitis C virus infection related to a growing opioid epidemic and
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HEALTH PROMOTION AND POLICY Q 9
associated injection drug use, United States, 2004 to 2014. American journal of public
health, 108(2), pp.175-181.
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