Fighting Hepatitis and Liver Cancer in the Asia-Pacific: Charting New Policy Paths for Progress
Hi everyone, today, we're diving into a critical issue that's been staying in the shadows, silently affecting millions in the Asia-Pacific (APAC) region. We're talking about the alarming prevalence of hepatitis and hepatocellular carcinoma (HCC) in APAC and why it's high time we chart new policy paths to confront these health issues.
The Silent Epidemic
Picture this: APAC, the powerhouse of global liver disease deaths, accounting for a staggering 63% of the total. Viral hepatitis and HCC are playing a prominent role in this scenario. What's even more alarming is that 90% of those infected with viral hepatitis in APAC remain undiagnosed. It's a ticking time bomb.
The Stages of Liver Disease
Now, let's break it down. Liver disease isn't a one-size-fits-all issue. It unfolds through several stages, starting with chronic hepatitis, moving on to acute viral hepatitis (think B and C), cirrhosis, and ultimately, HCC. At each stage, it takes a toll on lives and economies.
Hepatitis: A Silent Killer
Hepatitis isn't just another health challenge; it's a challenging rival:
APAC loses a staggering one million lives to hepatitis each year.
Wrap your head around this: 182 million people in China and India alone grapple with chronic HBV or HCV infections.
Shockingly, hepatitis claims three times more lives than HIV/AIDS.
If you think the clinical aspect is heavy, wait till you hear this: the economic burden is a whopping AUD 26 billion, mostly due to lost productivity.
Current Status of Hepatitis Elimination
The World Health Organization (WHO) has set a goal: eliminate hepatitis by 2030. Unfortunately, most APAC territories are lagging behind. But here's what success looks like:
National Action Plans: It all starts with a solid national plan for hepatitis elimination.
Political Will: Without political commitment and coordination, we're stuck in neutral.
Funding: Adequate financial resources are non-negotiable.
Integrated Screening: Screening programs tailored to diverse populations are game-changers.
Eliminating hepatitis isn't just a health win; it's a financial jackpot.
The HCC Challenge
Now, let's shift gears to hepatocellular carcinoma (HCC):
HCC is the dominant liver cancer type, ranking fifth in the cancer hierarchy, and it's the second deadliest in APAC.
An astonishing 73% of global HCC cases in 2020 were in APAC, with 610,000 new cases.
More stats: 72% of all HCC deaths worldwide are in APAC, totalling 566,000 cases.
Premature death is a common outcome as 80% of HCC cases in APAC are diagnosed at an advanced stage.
The Economic Side of HCC
It's not just a health crisis; it's an economic one too:
In China alone, the economic burden of liver cancer was a staggering USD 11.1 billion in 2019, equivalent to 0.047% of the local GDP, and it's projected to soar to 34 billion by 2030.
Current HCC Management
While some APAC territories are doing well, others have room for improvement in managing HCC. Japan is leading the way thanks to these key factors:
National Surveillance: A robust national HCC surveillance program is fundamental.
Political Commitment: Political will and coordination matter—a lot.
Funding: Money talks; adequate funding is vital.
Protocols and Quality: High-quality treatments and precise protocols make a difference.
A well-funded HCC surveillance program isn't just a cost-effective move; it's a smart one.
The Time to Act is Now
It's not a time for complacency; it's time for collective action:
Comprehensive Hepatitis Plans: Let's create comprehensive national action plans with clear goals, adequate funding, and trackable progress.
Expanded Screening and Treatment: Integration is key; let's improve access to care for affected populations.
Integrated Funding: Advocate for domestic resources and catalytic funding to supercharge programs.
HCC Surveillance: Let's take a page from Japan's playbook; well-funded HCC surveillance programs are indispensable.
Boost Awareness: It's time to launch public awareness campaigns to combat stigma and gain political commitment.
A Call to Arms
In the past 8 months, I’ve been working to build a collaborative platform with key stakeholders in the liver space: healthcare companies, NGOs, global funds, patient advocacy groups, academia, experts and key opinion leaders. This platform is called The APAC Liver Disease Alliance and is facilitating policy discussions to reduce the growing burden of liver diseases in the Asia-Pacific. We’ve written a paper on this topic, that you can retrieve here. It is a comprehensive landscape analysis that highlights best practices and gaps and puts them together to build recommendations for better liver health management. Now it's time to put these recommendations into action. Each group has a role to play, and together, we can overcome the challenges of eliminating hepatitis and managing HCC.
Bibliography: For a full list of the resources I used to write this article, visit https://apacliverdiseasealliance.org/content/uploads/2023/07/Hepatitis-and-HCC-Elimination-in-APAC_White-Paper.pdf
