NMA President, Dr. Osahon Enabulele
By Patrick Ugeh
Deeply concerned about the rapidly increasing incidence and prevalence of viral hepatitis in Nigeria, the Nigerian Medical Association (NMA) has called for the subsidisation of the high cost of treatment of people with liver cancer and liver failure in Nigeria, caused by the disease said to be a silent killer.
NMA President, Dr. Osahon Enabulele, who said this could be attained through the National Health Insurance Scheme (NHIS), attributed the escalation largely to lack of awareness of the disease amongst Nigerians.
His assertions were contained in a statement issued Sunday to mark the World Hepatitis Day with the theme: "This is Hepatitis; Know It; Confront It" which, he said, emphasised the fact that hepatitis remained largely unknown as a health threat in most parts of the world.
Enabulele explained that Hepatitis virus A, B, C, D and E were responsible for acute and chronic infections and inflammation of the liver that could lead to liver cirrhosis and liver cancer.
According to him, while Hepatitis virus A and E were transmitted faeco-orally and largely responsible for acute hepatitis, Hepatitis virus B and C which are blood-borne were mainly responsible for chronic hepatitis.
"These viruses therefore constitute a major global health risk with around 240 million people said to be chronically infected with Hepatitis B and about 150 million people chronically infected with Hepatitis C," Enabulele said.
He added that available statistics shows that millions of people world-wide were living with viral hepatitis with millions at high risk of being infected.
"Most people with chronic infection with Hepatitis B or C virus are unaware that they carry the virus, and are, therefore, at risk of developing severe chronic liver disease before they are clinically diagnosed.
They also unknowingly transmit the virus to other people because of their lack of awareness," he stated.
Enabulele added that about one million people die each year from causes related to viral hepatitis, most commonly from liver cirrhosis and liver cancer.
"Though Viral Hepatitis, particularly Hepatitis B and C remain largely under-reported and under-diagnosed in Africa, Sub- Sahara African region has about the highest prevalence of hepatitis A globally, with around 90 per cent children in the region being exposed to hepatitis A before the age of 10.
"Hepatitis B prevalence is estimated at eight per cent in West Africa, while prevalence of Hepatitis C is about 10 per cent in parts of Africa. Indeed, about 20 to 25 per cent of Africa’s population are chronic hepatitis carriers with liver cancer prevalent among affected individuals, with men in the 30 to 45 age group severely affected with almost 100 per cent mortality, as well as great economic and social impact."
Based on the above, Enabulele noted that the goal was moving from awareness to commitment and action to address the ‘silent epidemic’ of viral hepatitis, hence the World Hepatitis Day provides an opportunity to focus on specific actions.
He listed them as strengthening prevention, screening and control of viral hepatitis and its related diseases as well as increasing Hepatitis B vaccine coverage and integration of the vaccine into national immunisation programmes.·
Also, he urged coordinating a global response to viral hepatitis, development of a sound and updated national policy and strategy for combating viral hepatitis in Nigeria, along with increased Hepatitis B vaccination coverage.·
Further, he advocated provision of adequate housing, food supply/nutrition and clean potable water to Nigerians, as well as enforcement of Environmental Sanitation and Public health laws.
Towards further remedying the situation, the NMA boss suggested huge investment in public awareness campaigns to close the information gap.
He advised all stakeholders, including the relevant ministries and agencies of government, to show increased commitment in this direction.
"In this regard, the NMA shall continue to create awareness and sensitise Nigerians on the reality of this silent killer, Hepatitis. More public health enlightenment campaigns shall be organised by NMA," he stated.
"The NMA shall also contribute to research efforts on Hepatitis, especially the conduct of surveys to establish the burden of Hepatitis in Nigeria."
Enabulele assured that his association would continue to constructively engage policy makers on the need for formulation of a robust Hepatitis policy and strategy for Nigeria.
"We also encourage Individuals to take steps towards ensuring that they are not infected with Hepatitis B, C and D through abstinence, being mutually faithful to a sexual partner, not sharing skin piercing instruments, ensuring that blood products are properly screened before a patient is transfused. Individuals are encouraged to ensure that they drink clean potable water and eat well cooked food to prevent infection with Hepatitis A and E.
He also called on governments at all levels to ensure greater investment of funds and resources for regular conduct of National Surveys/ Researches to determine the burden of hepatitis in Nigeria.
"While we thank the federal government for including Hepatitis in the list of routine NPI- driven vaccinations we strongly urge government to expedite all actions in the process of domestic vaccine production or more effective collaboration with partners in ensuring greater availability of vaccines at much reduced cost," he said.·