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Sri Lanka and Maldives Attain Hepatitis B Control, Confirms World Health Organization

The World Health Organization (WHO) declared on Wednesday (17) that Sri Lanka and the Maldives have successfully achieved control over hepatitis B, as verified by an expert panel. The panel affirmed that both countries have consistently maintained high coverage of hepatitis B vaccine doses for infants, coupled with a low prevalence of the deadly disease, as corroborated by recent serological surveys.

Dr. Poonam Khetrapal Singh, Regional Director of WHO South-East Asia, lauded the achievement, praising the concerted efforts of health leaders, officials, health workers, and the people of Sri Lanka and the Maldives in prioritizing the health and well-being of their communities.

The Expert Panel for Verification of Hepatitis B Control in the WHO South-East Asia Region meticulously reviewed childhood immunization data from both countries, revealing over 90% coverage with hepatitis B vaccine doses provided during infancy over the past several years. National surveys conducted in 2022-2023 further supported these findings.

Dr. Supamit Chunsuttiwat, Chairperson of the Regional Expert Panel for Verification of Hepatitis B Control, stated that based on the evidence presented, the panel concluded that the standards required for verification of Hepatitis B control have been met in both Sri Lanka and the Maldives. Consequently, the panel recommended the recognition of the accomplishment of this vital public health target in both nations.

Sri Lanka and the Maldives now join Bangladesh, Bhutan, Nepal, and Thailand, who achieved a similar feat in 2019.

Preventing hepatitis B infection in infancy significantly reduces the incidence of chronic infections, liver cancer, and cirrhosis in adulthood. Despite this achievement, the South-East Asia Region remains committed to ongoing efforts in hepatitis control, given the region’s estimated 60 million people living with chronic hepatitis B and the annual toll of 218,000 deaths from hepatitis B and C.

The Region set a goal in 2016 to reduce hepatitis B prevalence to less than 1% among children aged at least 5 years. The hepatitis B vaccine, part of the pentavalent vaccine, has been included in the national childhood immunization schedules of all countries in the Region.

While progress was made until 2019, there was a decline in coverage in 2020 and 2021 due to the COVID-19 pandemic. Recent estimates for 2022 indicate a recovery to pre-pandemic levels, with the overall coverage of the 3rd dose of the pentavalent vaccine reaching 91% in the Region.

Dr. Khetrapal Singh emphasized the need to improve the hepatitis B vaccine birth dose, highlighting challenges such as home deliveries hindering timely access to the vaccine for newborns. Inequities in immunization service delivery, suboptimal awareness, and training of health staff were also identified as contributing factors.

The Regional Director concluded by emphasizing the importance of achieving the control goal, marking a critical step toward eliminating mother-to-child transmission of the hepatitis B virus. The WHO’s “triple elimination initiative” encourages countries to commit to simultaneous elimination of hepatitis, HIV, and syphilis, reinforcing the call for integrated service delivery.

In addition to vaccination, the Regional Director stressed the need for continued efforts to scale up preventive measures such as safe injection, safe blood, and infection prevention and control in the ongoing fight against hepatitis.

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