The Vice President of Uganda, Edward Kiwanuka Ssekandi (Right) hands over an award of exceptional performance and contribution towards viral Hepatitis response in Uganda and the world, to Nicolas Granier, General Manager Africa (Centre) Infectious Disease - Markets, Rapid Diagnostics, Abbott and Jerome Clavel (Left), VP Global Marketing, Infectious Disease - Emerging Markets, Rapid Diagnostics, Abbott, during the opening ceremony of the Africa Hepatitis Summit at Speke Resort Munyonyo. Abbott is a manufacturer of medical diagnostics devices and kits.
Industry Wellness

Uganda intensifies hepatitis fight with an order to vaccinate all high-risk groups

President Yoweri Museveni has directed the Ministry of Health in Uganda and other partners to carry out activities targeting vaccination of hepatitis of all high-risk groups in terms of prevention and treatment.

In a statement read by the Vice President Edward Ssekandi on behalf of the President during the First African Hepatitis Summit held at Speke Resort Munyonyo Museveni said the risk of viral hepatitis B is more among health workers, infants born to mothers infected with hepatitis, the armed forces, prisoners, people with multiple sexual partners and individuals who get tattoos or those who do body piercing.

He said, all these must be vaccinated.

“I believe the African countries have the potential to address health challenges including ending the viral hepatitis diseases.

“I am glad to hear that the Ministers of Health from Africa, representatives of World Health Organisation, World Hepatitis Alliance, African Union and the Pharmaceutical Companies are here to address this important issue of viral hepatitis in Africa and globally,” said Museveni.

Uganda is one of the first countries in Africa to undertake the manufacture of Hepatitis B medicines, the first line drugs recommended for the treatment of Hepatitis B. This is being done by Cipla Quality Chemical Industries Ltd, a WHO-approved pharmaceutical manufacturer.

The company is also embarking on the manufacture of medicines for the treatment of Hepatitis C.

Museveni said that these efforts showcase the role that public and private partnerships can play in increasing access to hepatitis medicines and ensuring affordable, quality pharmaceuticals made in Africa for African patients.

Uganda’s Ministry of Health Jane Ruth Aceng said the at-risk population for chronic hepatitis B and C virus infections globally include; healthcare workers, the armed forces and prisoners who frequently receive blood/blood products, people living with HIV infection, people who inject with drugs and commercial sex workers.

However, the minister said they have not conducted prevalence and risk factor studies to ascertain National metrics/statistics.

“Globally, Hepatitis E outbreaks occur in resource-limited countries in areas where there is limited access to clean water, hygiene, sanitation, and health services.

“In the past, Uganda has experienced Hepatitis E outbreaks, in Northern Uganda districts of Kitgum and Napak in 2009 and 2013 respectively,” said Aceng.

Aceng said the government of Uganda has adopted the World Health Assembly (WHA) resolutions of 2010 and 2014 on viral hepatitis that recognize viral hepatitis as a public health problem and the need for governments and populations to take action to prevent, diagnose and treat viral hepatitis.

Following these resolutions, Aceng added that her Ministry has set up a Hepatitis Technical Working Group, which began developing a strategic action plan for the elimination of Hepatitis B.

The Vaccination plan to vaccinate adolescents and adults, and Statutory instruments declaring Hepatitis B as a public health threat in Uganda and another instrument which makes vaccination of health workers against Hepatitis B mandatory.

She said Uganda has made tremendous strides towards elimination of Viral hepatitis by introducing routine childhood pentavalent vaccine against hepatitis B into the National Expanded program on immunization in 2002. The infant three-dose Hepatitis B vaccination coverage has been over 90% since 2013.

“We do a screening of all donated blood against transfusable-transmittable Infections such as HIV, syphilis, Hepatitis B and Hepatitis C, the introduction of non-reusable injection devices at all public health care facilities and a phased approach screening and vaccinating the population for Hepatitis B beginning with regions with high prevalence,” said Aceng.

She said this started with the sub-region of West Nile, Acholi, Lango, Karamoja, and Teso sub-regions and are now in the Eastern region of the country (Bugisu and Busoga regions). A total of 3.7 million adolescents and adults have been screened and vaccinated since September 2015.

“We have designated treatment centres for viral hepatitis across the country from National Referral Hospital, Regional Referral Hospital, General Hospital to Health Center IV,  Cipla Quality Chemicals, a local manufacture and supply of single-agent Tenofovir making Uganda as one of the first countries in Africa to undertake the manufacture of Hepatitis B medicines and provision of free laboratory testing to those that test positive including; Liver Function Tests and Hepatitis B Viral load testing have all helped us in fighting the disease burden,” said Aceng.

Aceng said, her Ministry has as well met a number of challenges in conducting the population-based mass screening and testing for hepatitis B including high dropout rates for the vaccination of adolescent and adult.

“Initiation of positive patients on Treatment has uncertain rates of linkage and retention to care, Limited data on Hepatitis C since no serosurvey has been conducted to ascertain the burden of hepatitis C in the country which affects the capacity to plan effectively and Limited support from Health Development Partners especially with dwindling external financial support for disease control activities has affected diseases like viral hepatitis,” said Aceng.

Meanwhile, Abbott, a global healthcare leader that helps people live more fully at all stages of life, has announced that a recent clinical trial in Uganda demonstrated the high sensitivity of its Determine™ HBsAg 2 rapid test for the detection of hepatitis B surface antigen (HBsAg) in serum, plasma or whole blood.

The clinical trial findings also noted the test’s ease of use and excellent performance on various sample types.

“The Determine HBsAg 2’s unparalleled sensitivity in whole blood, plus its portability and ease-of-use, provides technology that can dramatically scale up testing services so more infected people can know their status and get treatment earlier,” said Damian Halloran, Vice President, Infectious Disease – Emerging Markets, Rapid Diagnostics, Abbott.

“The test is an ideal tool for African countries stepping up their hepatitis B elimination initiatives.”

Hepatitis B prevalence is high in the WHO Africa Region, where 6.1%, of the adult population, is infected.

While prevalence data is not currently available for Uganda, according to the 2016 Uganda Population-based HIV Impact Assessment (UPHIA) Survey, nine out of 10 Ugandans do not know their hepatitis B status.

Since 2015, the Ministry of Health of Uganda has implemented a nationwide education program to inform all Ugandans about hepatitis B and has provided testing, treatment and vaccination services.

BY PAUL TENTENA