Malaysia National Strategic Plan for Hepatitis B and C 2019-2023
The burden of viral hepatitis in the country has been increasing. It is estimated that 1.1%3 and 2.5% of the population in the country were infected with hepatitis B virus and hepatitis C virus in 2017 and 2009, respectively. Furthermore, a high disease burden also means more cases of complications resulting from viral hepatitis infection, such as liver cirrhosis and hepatocellular carcinoma. Viral hepatitis is generally preventable, treatable and potentially curable. Thus, it is crucial that appropriate intervention measures are put in place. With the latest advances in technology relating to screening and diagnosis of the disease, as well as the availability of effective and affordable treatment, the prevention, treatment and cure of viral hepatitis are now possible.
Malaysia has committed towards combating viral hepatitis by 2030. In working towards achieving this commitment, a national strategic plan has been developed; the first for the country. This National Strategic Plan for Hepatitis B and C (NSPHBC) documents a structured and comprehensive strategy and plan of action for the planning, implementation, monitoring and evaluation of viral hepatitis programmes and activities in the country. The NSPHBC is intended for the use by all stakeholders at various levels, from policy makers to implementers.
The objectives of this NSPHBC are:
- To establish and strengthen national policies for the prevention, control, diagnosis, treatment and care of viral hepatitis B and C.
- To prevent the transmission of viral hepatitis B and C.
- To reduce the morbidity and mortality of viral hepatitis through early detection and effective case management.
- To improve the survival and quality of life among individuals with chronic liver disease.
- To promote partnerships with relevant stakeholders for the prevention, control, diagnosis, treatment and care of viral hepatitis B and C.
This NSPHBC outlines five key strategic areas:
Strategy 1 : Advocacy, communication and social mobilisation
Strategy 2 : Quality and coverage of prevention programmes
Strategy 3 : Access to diagnostic, treatment and care services
Strategy 4 : Quality strategic information, monitoring and evaluation, and research
Strategy 5 : Capacity building and enhancement
The targets to be achieved by 2030 are:
- To diagnose 90% of the population living with viral hepatitis.
- To reduce the number of new cases of viral hepatitis by 90%.
- To reduce mortality due to viral hepatitis by 65%.
- To treat 90% of the population in need of treatment.
The action plan outlined to guide the implementation of activities to address the key strategies and to achieve the targets set mainly focus on the following:
a) Promoting the awareness of viral hepatitis among healthcare providers, the general population and high-risk groups;
b) Strengthening the professional training for viral hepatitis management;
c) Establishing a national-level steering group for the strategic planning and governance of viral hepatitis management;
d) Upscaling the screening for viral hepatitis, especially in high-risk groups and antenatal mothers;
e) Strengthening the current system for blood and blood product screening;
f) Sustaining the coverage for HBV vaccination;
g) Improving and upscaling the existing harm reduction programmes;
h) Expanding the coverage, ensuring the sustainability and improving the patient adherence for hepatitis B and C treatment;
i) Strengthening the current notification system, developing a centralised monitoring system or patient registry, establishing a domestic laboratory network and encouraging research activities for viral hepatitis;
j) Strengthening the collaboration with non-governmental organisations via knowledge sharing.
The NSPHBC also outlines the proposed budget requirements for five years from 2019 to 2023. A midterm review and a second evaluation are to be carried out, in 2021 and 2023 respectively.