1. Overcome Health Inequities to Eliminate Viral Hepatitis, The Journal of the American Medical Association (JAMA)

Valdiserri, R.O., Koh, H.K., & Ward, J.W.*

April 17, 2023

This opinion piece co-authored by CGHE director John Ward was published in the Journal of the American Medical Association in May of 2023. It presents the argument that efforts to eliminate viral hepatitis in the United States can be accomplished by overcoming systemic health inequity barriers that impact many traditionally underserved communities and people. Health inequities stem from social, environmental, economic, and structural challenges causing unfair disparities within healthcare. “Overcome Health Inequities to Eliminate Viral Hepatitis,” emphasizes the need to overcome these health inequities by expanding access to prevention and care services for those disproportionately impacted by viral hepatitis. Read more on the article co-authored by John Ward, Howard Koh, and Ronald Valdiserri on how community level coalitions can contribute to health equity, including advocating for hepatitis services law and policy revisions.

Read “Overcome Health Inequities to Eliminate Viral Hepatitis” here.

2. Status of HBV Birth Dose Vaccination in Africa: The Impact of COVID-19 and Gavi Support on Policy Development, The Lancet Gastroenterology & Hepatology

Njuguna, H.*, Hiebert, L.*, Gupta, N.*, & Ward, J.W.*

March 27, 2023

Hepatitis B birth dose (HepB-BD) vaccination coverage in the WHO Africa Region is the lowest compared to other regions, with 14 of 47 African countries having active policies for routine hepatitis B vaccination as of 2022. From Oct 11, 2022 to Jan 9, 2023, CGHE distributed an electronic survey to Expanded Program on Immunization managers and hepatitis program leaders in 36 African region countries in order to review existing policies for routine HepB-BD vaccination and assess the impact of the response to the COVID-19 pandemic, including the delay in Gavi support on decisions to introduce or scale-up HepB-BD vaccination. The survey also sought to review the impact of the COVID-19 pandemic on decisions to introduce or scale-up HepB-BD vaccination and to assess national priorities for the use of future Gavi support to improve HepB-BD vaccination programs in Africa. This comment from The Lancet,“Status of HBV Birth Dose Vaccination in Africa: The Impact of COVID-19 and Gavi Support on Policy Development” co-authored by Henry Njuguna, Lindsey Heibert, Neil Gupta and John Ward reviews the survey results and presents an argument for Gavi support for hepatitis B birth dose implementation in Africa.

Read "Status of HBV Birth Dose Vaccination in Africa: The Impact of COVID-19 and Gavi Support on Policy Development" here.

3. Paving the Way Towards Hepatitis B Virus-Free Generations in Africa, The Lancet Global Health

Lesi, O.A. & Ward, J.W.*

November 2021

Children in Africa are in need of protection from hepatitis B (HBV), with upwards of 4.3 million young children infected with HBV. Most infections within children occur in newborn babies through the mother-to-child transmission route. Limited access to routine hepatitis screening/testing services and lack of birth dose policies have led to the global inequities in the burden of new HBV cases. Hepatitis B is passed from a hepatitis B infected mother to child during pregnancy and/or childbirth. To eliminate mother-to-child transmission risks and stop HBV breakthrough infections of newborn babies, a HBV birth dose is recommended within 24 hours of birth. An article written by Olufunmilayo A. Lesi and the Coalition’s John Ward in The Lancet Global Health talks about opportunities and challenges regarding HBV mother-to-child transmission prevention. Improving health equity for young children in Africa includes expanding access and resources for HBV testing to better improve detection, improving care services ensuring the quality of health for mothers and their newborns, and advocating for birth dose vaccination policies in African countries. The African Union, Coalition for Global Hepatitis Elimination, and World Hepatitis Alliance work to provide assistance in implementing HBV birth-dose vaccination and mother and child health programs in Africa.

Read "Paving the Way Towards Hepatitis B Virus-Free Generations in Africa" here.

4. Retreatment of Chronic Hepatitis C Infection: Real-World Regimens and Outcomes From National Treatment Programs in Three Low- and Middle-Income Countries, Clinical Infectious Diseases

Boeke, C., Hiebert, L.*, Waked, I, Tsertsvadze, T., Sharvadze, L., Butsashvili, M., Zakalshvili, M., Naing, W., Gupta, N.*, Kateera, F., McClure, C., Ward, J.W.*, & Ramers, C.B,

July 3, 2021

Low- and middle-income countries rely on simple public health practices and affordable treatments and medications (generic direct acting antivirals - DAAs) to treat/eliminate hepatitis C (HCV). Gaining access to treatments within low-and middle-income countries can become a challenge for persons who have not actively participated in initial HCV therapies. High cost of recommended treatments have been a cause of absence of HCV initial treatments. Retreatment of Chronic Hepatitis C Infection: Real-World Regimens and Outcomes From National Treatment Programs in Three Low- and Middle Income Countries co-authored by the Coalition’s Lindsey Hiebert, Neil Gupta, and John Ward present results and discussion from a Coalition for Global Hepatitis Elimination and Clinton Health Access Initiative partnered survey. Despite the unavailability of recommended treatments (second-line therapies), medical care providers in Egypt, Georgia, and Myanmar have benefited by using alternative therapeutic medications which has cured upwards of 93% of individuals living with HCV in low- and middle-income countries.

Read "Retreatment of Chronic Hepatitis C Infection: Real-World Regimens and Outcomes From National Treatment Programs in Three Low- and Middle Income Countries" here.

5. Hepatitis C Standards of Care: A Review of Good Practices since the Advent of Direct-Acting Antiviral Therapy, Clinics and Research in Hepatology and Gastroenterology

Lazarus, J.V., Picchio, C.A., Guy, D., Aleman, S., James, C., Nava, F.A., Øverhus, A., Turnes, J., Ward, J.W.*, & Ustianowski, A.

March 2021

In order to achieve world-wide elimination of hepatitis C virus by 2030 as proposed by the World Health Organization, many steps must be taken nationally and globally. Tools to eliminate HCV have already been established; the next goal is to implement them in various settings worldwide. This seminar article co-authored by John Ward and others, “Hepatitis C standards of care: A review of good practices since the advent of direct-acting antiviral therapy,” documents 13 proven HCV practices that have become standard care or are believed to become standard practice of care in the near future. For example, to achieve HCV elimination, it is critical to increase access and availability of HCV treatment therapies (DAAs) and to limit barriers to screening and scale up treatments. Many of the good practices mentioned in this seminar article refer to improving methods to identify, evaluate, implement, and monitor health evidence. Documenting practices for HCV care contributes to health equity by exchanging new methods to improve health outcomes within populations and settings at risk for HCV.

Read "Hepatitis C Standards of Care: A Review of Good Practices since the Advent of Direct-Acting Antiviral Therapy" here.

To access all our staff publications, visit the CGHE Staff Bibliography page.