As part of a Pan-African awareness campaign for viral hepatitis B and C — in partnership with the TOTAL African Cup of Nations — Gilead Sciences has asked leading African experts to share their opinions on the disease. The opinions in this editorial are those of the author Theobald Owusu-Ansah and do not necessarily reflect the views of Gilead Sciences. To learn more about the campaign, visit www.kickthevirus.com.
By Theobald Owusu-Ansah
In Ghana, 3.7 million people have hepatitis B (HBV), a prevalence of 13%. A further 1.1 million have hepatitis C (HCV), a prevalence of 4-5%.The northern regions have especially high rates of HCV while the prevalence is significantly lower in the southern regions. Moreover, the problem is especially severe in the rural areas due to a lack of awareness and access to healthcare.
My organisation, The Hepatitis Foundation of Ghana, is a non-profit that fights on behalf of patients to expand access to screening, vaccination and treatment of hepatitis. Advocacy in Africa is difficult. You want to change something but you know it will take years before you can. Moreover, change always comes with a cost. When we first brought this issue to the attention of policy makers, many felt we were just creating problems for them because they feared that people who tested positive for hepatitis would demand treatment from the state.
Government had no official response to hepatitis when we first established the organisation in 2007 but by 2014 an official policy on fighting the disease was introduced and by 2016treatment guidelines had also been mandated. We were proud to play a part in developing Ghana’s hepatitis guidelines, in collaboration with other stakeholders. A Hepatitis Program Manager has also been appointed to the Ghana health service.
Now, we are focused on engaging politicians in dialogue around areas of shared interest, because the only way to get government attention is to get Parliament approval first. We will be requesting a meeting with the Parliament Committee on Health, during which we can relate our first-hand experience confronting the severe impact of hepatitis B & C on ordinary Ghanaians.
National insurance does not cover hepatitis in Ghana. Access to doctors who can treat hepatitis is available at teaching hospitals in only four out of the country’s 16 regions. So, patients have to travel to different regions to access treatment and the waiting period for an appointment can be up to six months.
As a way to overcome this barrier, we have appointed some of the doctors as board members of our organisation. This allows us to book appointments with the doctors directly so that our patients can bypass the six-month hospital waiting period and receive treatment immediately.
We coordinate between our partner doctors, hospitals and patients to make the process of diagnosis and treatment as easy as possible, regardless of how remote the area these patients may reside in. We often deliver medication directly to patients by car and send them test results through WhatsApp. Unfortunately, the transport costs have to be paid by the patients themselves, which raises the cost of the medication.
HCV drugs are not available in Ghana so we are forced to buy them from Egypt or India, which becomes quite an expensive exercise for the patients as they have to shoulder importation and bank charges.
We want to learn from the examples provided by countries such as Uganda and Egypt. The Ugandan government is showing commitment by devoting money to a programme created specifically to eradicate hepatitis in the country. As I have visited the country over the last two years, it’s easy to see how much the NGOs are delighted about the action government has taken on hepatitis.
For Ghana to win the fight against hepatitis, we will need strong political will; universal birth vaccination for all new-born babies; massive awareness efforts on radio, television and other media platforms; and free vaccination along with free screening for the five northern regions of Ghana, especially the rural areas.
I myself lost four of my family members to hepatitis, so I have seen first-hand the damage these viruses inflict on Ghanaian families. I’m hopeful that we can eliminate viral hepatitis in Ghana by 2030. Patient organisations, NGOs and health practitioners need to all come together because if we speak as one voice we can fight this disease more effectively than if we try and tackle it individually.
I believe that within my lifetime Ghana can join the ranks of countries that have successfully eliminated hepatitis. At the very least, we should introduce free vaccination, screening and treatment for all so that no family ever has to lose a loved one to hepatitis again.
Theobald Owusu-Ansah is President of the Hepatitis Foundation of Ghana and the Hepatitis Coalition of Ghana.