Following an energetic dinner where delegates showed off their samba moves, the second day of the Summit was dedicated to strategic directions 2 and 3, which cover the issues of "interventions for impact" and "delivering for equity" “the what and the how” of elimination.
At morning side meetings, early risers learnt about strategies to eliminate hepatitis E, an often-overlooked form of the hepatitis virus, as well as hearing about the liver societies’ role in elimination. The morning plenary session looked at the five core interventions needed to address viral hepatitis: infant vaccination, prevention of mother-to-child-transmission, blood and injection safety, harm reduction, and diagnosis and treatment. In a presentation from WHO’s Hande Harmanci, the importance of a public health approach to deliver these interventions was stressed. Director for STI, HIV/AIDS and Viral Hepatitis Department of the Ministry of Health of Brazil, Dr Adele Benzaken echoed the Minister’s comments from yesterday on their treatment for all announcement. The session also featured presentations on challenges and opportunities for hepatitis B services in Nigeria from the Ministry of Health, interventions to prevent hepatitis B infection at birth from John Ward of the U.S. Center for Disease Control, hepatitis C prevention and treatment for PWID by Greg Dore of the Kirby Institute and hepatitis services for Indigenous Peoples from Luana Silveira de
Faria from the Ministry of Health of Brazil. The “Access to Hepatitis Medicines” session was opened by Portuguese MP Ricardo Leite, who reaffirmed that governments must make access a priority. His speech made a poignant note: “political commitment from governments is a moral and ethical obligation”. This was closely followed by Giten Khwairakpam, amfAR, who provided an overview on how to get generics. His presentation was complemented by Dr. Andrew Hill, Liverpool University, UK, who spoke about the cost and efficacy of generics. His studies have shown that hepatitis C medicine can be purchased for $70 - and, by the end of the year, it could be as low as $50. Both speakers agreed that without greater diagnosis and better linkages to care, the dropping prices won’t make a difference. Dr. Yvan Hutin, World Health Organization, concluded the session by highlighting that price is only one aspect. Access will only be successful when it’s the right product, in the right place, at the right time and for all people who need it. After the session, participants attended workshops to further explore ways on how to overcome barriers to access. Then attendees spent the afternoon taking part in a range of parallel breakout sessions. Topics ranged from treatment interventions, prevention interventions and delivering for equitable services. The “Prevention Interventions” session kicked off with Dr. Amr Kandeel, Ministry of Health, Egypt, discussing how the countries’ adoption of a comprehensive prevention control plan in 2003 that has led to 95% hepatitis B coverage and screening of more than 4 million people for hepatitis C. Dr. Arshad Altaf, World Health Organization, added to this update by focusing on injection safety in Uganda and India, underscoring the importance of awareness activities to educate. Likewise, Dr. Huma Qureshi, Pakistan Health Research Council, discussed injection safety challenges and opportunities in Pakistan. With the highest level of therapeutic injections globally with 13-14 infections per person per year, she discussed their campaign to promote injection safety in 26 facilities across Pakistan, which included needle cutting and training of 1500 healthcare workers. Dr. Jinlin Hou, Nanfang Hospital, China, focused on activities to prevent mother-to-child transmission and Dr. Marcelo Addas-Carvalho, Blood Center of Campinas/UNICAMP, discussed blood safety. Dr. Niklas Luhmann, Médecins du Monde, looked at prevention amongst people who inject drugs. He used this opportunity to present the declaration on the hepatitis community on decriminalization. In the “Testing Inter