Globally an estimated 257 million people were living with chronic hepatitis B (CHB) virus infection resulting in 887 000 deaths in 2015[1][2]. The World Health Organisation (WHO) Western Pacific Region has the highest prevalence of Hepatitis B Virus (HBV) at 6.2%[3]. To respond to this the Regional Action Plan for Viral Hepatitis in the Western Pacific 2016–2020 recommends integrating HBV screening into health and other settings that serve at-risk populations and ensuring screening is directly linked to staging and treatment programmes[4].

Introduction of infant hepatitis B immunisation in the national immunisation programs of all countries in the Western Pacific Region resulted in the seroprevalence of hepatitis B surface antigen (HBsAg) reducing to less than 2% (among children 5 years of age) in all countries by 2012, and to less than 1% prevalence in 13 countries by 2017[5]. However, an estimated 115 million people are still living with chronic hepatitis B (CHB)[6]. Without treatment, 15-25% of these individuals will die from cirrhosis and hepatocellular carcinoma[7].

Last year ASHM, contracted by WHO, carried out a scoping of the viral hepatitis response in 4 pacific countries. We found that it is estimated that 20% of adults in the Solomon Islands living are living with HBV related liver disease and chronic infection[8]. 15% of health care workers in Kiribati are infected with Hepatitis B Hepatitis D co-infection[9]. In Vanuatu 10% of blood donors and antenatal women tested have hepatitis B[10], whilst in Fiji the estimate of hepatitis B in the population is between 2-4% following a successful child immunization program[11].  Each country showed a commitment to the viral hepatitis response and was at various stages of implementing national hepatitis action plans, however at the time of the scoping mission HBV testing was limited and treatment was unavailable in Solomon Islands, Vanuatu and Fiji and of limited availability in Kiribati. These challenges were related to a lack of infrastructure, health worker training and treatment access.

Part of ASHM’s role was to work with countries to development national viral hepatitis testing and treatment guidelines and secure HBV treatment on their essential medicines list. ASHM International is keen to support countries through the delivery of our 3 day Hepatitis B (HBV) in Health Settings Training for Asia and the Pacific Regions which aims to increase health care workers confidence and competence in clinical management of Hepatitis B and in turn increased testing, linkage to care, clinical management and treatment of hepatitis B. Due to COVID-19 our plans to begin training in Solomon Islands have been delayed this year. ASHM International is now working with the Solomon Islands Ministry of Health to explore ways to provide health workforce capacity building in Hepatitis B through tele-education and tele-mentoring methods.

COVID-19 and the related restrictions have also required health workers to adapt service delivery in many health areas including viral hepatitis. The Blood-Borne Virus, Sexual Health and COVID-19, established by ASHM, has developed guidance on the delivery of HCV and HBV services during the pandemic. Click here to view these resources: www.ashm.org.au/covid-19/regional/.

The group also ran a webinar with key speakers from across the region from WHO, the World Hepatitis Alliance, CEVHAP and the Indian Drug Users Forum, who shared lessons learnt from the viral hepatitis response during COVID-19. Click here to view this and other COVID-19 related webinars under the Regional Advisory Group webinar series: https://ashm.org.au/covid-19/webinars/


[1] WHO. (2017). Global hepatitis report 2017. Available at www.who.int/hepatitis/publications/global-hepatitis-report2017

[2] WHO. (2018). Hepatitis B. Available at www.who.int/en/news-room/fact-sheets/detail/hepatitis-b

[3] WHO. (2017). Global hepatitis report 2017. Available at www.who.int/hepatitis/publications/global-hepatitis-report2017

[4] WHO. (2016). Regional Action Plan for Viral Hepatitis in the Western Pacific 2016–2020. Available at www.wpro.who.int/hepatitis/resource/features/regional_action_plan/en

[5] WHO. (2016). Regional Action Plan for Viral Hepatitis in the Western Pacific 2016–2020. Available at www.wpro.who.int/hepatitis/resource/features/regional_action_plan/en

[6] WHO. (2017). Global hepatitis report 2017. Available at www.who.int/hepatitis/publications/global-hepatitis-report2017

[7] WHO. (2017). Global hepatitis report 2017. Available at www.who.int/hepatitis/publications/global-hepatitis-report2017

[8] WHO/ASHM (2019). Viral Hepatitis Response Scoping Report: Solomon Islands.

[9] WHO/ASHM (2019). Viral Hepatitis Response Scoping Report: Kiribati.

[10] WHO/ASHM (2019). Viral Hepatitis Response Scoping Report: Vanuatu.

[11] WHO/ASHM (2019). Viral Hepatitis Response Scoping Report: Fiji.