01 Jun 2017
Working with Mongolia to reduce hepatitis B
In Mongolia, the leading cause of death is liver cancer. It has one of the highest rates in the world, accounting for an estimated one in 10 deaths, and a high proportion of this burden is attributed to hepatitis B virus (HBV).
Nearly 80 per cent of the population is estimated to have been infected with the virus at some stage in their lives, and at any one time, between 10-22 per cent of the population is chronically infected.
Compare this to a prevalence of 1 per cent in Australia, and you’ll get a sense of how central it is to people’s lives and consequently, to health policy in the country. Indeed, Mongolia was one of the first countries in the world to immunise newborns and infants under a year – a move that resulted in a substantial drop in viral hepatitis B rates.
Last month, suitcases packed with the finest winter-woollies Melbourne had available in early April, five members of the WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute – Associate Professor Benjamin Cowie, Dr Suellen Nicholson, Dr Margaret Littlejohn, Nicole Romero and Laura Thomas – braved what turned out to be a 42-hour transit (from a scheduled 24 hours) to Ulaanbaatar, the nation’s capital.
We had been invited by the Mongolian Ministry of Health and WHO to co-facilitate and present the WHO’s first National Workshop for Strengthening and Linking Viral Hepatitis Laboratory, Surveillance and Patient Monitoring Systems (24-27 April 2017).
The workshop was organised by a range of people from the WHO, the Doherty Institute, the National Reference Laboratory (NRL), US Centers for Disease Control and Prevention (CDC), Korean CDC, and the Mongolian Ministry of Health and National Centre for Communicable Diseases (NCCD).
The aim was to assist key Mongolian stakeholders to examine the capacity in strategic information and laboratory diagnosis of viral hepatitis in order to formulate recommendations for improvement, and to identify ways forward to implement these recommendations.
The workshop was well received and attended by almost 90 people including public and private laboratory staff and managers, clinicians, and epidemiologists from across Mongolia.
Attendees provided a thorough analysis of the current status of strategic information and in vitro diagnosis systems for viral hepatitis in Mongolia. Gaps were identified the between the WHO-recommended benchmark and the current situation to propose recommendations, and identified ways forward for implementing workshop recommendations. Attendees and facilitators alike were pleased with the range of perspectives and recommendations that were garnered through the workshop, and were optimistic about their effective implementation. Together we took a small step towards ultimately eliminating hepatitis B and C.
Given the broad range of participants, the extensive engagement of key stakeholders, and positive feedback, the WHO (and collaborators) have committed to organise more national workshops in more countries in the region in the coming months.
Ulaanbaatar was absolutely beautiful and the Mongolian people were so friendly and welcoming. After a successful week of workshops we had the opportunity to get outside the city and see a few sites. All of us were blown away by the stunning countryside and have promised ourselves to re-visit.