Hepatitis C in Moldova, Essay Example

Hepatitis C and Global Health in Moldova

Introduction

Several global initiatives have been launched in recent years to control and prevent the spread of viral Hepatitis. This paper analyzes the current situation in Moldova, one of the former Eastern bloc countries, in order to determine the effectiveness of national and global health policies targeting viral infections.

Diseases Caused By Hepatitis C

Hepatitis C virus (HCV) is one of the Hepatitis viruses currently known by health care professionals. It is one of the viruses that can result in chronic hepatitis. Currently, there are approximately 184 million people in the world infected by the virus.  HCV is the second most dangerous virus that causes chronic hepatitis infection, after Hepatitis B.  The World Health Organization report (2003) states that one of the most important risks associated with HCV is hepatocellular carcinoma, which occurs in the late cycle of the infection. Further, the damage of lungs and complications related to a weakened immune system.

Drug-Resistant Hepatitis C

Currently, there is no vaccine that prevents HCV infection, according to the WHO report. Liang (2013) states that while researchers have been working for years on the development of a vaccine, however, according to the author (Liang, 2013), “the ultimate path to a successful preventive vaccine requires comprehensive evaluations of all aspects of protective immunity”(p. 869).

Treatment Of Hepatitis C

The 2003 World Health Organization report (2003) states that the most effective treatment approach towards HCV and its complications is Interferon combination therapy. Treatment should be based on the patient’s  genotype strain one is not as responsive to interferon than other genotypes  (WHO, 2003, p. 47). Therefore, identifying the virus correctly is essential. The outcome of the Interferon therapy, however, depends on when it is introduced. The sooner the patients receive treatment, the better the chances for full recovery will be.  If the infection is in an advanced stage and results in a chronic kidney disease, transplant is the only solution. Waiting lists for a new kidney are long, and this means that many patients die before health care professionals would be able to find a suitable donor. HCV is resistant to thymosin, ursodiol, corticosteroids, rimantadine, and amantadine.

Assessing The Hepatitis C Epidemic

Historically, HCV accounted for 90 percent of post-transfusion hepatitis cases worldwide. Due to policies and advanced donor screening guidelines introduced in many countries’ health care systems, today, HCV only accounts for 20 percent of acute hepatitis cases. HCV has a higher prevalence in Africa, Eastern Europe, including Moldova, and the Mediterranean than in the USA and Western Europe. According to the 2003 WHO estimation (WHO 33), three percent of the world’s total population has been infected with HCV.

Financing Hepatitis C Treatment

In 2012, according to Ocheret et al. (2013), 69 percent of the countries surveyed  by the  World Hepatitis Alliance reported that they had government funding for treatment. Government-funded awareness campaigns are also in place. Only 18 percent of European countries offered testing at a fee for citizens.  However, testing of health care workers and donors was generally free of charge in the majority of countries.  Ocheret et al. (2013) confirm that Hepatitis C ampule prices are the lowest in Moldova within the Eurasian region, based on 2012 data. The authors of the study also state that “, the majority of patients in need in the region still have limited (if any) access to the standard of care treatment regimen that has been included in internationally recommended guidelines for the past several years” (Ocheret et al., 2013, p.11 ).

Assessing The Hepatitis C Epidemic

The World Hepatitis Alliance created an international policy based on the findings of studies involving several countries’ health data. In collaboration with the WHO, the research found that within 65 percent of Europe, Hepatitis B or C is considered as an urgent public health issue. In Europe, over 98 percent of countries reported that disease surveillance for hepatitis B and C was in place. However, only 45 percent of the countries had government funded disease awareness campaigns.

Addressing The Hepatitis C Epidemic In Moldova

In 1997, the Government of Moldova created a National Program for Combating Viral Hepatitis B, C, and D (UNAIDS Moldova, 2013). The report also states several HIV and viral hepatitis and related health outcome goals for the future. The government is planning to increase the capacity of the country’s laboratories to improve the country’s epidemiological surveillance.  Further, the government is planning to improve the safety of donated blood.  The development of counseling, testing services within Moldova is also being planned, in order to create effective preventive and treatment services. Health care facilities’ medical practice and hygiene guidelines are also to be monitored through new, international standard regulations to prevent the viral infections from spreading within health care facilities.

Research and Development: The Future

As it has been previously stated that, there is currently no vaccination against HCV. Further, the treatment options do not work equally for various genotypes of the virus. In developing, post-communist countries, people living in poverty are extremely vulnerable to the infection. Therefore, – agreeing with the recommendations of Ocheret et al. (2013) and the WHO (2013), in the guidelines set to strengthen prevention it is imperative that researchers are looking at low-cost, easy to implement treatment and prevention solutions to benefit low income countries, where HCV has a higher than average prevalence. They are easy to monitor, can produce results fast, and reduce the risk of the population to become infected in a short period of time.

References

Liang, J. (2013) Current progress in development of hepatitis C virus vaccines. Nature Medicine 19, 869–878.

Ocheret, D., Bikmukhametov, D., Sultangaziev, A., Matuizaite, E. (2013) Current situation regarding access to hepatitis C treatment in Eastern Europe and Central Asia. Eurasian Harm Reduction Network.

Unaids Moldova (2013) Statement of work preventing HIV/AIDS and Hepatitis B &C in Moldova . Project Technical Assistance Support Contract.