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Mission to eliminate hepatitis

In 2010, Humberto Silva was getting ready to travel from Brazil to South Africa to watch his country’s soccer team play in the World Cup. When he went to get the necessary vaccinations, his doctor recommended he also be tested for hepatitis.  

A volunteer encourages people to get tested for hepatitis in São Tomé and Príncipe.

Photos courtesy of Hepatitis Zero

Silva thought this was silly. He felt fine. How could he have hepatitis? When the results came back, he was shocked: He had hepatitis C. If he didn’t get treatment, his liver would fail and he would die. 

As Silva thought about how he might have contracted the disease, he remembered that when he was eight years old, he had received a blood transfusion after a surgery. If that was the source of the infection, it meant that the virus had been in his body for nearly 40 years, attacking his liver over and over.

Silva, a member of the Rotary Club of São Paulo-Jardim das Bandeiras, underwent treatment and is now free of the virus. And he knows much more about the disease. 

There are five main types of hepatitis, each of which involves a different virus that attacks the liver. The most serious are B and C. There is a vaccine for hepatitis B, which is spread through contact with blood or bodily fluids, but not for hepatitis C, which is spread almost exclusively by blood contact. There is, however, a treatment that eliminates the hepatitis C virus from the body; it costs around $120 per person. 

Roughly 325 million people worldwide live with some form of viral hepatitis, and the disease causes 1.34 million deaths per year. Globally, an estimated 71 million people are infected with hepatitis C, but only 20 percent of them have been tested and are aware of their status. For those with hepatitis B, that figure is just 9 percent.

“Every 30 seconds, someone dies of hepatitis B,” says Homie Razavi, founder and managing director of the Center for Disease Analysis Foundation (CDAF), an organization dedicated to hepatitis eradication, “and every 80 seconds, someone dies of hepatitis C. Those numbers are going up every year as the population ages. In fact, it’s one of the deadliest diseases around, but very few people know about it.”

According to the Polaris Observatory, which gathers hepatitis data under CDAF, only 12 countries are on track to eliminate hepatitis C. Thirty countries have no possibility of eliminating hepatitis B under their current health policies. 

“This is one of the major failures of global public health,” Razavi says. “All the tools are there to eradicate both hepatitis B and hepatitis C. Hepatitis B should have been eliminated about 15 years ago. The vaccine has been available since the 1980s, and it’s very efficacious.”

After Silva started his treatment, he made a decision. “I realized that I was blessed by receiving a chance,” he says. “So I made a vow to God that I would dedicate the rest of my life to fighting the disease.” 

In 2011, while he was being treated for hepatitis, Silva founded the Associação Brasileira de Portadores de Hepatite (Brazilian Association for Hepatitis Carriers), which opened a free clinic in São Paulo to test and treat people for hepatitis. “There is a finger prick test like the diabetes test,” he says. “In three minutes we can diagnose if people have hepatitis.”

This was so successful that the ABPH opened four more clinics in Brazil, plus one in Mexico City, and has seen some 60,000 people. But Silva knew there were still tens of thousands of people who were unaware of the threat that hepatitis posed to their health, just as he had been. He wondered how he could reach them all. He established Hepatitis Zero, a worldwide campaign to identify and support people with hepatitis, educate the public about the disease, and aid in eradication efforts.

In 2015, the Rotary International Convention was held in Silva’s hometown of São Paulo. So he set up a booth there to test people for hepatitis. 

Humberto Silva behind the wheel of a converted military ambulance in which two brothers, Fred Mesquita and José Eduardo, are traveling the world educating people about hepatitis.

At the convention, Silva spoke to Rotary’s incoming president, K.R. Ravindran, who suggested that they form the Rotarian Action Group for Hepatitis Eradication. The action group launched last year with Silva as its founding chair. 

Since then, Argentina has embarked on a nationwide campaign, and countries including Democratic Republic of Congo, Kenya, Korea, Mexico, and Nigeria have begun testing. Currently, the action group has hepatitis eradication projects in countries in the Americas and Africa. 

In the small African island nation of São Tomé and Príncipe, ABPH and the action group are working with Rotary clubs and the government to make it the first country to eradicate hepatitis. “We are going to test the whole population for hepatitis B and C,” Silva says, “and we are going to provide the medicine to the ones we find who are sick.” And that’s just one of the places where these organizations have projects underway. 

The action group is also setting up committees across Africa and recruiting ambassadors to publicize and coordinate testing in preparation for the Pan-African Week Against Hepatitis from 20 to 28 July. It is sending two testing machines to Africa and plans to organize another major campaign.

Silva hopes these will be major steps toward ridding the planet of the disease. “It’s not going to be easy,” he says. “But we are going to win. There are people who are standing on the edge of a cliff without realizing it. We’re going to tell them that they are sick and we are going to give them medicine. Rotary is going to do that.”   

— Frank Bures

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The Rotarian action group and ABPH perform tests at public places such as train stations and malls to reach more people.

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