title: Control of viral hepatitis infection in Africa: are we dreaming?
abstract: BACKGROUND
  At least five different types of viral hepatitis cause problems of significant public health importance in Africa, where together they constitute a huge burden of disease. But until now, efforts to control the infections have been largely piecemeal. Analysis of the strategies needed to control each virus, however, reveals major overlaps.
  
  
  METHODS
  We propose that the control of these infections in the WHO African Region should start with the common strategies rather than with each disease. But this approach presents potentially huge problems to overcome, such as the difficulty of integrating multiple health service elements - the track record for successful integration of such services is not good. This is despite encouraging rhetoric from donors and national leaders alike. And to succeed, disparate programmes must work closely together. But we believe that the time is right to create new opportunities for prevention and treatment of hepatitis, including increasing education, and promoting screening and treatment for more than 500 million people already infected with hepatitis B and C viruses.
  
  
  CONCLUSIONS
  The impact of these efforts on decreasing mortality and morbidity will be significant because of the high burden of disease from these infections, and also because the effect will spill over to benefit the control of other communicable diseases and health systems strengthening. Such a project will inevitably involve multiple strategies that will vary somewhat according to the epidemiology of the diseases and the location.
authors.affiliation: Immunization and Vaccine Development Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo.
authors.forename: Richard
authors.initials: R
authors.lastname: Mihigo
authors.forename: Deo
authors.initials: D
authors.lastname: Nshimirimana
authors.forename: Andrew
authors.initials: A
authors.lastname: Hall
authors.forename: Michael
authors.initials: M
authors.lastname: Kew
authors.forename: Steven
authors.initials: S
authors.lastname: Wiersma
authors.forename: C John
authors.initials: CJ
authors.lastname: Clements
mesh_terms: D000349:Africa / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006518:Hepatitis Viruses / Q000276:immunology*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control*; D006801:Humans; D014761:Viral Hepatitis Vaccines / Q000008:administration & dosage* / Q000276:immunology*
chemical_list: D014761:Viral Hepatitis Vaccines