Nuru was prepared for the worst when she went to get screened for HIV eight years ago. After caring for her mother in Uganda, who died as a result of the virus, Nuru moved to the United Kingdom to study, and decided to take her health into her own hands.
The hepatitis B virus (HBV), which spreads through blood and bodily fluids and invades liver cells, is thought to kill just under 1 million people every year around the world, mostly from cancer or scarring (cirrhosis) of the liver. HBV is less likely to be fatal than HIV, and many people who carry the virus don’t have symptoms. But because more than 250 million people live with chronic HBV infections, more than 7 times the number with HIV, its global death toll now rivals that of the more-feared virus.
Researchers and health workers are now hoping to change that. Two years ago, the World Health Assembly endorsed a World Health Organization (WHO) strategy to eliminate hepatitis as a public-health threat by 2030, which the WHO defined as reducing new infections by 90% and deaths by 65%.
As the world has focused on combating HIV, billions of dollars have been poured into developing antiretrovirals — drugs that people with HIV take indefinitely to inhibit the replication of DNA viruses. In low-income countries, the cost of these drugs is heavily subsidized, and in many cases, the same drugs can treat both HIV and HBV.
But when it comes to access to drugs, people with HBV in many resource-limited regions find themselves overlooked in favour of those with HIV. Ocama says he has known hospital administrators who have allowed physicians to administer drugs reserved for people with HIV to those with HBV — but overall, an abysmally small fraction of people in sub-Saharan Africa with HBV receive treatment.