In partnership with the Hainan Bureau of Health and China’s National Center for Women and Children’s Health, ZeShan organized an international roundtable summit on the Integrated Prevention of Mother-to-Child Transmission (iPMTCT) of HIV, HBV and syphilis, which was hosted in Hainan Province in January 2014.

Focusing on public-private partnerships and innovative practices for high-impact outcomes, the Summit brought together a blue-ribbon panel of experts, scholars, practitioners, policy makers, and representatives from major health organizations, including WHO China, WHO Western Pacific Region, UNICEF, UNAIDS, Aaron Diamond AIDS Research Center, and Chinese Center for Disease.

Participants shared insights on lessons learnt and best practices in this field, and debated over the unique challenges of effectively implementing iPMTCT in culturally and demographically diverse settings. Prompted by Hainan’s relatively low HIV prevalence and very high HBV rate (over twice the national average), the discussion inevitably tilted toward exploring effective PMTCT of HBV.

Following the Summit in Sanya, participants went on a field trip to visit local maternal and children’s hospitals and clinics in surrounding villages. Local health officials and practitioners shared their experiences in and views on the healthcare system, in particular focusing on effective approaches to iPMTCT operation in low HIV and high HBV settings.

Emerging as a result of this Summit was the agreement among the UN China network to promote China’s iPMTCT practice around the world as innovative practice, which was decided at the coordinating committee meeting of UN health-related organizations in China held the week following the Hainan Summit.

ZeShan Foundation has been supporting the Asian Liver Center (ALC) . Founded in 1996 by Dr. Samuel So, a professor of surgery at the Stanford University School of Medicine, ALC is the first non-profit organization in the United States that addresses the high incidence of hepatitis B and liver cancer among Asians and Asian Americans. Since then, ALC has been at the forefront of educational outreach and advocacy efforts in the areas of hepatitis B and liver cancer prevention and treatment, providing valuable resource for both the public and health practitioners.

Partnering with the Hong Kong Hep B Free Foundation, APAVH and ALC launched the first World Hepatitis Day media campaign in the city on 28 July 2011, public service announcements were made on radio, newspaper, magazines and public transportation billboards.  The message of getting tested and vaccinated was well received by the public.

Recognizing the impact and reach of national television networks, ZeShan in 2010 underwrote the production of a documentary on the prevention of mother to child transmission of hepatitis B by the China Central Television’s (CCTV) Population program, under the auspices of the National Population and Family Planning Commission.  The documentary was recognized with a special award in November 2010 at the Fifth National Conference on Public Health and Media, co-organized by the Ministry of Health and Tsinghua University. It was premiered on CCTV Channel 1 on November 18, 2010.  Plans are underway to develop an extended version for wider distribution to provincial television networks.

To build on the success of the pilot initiatives, ZeShan stepped up support for integrated prevention of mother-to-child transmission (PMTCT) prevention in 2010. One of the programs being implemented takes place in high prevalence and low income regions of Hubei, Hebei, Xinjiang and Shanxi provinces, and is expected to screen 24,000 pregnant women for HBV, HIV and syphilis, while providing 42,000 people with pre-marital medical screening in the next two years. Emphasis is on building capacity in integrated prevention for local maternal units in partnership with Chinese CDC’s and infectious disease departments. A comprehensive training manual with participation from WHO China is currently in trial use.

Another program, a scaled-up initiative in Yunnan, will continue to integrate HBV, HIV and syphilis in the prevention of mother-to-child transmission in 26 counties of Yunnan province.  The effort is expected to provide screening on HBV and syphilis for up to 146,000 pregnant women.  Spouses and children of those tested positive will also receive screening and counseling services.

ZeShan Foundation was a founding contributor to the Asia and Pacific Alliance to Eliminate Viral Hepatitis(APAVH), a global initiative co-founded by the Asian Liver Center at Stanford University, US CDC and WHO in 2008.  The first global effort to work towards the elimination of viral hepatitis, APAVH aims to create a sustainable public and private partnership to eliminate the transmission of viral hepatitis infection and reduce the stigma and complications of chronic viral hepatitis infection.

Hosted by ZeShan in April 2010, APAVH’s first regional meeting entitled “Learning from China to Enhance Prevention and Control Efforts in Asia” was held in Hong Kong.  Experts shared best practices and lessons learned in China, and how APAVH could address the remaining gaps, from vaccinating susceptible populations that include college students, healthcare workers and migrants, to providing antiviral treatments for the estimated 35 million hepatitis B patients. The first APAVH 2010 regional meeting report has been published as a reference guide to demonstrate China’s leadership role in the Western Pacific Region.

As a demonstration project, APAVH has formed a partnership with the Shandong CDC to develop an evidence-based online training course to raise hepatitis B awareness and improve healthcare providers’ knowledge and practices.   The course consists of three modules covering hepatitis knowledge and vaccination, safe injection practices and physician-patient education.  The online education tool was opened for enrollment in July 2011 at http://knowhbv.org.  Pilot test to evaluate the effectiveness and value of the course has been conducted and a preliminary qualitative analysis shows significant improvement in hepatitis B knowledge.

And as part of the advocacy and education act, the official APAVH website has been launched, providing a centralized resource for global viral hepatitis and liver cancer data, reports and publications.   Researches on hepatitis B and related liver diseases in countries in the Western Pacific and South East Asia regions have been conducted and country profiles are developed and available on https://www.stanfordapavh.org/.  And the first WPRO website on hepatitis B was created in late 2011; meanwhile brochures and posters promoting hepatitis B vaccination were produced and distributed in 8 countries in the region.

With prevalent infection and vast high risk groups, misunderstanding of hepatitis B and discrimination against hepatitis B carries were common in China.  Teaching and learning materials for Chinese citizens would benefit many.  APAVH completed the development of an online animation in Chinese to better inform people in the country about hepatitis B.  The animation covers common questions the public have about the disease, such as ways of transmission, prevention and treatment.  The material can be accessed through APAVH China website and is an important means to clear misunderstandings and discriminations.