International iPMTCT Summit 2014

Health Bureau, Hainan Province, China

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.

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When an unknown printer took a galley of type and scrambled it to make a type specimen book.

Neque porro quisquam est qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit…Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

When an unknown printer took a galley of type and scrambled it to make a type specimen book. It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Photos Grid for Heading 02

Placeholder image
  • Tab 1
  • Tab 2
  • Tab 3

Inside Tab Heading 01 H4

It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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Combating Hepatitis in Western Pacific Region

World Health Organisation Office for the Western Pacific Region (WPRO), Asia

Since 2013, ZeShan Foundation has been providing support to the World Health Organisation Office for the Western Pacific Region (WPRO). ZeShan’s grants aid WPRO in combating viral hepatitis in the region, and includes the allocation of specific support to the China office.

Viral hepatitis is responsible for 1.4 million deaths globally. There are estimated to be 115 million people with chronic hepatitis B (HBV) infection and 14 million with chronic hepatitis C (HCV) infection living in the Western Pacific Region, accounting for 40 % of people burdened with chronic hepatitis B and C across the globe. 

Chronic HBV and HCV is known to lead to the development of cirrhosis and liver cancer over time. With 60% of the worlds’ affected population, the Western Pacific Region has the highest number of deaths caused by liver cancer globally, which is also the 6th top cause of death in the region. Six of the top ten countries with the highest incidence (new annual cases) of liver cancer in the world include Mongolia (highest incidence globally), Viet Nam, Lao People’s Democratic Republic, Cambodia, China and South Korea.  This being said, early testing and treatment can effectively reduce the progression of these diseases and subsequently the risk of development of liver cancer.   

Patient Story (Philippines): https://www.who.int/philippines/news/feature-stories/detail/surviving-hepatitis-b-and-liver-cancer-vhal-s-story

News feature: https://www.montsame.mn/en/read/136120    World Hepatitis Day in Mongolia, 2018

The grant support from ZeShan Foundation has vaulted WPRO into leading the action on viral hepatitis in the Region, and has allowed the organization to establish regional responses in the effort to eliminate viral hepatitis as outlined by the Global Health Sector Strategy for Viral Hepatitis 2016-2021 . With the elimination of viral hepatitis being highlighted within the 2030 Sustainable Development Goals, the Regional Action Plan for Viral Hepatitis in the Western Pacific 2016-2020  has been endorsed by all countries in the Western Pacific Region, which defines specific actions to be taken in order to better understand hepatitis epidemics. The outlined actions include awareness and knowledge building among stakeholders, strengthening public policy, and data generation, which will also be essential factor in the process of enhancing prevention strategies and improving access to affordable screening, diagnosis and treatment of hepatitis B and C.

Figure 1 illustrates the current progress in hepatitis response programmes in the Western Pacific Region, which underscores the critical importance of national leadership, development of national response plans and having data to inform policy and decision making.

Source: WHO Western Pacific Regional Office, January 2021.

Supporting countries to scale up interventions towards hepatitis elimination

The Western Pacific Region has led global efforts in working towards hepatitis elimination. Some of the regional successes include the triple elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B, as well as the scaled up hepatitis testing and treatment encompassed in Universal Health Coverage. See more here in country case studies[1]  [2]   – China, Triple elimination, Mongolia, Malaysia

Links:

Link to overall WPRO hepatitis website: https://www.who.int/westernpacific/health-topics/hepatitis

Building capacity of healthcare providers

It is critical to ensure that healthcare providers are trained to deliver good quality hepatitis care and treatment. WPRO has published Training Modules on Hepatitis B and C Screening, Diagnosis and Treatment[1] in collaboration with the WHO South East Asia Region and other WHO centers.

[1] WPRO-SEARO clinical training modules, published July 28, 2020

https://www.who.int/southeastasia/publications-detail/9789290227472

 WPRO-SEARO clinical modules

https://www.who.int/southeastasia/publications-detail/9789290227472

Raising public awareness on viral hepatitis

To improve awareness around viral hepatitis and its impact on health, WHO offices in all countries work closely with the Ministries of Health and their partners to provide information to the public. Every year, awareness is raised globally through World Hepatitis Day on 28th July.

Link to videos: (snapshot)

Link to video on hepatitis (mash-up) https://youtu.be/Xl1hRjm-Uhk

WPRO-SEARO clinical training modules, published July 28, 2020

https://www.who.int/southeastasia/publications-detail/9789290227472

Philippines: scaling up hepatitis B services during the COVID-19 lockdowns (video World Hepatitis Day 2020): https://www.facebook.com/whophilippines/videos/291155845324695

Malaysia – Yap’s Story: Road to Recovery (a story of HIV and HCV for World AIDS Day 2020):  https://www.youtube.com/watch?v=D-6T-J0Sd10

Malaysia – Silas’s Story: Road to Recovery (World Hepatitis Day 2020):  https://www.youtube.com/watch?v=5aBstAHJ-0M&feature=youtu.be

Viet Nam – Chiến thắng bệnh viêm gan C | Successful fight against hepatitis C (World Hepatitis Day 2020): https://www.youtube.com/watch?v=KjT3r6OCxdY&t=48s

WHO country office China – 肝炎,做好检测,及早治,活出最好的自己 (World Hepatitis Day 2020): https://v.qq.com/x/page/o0530ahwxel.html

WHO country office China –消除歧,消除肝炎 (World Hepatitis Day 2020): https://v.qq.com/x/page/d0530xpdu1y.html

WHO country office Mongolia – World Hepatitis Day 2020: https://www.facebook.com/WHO.MGL/videos/981267499003176

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Heading 02 (H3)

When an unknown printer took a galley of type and scrambled it to make a type specimen book.

Neque porro quisquam est qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit…Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

When an unknown printer took a galley of type and scrambled it to make a type specimen book. It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Photos Grid for Heading 02

Placeholder image
  • Tab 1
  • Tab 2
  • Tab 3

Inside Tab Heading 01 H4

It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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Supporting Asian Liver Center

Stanford University School of Medicine, United States of America & Hong Kong

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.

https://zeshanfoundation.org/wp-content/uploads/2021/05/asianLiverCentre800600.jpeg

CCTV: Public Education Campaign

China Central Television, China

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.

https://zeshanfoundation.org/wp-content/uploads/2021/05/cctv800600.jpeg

Scaled-up iPMTCT Demonstration Programs

Centre for Disease Control and Prevention, China

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.

https://zeshanfoundation.org/wp-content/uploads/2021/05/scaled-up-iPMCT-800600.jpeg

Supporting Asia-Pacific Alliance to Eliminate Viral Hepatitis (APAVH)

APAVH, Asia

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.

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Heading 02 (H3)

When an unknown printer took a galley of type and scrambled it to make a type specimen book.

Neque porro quisquam est qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit…Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

When an unknown printer took a galley of type and scrambled it to make a type specimen book. It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Photos Grid for Heading 02

Placeholder image
  • Tab 1
  • Tab 2
  • Tab 3

Inside Tab Heading 01 H4

It is a long established fact that a reader will be distracted by the readable content of a page when looking at its layout. The point of using Lorem Ipsum is that it has a more-or-less normal distribution of letters, as opposed to using ‘Content here, content here’, making it look like readable English. Many desktop publishing packages and web page editors now use Lorem Ipsum as their default model text, and a search for ‘lorem ipsum’ will uncover many web sites still in their infancy. Various versions have evolved over the years, sometimes by accident, sometimes on purpose (injected humour and the like).

Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry’s standard dummy text ever since the 1500s, when an unknown printer took a galley of type and scrambled it to make a type specimen book. It has survived not only five centuries, but also the leap into electronic typesetting, remaining essentially unchanged. It was popularised in the 1960s with the release of Letraset sheets containing Lorem Ipsum passages, and more recently with desktop publishing software like Aldus PageMaker including versions of Lorem Ipsum.

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