Rwanda’s efforts to expand hepatitis screening, treatment and decentralised care have been highlighted as an example of how African countries can take greater ownership of their health systems. The recognition was made by Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention (Africa CDC), who cited Rwanda, Egypt and Uganda as countries demonstrating that domestic leadership and investment can accelerate progress against viral hepatitis. ALSO READ: Rwanda on track to eliminate Hepatitis B by 2030 - RBC In his article released on the occasion of World Hepatitis Day on Tuesday, July 28, and alongside the launch of Africa CDC’s Operational Toolkit for the Prevention, Diagnosis and Management of Hepatitis B, Kaseya said Africa’s challenge was no longer a lack of knowledge or tools, but a gap between available solutions and their implementation. “Every one of those deaths was avoidable using tools invented decades ago,” he said, describing the situation as an “implementation failure.” Africa is home to an estimated 64 million people living with chronic hepatitis B, accounting for about 63 per cent of new hepatitis B infections globally, according to Africa CDC. ALSO READ: RBC relies on youth centres, campaigns to curb HIV in Eastern Province The disease caused an estimated 272,000 deaths on the continent in 2022, while fewer than five per cent of infected people have been screened and fewer than one per cent receive treatment. Kaseya said Rwanda has demonstrated what sustained political commitment can achieve, noting that the country has screened more than seven million people, made hepatitis C treatment free nationwide, decentralised services and allowed trained nurses to manage uncomplicated cases at primary healthcare facilities. “Egypt, Rwanda and Uganda have shown what determined action achieves. Their progress should now become the continental standard,” he said. The Africa CDC toolkit is intended to help health workers, particularly those in district facilities with limited access to specialists, manage hepatitis cases through practical guidance on diagnosis, treatment and patient monitoring. Kaseya said hepatitis presents a test for Africa’s health sovereignty agenda because the tools needed to address it are already available. “The vaccine costs cents. The medicines are off patent. The diagnostics are simple,” he said, arguing that existing platforms used for maternal health, HIV and tuberculosis services can also deliver hepatitis interventions. He said health sovereignty does not mean isolation but requires African countries to lead in setting priorities, financing health systems, strengthening local production and reducing dependence on external support. The Africa CDC boss also pointed to Rwanda’s approach of integrating hepatitis services into primary healthcare as part of a wider model that other countries can learn from. ALSO READ: A look at PrEP and PEP in Rwanda’s HIV prevention efforts Across the continent, nearly all African Union member states have introduced hepatitis B vaccination into routine childhood immunisation programmes. However, challenges remain, particularly in ensuring newborns receive the vaccine within 24 hours of birth — a measure that can prevent almost all mother-to-child transmission. Kaseya called on African countries to increase domestic financing, strengthen local manufacturing of vaccines and medicines, integrate hepatitis services into primary healthcare systems, deepen regional cooperation and increase public awareness. He said progress should ultimately be measured through practical outcomes, including newborns receiving timely vaccination, pregnant women accessing screening, and patients being diagnosed and treated before developing severe liver disease. “None of that requires a scientific breakthrough. All of it requires a decision,” he said.
