Henry E. Chang, President, Actevis Consulting Group

Globally, an estimated 292 million people have chronic hepatitis B virus (HBV) infection and 71 million people have chronic hepatitis C virus (HCV) infection. Viral hepatitis infections are often dubbed the “silent killers” as a majority of people – 91% with HBV and 80% with HCV – are not aware that they harbour the blood-borne viruses that attack the liver and can unknowingly infect others. Chronic HBV and HCV infections can lead to liver fibrosis, cirrhosis, and are the major causes of liver cancer worldwide.

Viral hepatitis remains amongst the top ten leading global killers that not only impacts population health, but also drains community resources and hinders global economic productivity for years to come. In the United States, the annual number of HCV-related deaths from 2012 to 2013 exceeded the total number of deaths reported to the Centers for Disease Control and Prevention associated with the 60 other nationally notifiable infectious diseases combined. According to the 2016 Global Disease Burden Study, deaths caused by viral hepatitis have surpassed all chronic infectious diseases, including HIV/AIDS, tuberculosis, and malaria.

The economic and public health consequences of viral hepatitis infections have long been neglected until a World Health Assembly (WHA 45.17) resolution in 1992; it called for the introduction and coverage of hepatitis B vaccine in all WHO members states by 1997. Other prevention initiatives were also implemented, such as blood safety, injection safety, and harm reduction interventions. However, it is only recently that more focused efforts have been directed toward testing and treatment, following the introduction of highly efficacious, all-oral, direct-acting antiviral (DAA) therapy in 2014 that can achieve cure rates of more than 95%.

In 2015, the United Nations General Assembly adopted the 2030 Agenda for Sustainable Development which calls on the international community to combat viral hepatitis as a public health threat by 2030 (SDG Target 3.3). In 2016, the World Health Assembly approved the Global Health Sector Strategy which was endorsed by 194 WHO member states to eliminate viral hepatitis by 2030.

Despite these calls for action, the global response for mustering political will and investing the necessary resources to combat and eliminate viral hepatitis has been slow with only 12 countries on track to eliminate HCV infection by 2030. Private-sector leadership is essential for breaking the silence on viral hepatitis and contributing to elimination efforts at the workplace and in the communities where companies operate through their unique assets, core competencies, and networks. Below is a leadership profile of a business case in Taiwan that has made significant impact on viral hepatitis control and elimination, consistent with Sustainable Development Goals and universal health coverage. 7-ELEVEN hopes to inspire other businesses to take practical steps toward prioritizing efforts for viral hepatitis elimination.

Convenience Stores As Hepatitis Screening Stations in Rural Areas

Since 2006, 7-ELEVEN, the largest convenience store chain in Taiwan (5,000 stores serving five million customers daily) owned and operated by President Chain Store Corporation (PCSC), has been partnering with Liver Disease Prevention and Treatment Research Foundation to help raise public awareness about viral hepatitis and promoting liver health through 7-ELEVEN’s “Bring Back the Love” Campaign and PCSC’s Good Neighbor Foundation.

Fifty-four 7-ELEVEN stores throughout Taiwan took part in the campaign.  They provided free liver disease screening resources in-store, including those for HBV, HCV, and liver cancer, to local residents aged 20 and above in rural and remote townships that suffer from a shortage of medical resources, such as Binan in Taitung, Shuishang in Chiayi, Nangan in Mazu, and Jinsha in Kinmen. Those who tested positive were referred to the nearest liver health centers for additional follow-up and linked to treatment and care. In addition, the campaign employs the concept of “health steward” in which lay individuals are tasked with following up regularly with patients found to need treatment during liver screening to improve the follow-up rates of patients seeing their doctors and receiving medical treatment. These innovative efforts resulted in early detection and prompt linkage to care and treatment for rural residents by screening more than 25,000 people per year.

With the goal of ensuring sustainability of these efforts, 7-ELEVEN’s “Bring Back the Love” Campaign also raised more than NT$280 million (about US$9 million) through in-store donations of spare change by customers; this enabled continued support and expansion for free hepatitis and liver cancer screening in rural townships as well as subsequent medical follow-up and assistance.

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