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WHO CC for Viral Hepatitis | Centre Activities

WHO Surveillance and Laboratory Capacity Building

Surveillance and Laboratory Capacity Building

The Western Pacific Region of WHO (WPRO) is disproportionately affected by hepatitis B and C, and also faces challenges associated with limited resources and capacity. Compared with other geographical regions, WPRO has the highest number of viral hepatitis-related deaths per year, accounting for approximately 39% of global mortality due to hepatitis, of which 94% is attributable to chronic hepatitis B and C infections. Within WPRO, the highest percentage of hepatitis-related mortality is attributed to liver cancer (67%), followed by cirrhosis (27%), and acute hepatitis (6%). More people die in the region from hepatitis related illness than from HIV, Tuberculosis and Malaria combined.

The WHO Collaborating Centre for Viral Hepatitis works in partnership with the WHO in moving towards viral hepatitis elimination in our region and globally. In conjunction with the designation as a Collaborating Centre and as a WHO Regional Reference Laboratory for Viral Hepatitis in 2010, the Centre assists the WHO Headquarters and WPRO Office with advice and support for approaches to the prevention and management of viral hepatitis, and provides reference testing for samples collected as part of national serosurveys conducted across WPRO.

The majority of the Centre’s collaborative work with WHO is coordinated with WPRO Office in Manilla with the Viral Hepatitis Office within the HIV/AIDS and Sexually Transmitted Infection Units in the Division of Communicable Diseases and with WHO Headquarters in Geneva. The Centre also work closely with Country Office’s in WPRO including, China, Mongolia, Viet Nam, Laos, Cambodia, The Philippines, Kiribati, Papua New Guinea, The Federated States of Micronesia, and Timor-Leste. In addition to working with WHO colleagues (with HQ in Geneva, WPRO in Manila and other regional offices), and with partners at other collaborating centres, staff are honoured to regularly be invited by member states to visit, learn from experts and stakeholders in country, and jointly develop strategies to address viral hepatitis locally and regionally. 

In 2015, Member States in the Region approved the Regional Action Plan for Viral Hepatitis in the Western Pacific 2016-2020. The Regional Action Plan and subsequently the Global Health Sector Strategy on Viral Hepatitis 2016-2021 identified strengthening of national surveillance and laboratory capacity systems as a priority action needed for quality hepatitis diagnosis, treatment and monitoring of disease burden.

Prevention, treatment and surveillance programmes are all underpinned by laboratory testing so gaps in laboratory capacity should be accessed and strengthened where necessary.  Most WPRO States have health information systems and preventive and care services for viral hepatitis. However previous assessments suggested that capacity for viral hepatitis B and C serology testing was generally poor and quality assurance systems were inadequate, particularly among countries where the viral hepatitis burden is high (Cambodia, China, Mongolia, the Philippines and Viet Nam). The laboratories need support to establish national external quality assessment schemes for hepatitis testing, to use approved test kits and to implement uniform quality management systems and standards in their countries, as well as support to strengthen (and in some countries design and implement) surveillance and monitoring systems to accurately measure and manage diagnosis, treatment and monitoring of disease burden and help to achieve the surveillance milestones outlined in the Regional Action Plan.

WPRO, in collaboration with local, regional and global experts, aimed to organise national integrated surveillance and laboratory workshops in high burden countries. WPRO (and their collaborators) have committed to organise national workshops in a range of high burden countries in the region (including, but not limited to, Mongolia, China, Philippines, Laos, Vietnam, Cambodia, Papua New Guinea and Kiribati). As each country is assessed and actions implemented, it is expected that an improvement in the quality of hepatitis testing will occur, supporting hepatitis prevention, treatment and surveillance programmes in the region.

The integrated laboratory and surveillance workshops are the first steps towards the successful establishment of a Regional Network of Hepatitis Reference Laboratories.  The aim of this Network of laboratories is to provide quality assurance and quality management programmes to increase and monitor quality of testing in the region, provide advice to implementing partners, surveillance data to monitor intervention and the ability to rapidly respond to outbreaks and emergencies. Establishing a Viral Hepatitis Laboratory Network will also facilitate enhanced surveillance activities by providing guidance and support for seroprevalence surveys and data management systems to collect WHO recommended viral hepatitis diagnosis and treatment monitoring indicators. Currently, no such network exists at the global or regional level within the WHO. WPRO would be the first region to develop a Regional Hepatitis Reference Laboratory Network.

Engagement and Collaboration with WHO

The Centre works in partnership with the WHO in moving towards viral hepatitis elimination in our region and globally. 

In conjunction with the designation as a Collaborating Centre and as a WHO Regional Reference Laboratory for Viral Hepatitis in 2010, the Centre assists the WHO and Western Pacific Regional Office for the WHO (WPRO) with advice and support for approaches to the prevention and management of viral hepatitis, and provides reference testing for samples collected as part of national serosurveys conducted across the Western Pacific Region.

The Centre also enables VIDRL and the Doherty Institute to extend the scope and geographic reach of their research, training and regional capacity building activities related to viral hepatitis in collaboration with the WHO, other WHO Collaborating Centres and research partners to support the global agenda for viral hepatitis control. 

The majority of the Centres collaborative work with WHO is coordinated with the Regional Office for the Western Pacific in Manilla with the Viral Hepatitis Office within the HIV/AIDS and Sexually Transmitted Infection Units in the Division of Communicable Diseases. The Centre also works closely with WHO Headquarters in Geneva. 

In addition to working with WHO colleagues (with HQ in Geneva, WPRO in Manila and other regional offices), and with partners at other collaborating centres, staff are honoured to regularly be invited by member states to visit, learn from experts and stakeholders in country, and jointly develop strategies to address viral hepatitis locally and regionally. 

Summaries of some of the work that the Centre has undertaken globally and in our region can be accessed below. 

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