By Kizito Khalid Ssekabembe 

According to World Health Organization, “Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease. The virus is most transmitted from mother to child during birth and delivery, in early childhood, as well as through contact with blood or other body fluids during sex with an infected partner, unsafe injections or exposures to sharp instruments. The WHO estimates that 240 million people were living with chronic hepatitis B infection in 2024, with 0.9 million new infections each year. In 2024, hepatitis B resulted in an estimated 1.1 million deaths, mostly from cirrhosis and hepatocellular carcinoma (primary liver cancer).  

In Uganda, approximately 1.845 million Ugandans are chronically infected with the virus and liver cancer caused by HBV contribute 5.1% of all cancer deaths. 

According to the 2016 Uganda Population based HIV Impact assessment survey, prevalence of Hepatitis B infection among adults stands 4,3% (5,6% among men and 3.1% among women). The survey indicates that Hepatitis B prevalence is highest in Northern region with 4.6% in mid North ,4.4% in Northeast and 3.8% in West Nile.  Hepatitis B infection was lower in the rest of the country with a range of 0.8% in the Southwest region to 2.7% in East Central region. 

Laws and Policies on Right to Health and Hepatitis B in Uganda and gaps that need to be addressed. 

Although the constitution is not so clear on the right to health, there are laws and policies that have been put in place: Uganda guidelines for prevention, testing, care and treatment of hepatitis B and C virus 2024, Public Health act 2023, National immunization Strategy (2024-2028), immunization act 2017, public health rules 2014. 

Gaps that need to be addressed  

Financial gaps: financial disparity needs to be given attention because financial allocations are more given to HIV than Hepatitis B; Hepatitis B remains underfunded despite its high disease burden. Financing structures must be reevaluated for purposes of equity and fairness. 

Implementation and sensitization: there is an urgent need to bridge the persistent and sensitization gaps in Uganda’s public health response to Hepatitis B. While the Uganda guidelines for prevention, testing, Care and treatment of Hepatitis B 2024 offer a robust framework, a disconnect between these clinical standards and public understanding. The government must effectively engage the public by educating high risk groups such expectant mothers and sex workers on Hepatitis B prevention and procedures. 

Human rights and stigma protection on Hepatitis B patients: government policy must protect the rights  of Hepatitis B patients and one of the ways should be guaranteed confidentiality by strictly enforcing medical confidentiality laws, workplace equality like banning mandatory screening at places of work to prevent unfair termination or exclusion. 

The battlefield as an eco-system our focus being prevention 

Since hepatitis B is non-curable, we can work on control and prevention as our mode of fighting, one of the ways we can do this to make sure we do regular checkups.  

Diagnosis: This involves the steps that your health care professional takes to find out if you have hepatitis B. Your healthcare professional gives you a physical exam and looks for symptoms of liver damage. These symptoms can include yellow skin and stomach pain. Tests that can help diagnose hepatitis B or its complications are Blood tests that can detect the hepatitis B virus in your body. They can also tell your health care professional if the infection is acute or chronic. A simple blood test also can find out if you are immune to the condition this is according www.mayoclinic.com 

Vaccination: hepatitis B is preventable with a vaccine. All babies should receive hepatitis B as soon as possible after birth (within 24 hours). This is followed by two or three doses of hepatitis B vaccine at least four weeks apart. Hepatitis B can be passed from mother to child. this can be prevented by taking antiviral medicines to prevent transmission, in addition to the vaccine shortly after birth. The pentavalent vaccine to infants at 6,10 and 14 weeks. Adult vaccination may also be offered as long as there is no evidence of chronic infection. This vaccine should be given at 0,1and 6-month intervals. 

Public campaigns and addresses especially among the Youth on Hepatitis B prevention, especially on regular condom use: To effectively eliminate the spread of Hepatitis B, we must promote safe sex practices such as consistent condom use. The phrase of ‘’eating a sweet in polyethene bag ‘’ is a commonly slang term used by young people   to express that using condoms reduces sexual pleasure and intimacy during sex.  Public health campaigns frequently fail to address this mindset because they heavily focus on clinical facts rather than addressing consistent use of condoms. 

Currently public health awareness is overwhelmingly focused on HIV but it’s high time we also intentionally focus on Hepatitis B. Targeted intervention is urgent in transit and the areas around Busega and  Nateete are well known hubs for nighttime, trade, transport and informal businesses which correlate with high levels of commercial sex. Introducing focused Hepatitis B awareness and its prevention is essential in these communities and many other communities. 

According to the world health organization we should also avoid sharing needles or any equipment used for injecting drugs, piercing or tattooing, wash your hands thoroughly with soap and water after coming into contact with blood, body fluids, or contaminated surfaces and get a hepatitis B vaccine if working in a health care setting. 

Conclusion

The World Health Assembly called for governments and populations to take action to prevent diagnosis and treat viral hepatitis. Globally, 90% of people living with viral Hepatitis B and C do not know they have it, leading to an average of 3000 deaths every day. It is important to remember that the fight against Hepatitis B cannot be won in isolation, we must recognize that eliminating this disease requires a fully integrated ecosystem rather than leaving the government to carry the burden alone. 

The Author is a Lawyer and an Intern as Center for Health, Human Rights and Development (CEHURD).