Renowned hepatologist and global expert in liver disease, Dr Robert Gish, has called for urgent government intervention in dealing with the rising cases of Hepatitis B in the country. 

Describing Hepatitis B as a ‘killer disease’ with far-reaching implications, he said Ghana had one of the highest rates of liver cancer globally, with prevalence rates especially high in the northern region of the country. 

“I think the only other country close is Mongolia; we don't fully understand why the rates are so high, but we know how to break the cycle through testing, treatment, vaccination, and education about safe practices,” he said.

Speaking at a stakeholder engagement at the Urology Nephrology Centre of Excellence at Korle Bu, Dr Gish disclosed the need for lower medication costs, widespread testing, and immediate implementation of birth-dose vaccinations.

He said, “It is an infectious disease that changes people's lives as it could cause cancer, cirrhosis which is a condition where healthy liver tissue is replaced by scar tissue, leading to reduced liver function and potentially liver failure, and added that one out of four people with Hepatitis B die from complications.

According to him, the disease affected the quality of life of those infected and how they interact with society, saying, “There is stigma and discrimination, and every family in some way is connected to this disease.”

Cost of treatment

While the actual monthly cost of Hepatitis B medication is as low as $2.40, patients in Ghana are being charged between $30 and $50 due to excessive mark-ups in the distribution chain.

“We need to break that cycle, we need a direct pass-through from import to a public hospital to patient.

That is the only way we can reduce costs and increase access,” he said.

He further recommended a nationwide campaign to test all adults using simple screening tools, while linking positive cases to proper care.

“We are at the dawn of progress, very few people have been tested, and only a tiny fraction treated.

This must change now,” he said.

Echoing Dr Gish’s concerns, a local expert, who wished to remain anonymous, criticised the country’s failure to introduce the birth-dose Hepatitis B vaccine despite its proven effectiveness in reducing infection rates in other endemic countries.

The expert explained that reducing the viral load through treatment not only helped the individual but also lowered the chances of transmission within the community.

“As a country, we have failed in two major areas, first is vaccination, we still haven’t introduced the birth-dose vaccine.

Second is treatment, when we test and someone is positive but we don’t link them to care or start treatment, that person continues to spread the virus,” he said.

Equity in healthcare

President of the Hepatitis B Foundation of Ghana, Theobald Owusu-Ansah, also raised concerns about inequalities in healthcare resource allocation.

He urged teaching hospitals to repurpose machines used for HIV treatment to also serve Hepatitis B patients.

“The cost of medication and testing for Hepatitis B is very high in this country, however, we understand that the Ministry of Health is planning to introduce birth vaccinations, and we hope this will be implemented soon,” he said.