On 28th July 2023, the world celebrated global hepatitis day. Like every other previous year, the celebration is marked with a theme. ‘One Life One Liver’ is the theme for 2023 and it draws the attention of communities and Nations to the importance of the liver for a healthy life, and the urgent need to scale up testing, treatment, and preventive measures to maximize liver health, prevent liver disease and achieve the 2030 hepatitis elimination goals (World Hepatitis Day 2023, 2023). Although the celebration is coming at a time when COVID-19 is no longer a global threat, the threat of climate change and environmental exposure remains otherwise and deserves critical attention.
What are the types of Hepatitis?
The liver is a body organ located in the upper right part of the human abdomen. It is responsible for an array of functions that include support with metabolism, immunity, digestion, detoxification, and vitamin storage. Sadly, and due to many factors, this critical organ in the human body can become plagued with diseases such as cirrhosis, liver cancer, and viral hepatitis (Kalra et al., 2023).
Hepatitis A is an inflammation of the liver caused by the hepatitis A virus (HAV) pathogen. It spreads when a vulnerable person ingests contaminated food and water or has direct contact with an infectious person. Hepatitis A is common in low- and middle-income countries (LMICs) where poor sanitary conditions and hygienic practices are predominant (World Health Organization, 2023a).
Similarly, Hepatitis B is caused by hepatitis B virus (HBV), but unlike Hepatitis A, it is regarded as a major global health problem due to the highest burden of infection across world regions. While Hepatitis B is commonly spread from mother to child during birth (vertical transmission) or through horizontal transmission (exposure to infected blood), it is preventable with a vaccine (World Health Organization, 2023b).
On the contrary, there is no effective vaccine against Hepatitis C – a viral liver infection caused by the hepatitis C virus. The exposure to this virus can be from unscreened blood transfusion, sharing of injection equipment, and inadequate sterilization of medical equipment (World Health Organization, 2023c).
As regards Hepatitis D, this is an aggravated form or stage of Hepatitis B occurring in at least 5% global population of people who already have HBV. Hepatitis D infection can be prevented by HBV vaccine (World Health Organization, 2023d).
Lastly, the Hepatitis E viral infection, which is like Hepatitis A, is common in LMICs where access to essential water, sanitation, hygiene, and health services is limited. Prevention is the most effective approach (World Health Organization, 2023e).
How is Climate Change contributing to Hepatitis?
According to the United Nations climate change effects range from hotter temperatures, increased flood, and drought, rising oceans, inadequate food, increased health risks, poverty, and displacement (United Nations, n.d.).
Hotter temperatures – The rise in greenhouse gases has continued to contribute to increasing global surface temperature. It has been reported that global warming is a determining factor in pathogens selection and resistance, man’s environment, and immunity, as well as vector (parasites serving as means of transmission) and capacity. Owing to greenhouse gas emissions, the rate of reproduction and distribution of vectors in different locations is affected by climate change (Saad-Hussein et al., 2022).
Climate change is attributed to deforestation and encroachment into animal habitats, forcing animals to migrate and increasing their chances of contact with humans and other animals, thus encouraging the distribution of communicable liver diseases. Further, global warming increases the likelihood of the development of poor air quality due to unregulated chemicals in the environment. The dispersion of pollutants in the air penetrates the body either through skin or inhalation, promoting damage to the liver (Saad-Hussein et al., 2022).
Increased flood and drought – These have been exacerbated by climate change as rising temperatures disrupt the natural water cycle process. As mentioned earlier, Hepatitis A and Hepatitis E are primarily related to poor water supply, sanitation, and hygienic practices. For instance, in an African country like Nigeria, the Hepatitis E outbreak in the northeastern region of the country has been connected to the unavailability of soap or clean water (Doctors Without Borders, 2017). Worse still, flooding which has plagued Nigeria in recent years has added to serious pollution and health risks associated with open defecation which is a problem in Nigeria. This creates opportunities for contamination of drinking water and food.
In Asia, Bangladesh is also a country where Hepatitis E is common. This is not unrelated to the absent sanitation infrastructure and the regular occurrence of flood events. When flood water does not go into sewers and becomes contaminated with feces, Hepatitis infection transmission remains unavoidable (DW, 2022). Evidence has also indicated flooding events as a causal factor in a high incidence of Hepatitis A in countries like Brazil, and Spain. It is appalling that Hepatitis A is responsible for at least 70,000 deaths per year around the world (Leal et al., 2021).
How do we go forward with One Life One Liver?
Emphasis on this year’s World Hepatitis Day is about keeping the liver healthy from hepatitis infection through testing, treatments, and preventive measures. This can be promoted by any government through improved access and provision of adequate sanitation and healthcare facilities, strategic location of dumpsites and control of environmental pollution, making available efficient water supply and drainage systems, mass education and vaccination programs on hepatitis, as well as judicious use of resources. However, these remedies may be farfetched if the fundamental problem posed by climate change remains unsettled. Climate change is the biggest health threat facing humanity with around 13 million people losing their lives annually due to environmental factors (United Nations, n.d.)
There is a growing body of literature and evidence of the relationship between hepatitis, climate change, and environmental factors. Every country has its peculiar challenges which are aggravating the level of occurrence and distribution of viral hepatitis among their populations. Despite these challenges, if all development actions are not climate change responsive at individual, community, or leadership levels, then One Life One Liver will not matter.
What do you think about the linkage of climate change to hepatitis? What is the situation of hepatitis in your community? Are you aware of climate change-responsive action toward hepatitis elimination?
- Doctors Without Borders. (2017). Nigeria: Hepatitis E Outbreak Declared in Borno as Rainy Season Increases Risk of Disease | Doctors Without Borders – USA. https://www.doctorswithoutborders.org/latest/nigeria-hepatitis-e-outbreak-declared-borno-rainy-season-increases-risk-disease
- DW. (2022). Global heating may spread hepatitis E. https://www.dw.com/en/more-flooding-drought-may-cause-hepatitis-e-to-spread/a-62609920
- Kalra, A., Yetiskul, E., Wehrle, C. J., & Tuma, F. (2023). Physiology, Liver. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK535438/
- Leal, P. R., Guimarães, R. J. de P. S. e., & Kampel, M. (2021). Associations Between Environmental and Sociodemographic Data and Hepatitis-A Transmission in Pará State (Brazil). GeoHealth, 5(5), e2020GH000327. https://doi.org/10.1029/2020GH000327
- Saad-Hussein, A., Ramadan, H. K. A., Bareedy, A., & Elwakil, R. (2022). Role of Climate Change in Changing Hepatic Health Maps. Current Environmental Health Reports, 9(2), 299–314. https://doi.org/10.1007/S40572-022-00352-W/TABLES/1
- United Nations. (n.d.). Causes and Effects of Climate Change | United Nations. Retrieved July 30, 2023, from https://www.un.org/en/climatechange/science/causes-effects-climate-change
- World Health Organization. (2023a). Hepatitis A. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
- World Health Organization. (2023b). Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
- World Health Organization. (2023c). Hepatitis C. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c
- World Health Organization. (2023d). Hepatitis D. https://www.who.int/news-room/fact-sheets/detail/hepatitis-d
- World Health Organization. (2023e). Hepatitis E. https://www.who.int/news-room/fact-sheets/detail/hepatitis-e
- World Hepatitis Day 2023. (2023). https://www.who.int/westernpacific/news-room/events/detail/2023/07/28/western-pacific-events/world-hepatitis-day-2023