Project Lead(s): Naranjargal Dashdorj
Mongolia has the world’s highest rate of liver cancer mortality – seven times the global average – and the number is increasing.
The prevalence of chronic viral hepatitis B and C in Mongolia is at an epidemic level, and constitutes the main cause of Mongolia’s liver cancer mortality rate.
The project was designed to collect data on the prevalence of viral hepatitis infection in the Mongolian population through the most comprehensive epidemiological study of hepatitis ever conducted in the country.
The project aim was also to test the feasibility of using cutting-edge, point-of-care tests, in combination with mobile (SMS) technology, in a rural healthcare setting.
In addition, media campaigns via the internet and traditional media were conducted to increase public awareness of viral hepatitis in Mongolia and how it can be prevented.
Several workshops were convened where study findings were shared with policy makers.
Results suggest there is a silver-lining for chronic viral hepatitis C (HCV) in Mongolia, as there appears to be a cohort effect with a reduction in the incidence of some high-risk factors, resulting in a reduced prevalence among younger generations. This would also mean that the probability for reinfection of HCV after getting treatment is less pronounced.
A total of 1,158 subjects were enrolled in the study, including 500 men (43.1%) and 658 women (56.9%). The overall prevalence of HBsAg and anti-HCV among study subjects were 10.6% (123/1158) and 11.1% (128/1158), respectively. Using these figures, the first country-wide estimate on the prevalence of hepatitis B and C among adults could be made, which estimates about 207,000 adults living with HBV in Mongolia and another 160,000 people with HCV.
Based on Mongolian Media Association and other data sources, it was also estimated that 1 million to 1.5 million people heard messages about viral hepatitis through the media campaign.
The project marked the starting point for a comprehensive national program on mitigating hepatitis B, C and D in Mongolia, initiated by the Onom Foundation. The Onom Foundation has initiated the Hepatitis Prevention, Control and Elimination Program, with the aim to eliminate hepatitis C by 2020 and to reduce the mortality due to viral hepatitis by 50% in Mongolia. As a most significant outcome, all Mongolians have access to substantial subsidies for hepatitis diagnostics and treatment through the public health insurance system.
In addition, Gilead Sciences has enrolled Mongolia into their Access Program that provides HCV and HBV treatment drugs at a massively discounted price (e.g., for $1,200 compared to $95,000 per HCV treatment).
Based on these findings, the study team believes that it is practically feasible to eradicate HCV in Mongolia by introducing breakthrough HCV treatments from Gilead Sciences.