Hepatitis-B vaccine is a 3 dose vaccine given at 0, 1 and 6 months. But for the kids, the 1st dose must be given within 24 hours of birth.
If the mother is an active carrier of chronic hepatitis-B the birth dose has the strongest influence on reducing the acquisition of hepatitis-B for the infant. But many countries are not fully implementing the birth dose vaccine. The problem is again of linkage to care. People are not accessing treatment. Also, countries are not purchasing the lowest cost or the best access price for the treatment or for the diagnostic tests. Just like we did for HIV, we have to get access price for hepatitis diagnostics and treatments to scale them up. Otherwise we are only serving a small proportion of the infected population. The message has to be spread and people have to start demanding, and unless they know how they would demand," says Dr Doherty.
Protecting the medicines that protect us
A cause of concern is that multi-antibiotic resistant gonorrhea cases are being reported in parts of the world, and we also have cases of resistance to dolutegravir - the wonder drug used in HIV treatment.
"Knowing about antimicrobial resistance (AMR) allows us to have a good public health response to it. We have good surveillance systems for multi-resistant gonorrhea with 87 different sites around the world reporting on it. But apart from setting up surveillance systems for STIs, we are also changing the guidelines- advocating for good communication and knowledge sharing, ensuring good stewardship of antibiotics, and also working for better regimens to come forward. There are at least two new medicines that are coming up to address drug-resistant gonorrhea," said Dr Doherty.
She added: "In hepatitis we have not seen a lot of resistance yet but we are doing surveillance to keep an eye on it. For HIV we have been doing surveillance for many years and right now we are reassured that dolutegravir-based regimens are still the working horse of HIV treatment. WHO recommended combination of Dolutegravir, Tenofovir and Lamivudine-based regimen is working well for most people living with HIV. But we have seen in certain settings that if not used properly or if used in people who have had a lot of different regimens in the past, there could be resistance developing [in the virus] against dolutegravir. So we have to be very careful as we want to protect that regimen. That also means we need to have a second-line regimen ready that might be able to be an alternative in the future. But right now dolutegravir is working very well for the majority of the people."
Connect, reconnect and recommit to end AIDS at #AIDS2024
Dr Doherty shares her message for the upcoming 25th International AIDS Conference (AIDS 2024): "My message is to connect, reconnect, and recommit to ending AIDS by 2030 - and - do it by bringing along other disease areas as well. We will only get there in this new world of multiple problems - whether it is climate change, or new infections, or NCDs or emergencies - if we work collaboratively with others. Also, do not lose energy. We need to work harder now because it is the last mile for HIV. HIV is not going to go away, people will be living their lives with HIV for years to come. But getting to a place where countries are in control of the number of new infections and they own their programmes. That is an awful lot of hard work that we need to do in the next six years. I hope that we can get ourselves to a point by 2030 where we have a significant number of countries that are able to manage their HIV epidemic and other diseases in their country and that people are living happy and long lives - not just with HIV but also with their NCDs, and with other infections."
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