as a force multiplier

The Task Force was launched as a catalyst. Five sponsoring agencies—the World Health Organization (WHO), UNICEF, World Bank, United Nations Development Programme and the Rockefeller Foundation—sought to accelerate the pace of childhood immunizations worldwide. They created The Task Force as a way to plan cooperative immunization efforts and be a resource for activities that were difficult for agencies to do on their own. Through efforts driven by The Task Force, the rate of children who had received at least one immunization globally quadrupled in the first six years. The success of that early vision paved the way for other ambitious endeavors, and this coalition model continues to thrive at The Task Force. 

One example is our work on viral hepatitis. WHO has set goals for hepatitis elimination by 2030. The Coalition for Global Hepatitis Elimination is playing a key role, serving as the secretariat for the UN Group of Friends to Eliminate Hepatitis, involving more than 40 countries, and supporting local community champions who are providing testing, vaccination, treatment and care. Progress is advancing rapidly—for example, in 2023, Egypt was certified as having eliminated hepatitis C, the first country to do so, following a comprehensive public health campaign. 

The Health Campaign Effectiveness Coalition (HCE Coalition) is a Task Force program through which representatives from 84 countries contribute to efforts to improve the integration, efficiency and effectiveness of health campaigns. Campaigns range from neglected tropical diseases, malaria and immunizations to nutrition. In 2023 the HCE Coalition released a report with key findings from 28 studies from 15 countries, such as Cameroon, Côte d’Ivoire, Ethiopia, Ghana, Nigeria and Vanuatu, sharing effective practices that can be tailored to local contexts. 

To further transition research findings into practice, in late 2023 the HCE Coalition co-developed the Collaborative Action Strategy for Health Campaign Effectiveness (CAS) with more than 40 partners from both global and country-level settings, representing more than 20 organizations. The CAS is a first-of-its-kind commitment by the global health community to collaborate internally, and with countries, to plan, implement, finance, and evaluate campaigns, driving forward smart integration approaches that improve efficiency and ultimately strengthen primary health care systems.

Another Task Force program, Voices for Vaccines, trained 1,000 volunteers from 13 immunization coalitions. These volunteers provide vital immunization information for their communities, reaching 200,000 families, advocates and public health workers. Program outreach ranged from peer-to-peer education in the Somali community in Kenya to an online Vaccines 101 course to sharing family stories through a social media campaign #WhyIVax.

At the global and national policy level, The Task Force is active in more than a dozen policy and advocacy working groups, working with NGO partners to develop and advance shared policy goals, collaborative advocacy strategies and common messages to maximize effectiveness and impact. These fora allow The Task Force to contribute to important global health policy developments and emerging opportunities across the US government, World Health Organization, United Nations system and other multilateral organizations; extend our reach to policymakers; and ensure Task Force programmatic technical expertise informs important policy and funding decisions. 

Saving people from Hepatitis Is Personal for Dr. Nida Ali

Globally, viral hepatitis is killing more people than HIV and malaria combined. The United Nations has declared hepatitis elimination as one of the Sustainable Development Goals with the intention to reduce the mortality, active infections and active transmissions by 2030.  An estimated 58 million people living with hepatitis C worldwide are at risk of death from progressive liver damage, liver failure, and liver cancer.

For Nida Ali, eliminating viral hepatitis is not just a public health challenge, it’s personal. In 2012, Dr. Ali’s mother lost her battle to hepatitis C because she could not get access to timely testing and access to the current treatment regimens. This had a profound personal effect on Dr. Ali and charted her career in public health.

“The hepatitis elimination community in Pakistan is still very small and infections are being transmitted through healthcare” said Dr. Ali. “We still need to do some real groundwork for prevention to prevent it at the source, which comes down to better healthcare: preventing unsafe injections, unsafe surgeries, unsafe blood transfusions.”

The largest number of hepatitis C patients in the world are living in Pakistan as the country contributes to 17% of hepatitis C infections worldwide. An estimated 20,000 people or more die each year in Pakistan from hepatitis-related causes. In 2019, in conjunction with World Hepatitis Day, the government of Pakistan launched a National Hepatitis Elimination Initiative to invest ($125 million) in hepatitis control. The initiative aims to screen 140 million people and provide treatment to those that are infected. 

Dr. Nida Ali is an active part of this effort. She is a medical doctor and public health specialist with expertise in infectious disease prevention and elimination, including both polio and hepatitis elimination. While Dr. Ali was a Humphrey Fellow studying Global Health Policy & Program Management at Emory University, she met Dr. John Ward, Director of The Task Force’s Coalition for Global Hepatitis Elimination (CGHE), who later became her mentor. 

Eliminating Hepatitis in her Hometown in Pakistan

When Dr. Ali returned to Pakistan in 2023, she became a CGHE Hepatitis Evaluation Research & Outreach (HERO) Fellow and founded an implementation research project called the Local Hepatitis Elimination and Prevention (LHEAP) in her hometown of Rawalpindi. Rawalpindi district has a population of 6.5 million people and is located in the Punjab Province of Pakistan. CGHE in partnership with the Ministry of Primary and Secondary Healthcare of Punjab provided technical and financial support for the LHEAP project.

“Although there are many micro-elimination projects in Pakistan, the comprehensive LHEAP project study was the first of its kind that catered to both hepatitis B and C and offered door-to-door hepatitis screenings and hepatitis treatments and vaccinations to Rawalpindi residents that ranged from newborns to age 95,” said Dr. Ali. “LHEAP screened 35,000 people, discovered 800 cases of hepatitis B and C and vaccinated 17,000 adults.”

Dr. Ali’s Global Advocacy for Hepatitis Elimination

With the support of her mentor, Dr. John Ward and the CGHE team, Dr. Ali’s advocacy for hepatitis elimination has reached beyond just Pakistan as she helps CGHE coordinate the UN Group of Friends to Eliminate Hepatitis, which, according to the WHO UN New York Office is the fastest growing UN Group of Friends dedicated to a specific disease. In 2022, CGHE reached out to Member States at the UN, under the leadership of UN Mission of Egypt, to raise diplomatic awareness and high-level political and diplomatic support for putting the hepatitis elimination on the forefront of high-level health discussion agendas.

“The purpose of the UN Group of Friends is to reach the right people who actually have a say and who actually have influence to have the financing and have the resources being drawn towards this cause. Mobilizing resources, generating political will, and orienting people who have high positions about why hepatitis is so important. This is the core of the UN Group of Friends” said Dr. Ali.

As Dr. Ali preps for the 3rd Annual UN Group of Friends to Eliminate Hepatitis which will happen on the sidelines of the 79th UNGA in September 2024, in the back of her mind and always in her heart, she is strategizing ways that she can adopt successes from other national hepatitis programs and implement them in her own country.

“If we have to eliminate hepatitis from Pakistan, we have to take the approach that Egypt took. The level of commitment from the President’s office and how he announced this program where Egypt screened millions of people and provided treatment in less than a year. They made this program cost effective by generating their own generic antiviral pills. Learning from Egypt, we need a very holistic approach and need to have a very effective, vertical elimination program catered to hepatitis C only. I am hopeful that if we invest in enough resources, enough human resources, enough political will, we can make good progress and we can eliminate hepatitis.”

In Pakistan, Dr. Ali is excited to witness more political and financial support for hepatitis elimination. Although under utilized, Pakistan also has the capacity to manufacture the generic antivirals for treatment of hepatitis C. 

“Most of the work we do in infectious disease surveillance is largely about prevention of new infections and timely diagnosis. I know that both these approaches can save lives and I believe that if my mother had access to these approaches, her life could have been saved. There is always this personal reason for being so empathetic towards people who are getting the virus, who are getting the disease, who are still dying of hepatitis”

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