By Bill Picture– October 28, 2010
Posted in: Health, National
Last month, the Centers for Disease Control and Prevention announced its priority issues in a list of “six winnable battles,” including HIV/AIDS, obesity and nutrition, traffic accidents, and teen pregnancy.
Some Asian American community activists, however, are saying that the list will do more harm than good to Asian Pacific Americans.
“The Centers for Disease Control’s new prioritization of ‘six winnable battles’ once again demonstrates the CDC’s poor track record towards achieving health equity for all Americans,” said AsianWeek Foundation Director Ted Fang in a statement.
Cancer kills more Asian Americans than any other disease, and Asians are the only racial group in which cancer is the number one killer. Liver cancer and hepatitis B liver disease are the greatest health disparities for Asians.
Community groups on the frontline in the battle against hepatitis B and liver cancer, say that the CDC’s new priorities could stymie their efforts to increase public awareness of the diseases, as well as lessen their chances of securing the funding necessary to implement effective and comprehensive prevention programs.
Hepatitis B attacks the liver when active, and is one hundred times more infectious than HIV. Left untreated, the disease can cause cirrhosis, liver cancer and liver failure. 80% of liver cancer cases worldwide are caused by hepatitis B. One out of ten Asian/Pacific Islanders is infected.
“You need to get people to get tested, you treat those who have it and vaccinate those who haven’t been exposed. That’s how you bring that (infected) number way down,” explains Janet Zola, Health Prevention Specialist with the San Francisco Department of Public Health
“We have a vaccine that works and drugs to manage it. Talk about a winnable situation,” she says. “The problem is, more than half of the people who have it don’t even know it.”
Hepatitis B has been called a “silent killer” because infected individuals often exhibit no symptoms until the liver has been compromised, limiting the effectiveness of available treatments. Early detection is key, and the blood test used is both simple and inexpensive. However, few physicians routinely test patients for hepatitis B.
The CDC has yet to explain why hepatitis B and liver cancer were not included on the list of agency priorities. CDC representatives did not comment for this story despite repeated attempts by AsianWeek.com to contact the agency. A few theories have been posed by members of the public health community, however.
“They don’t have the resources necessary for it to be considered winnable,” says Dr. Samuel So, founder of the Asian Liver Center at Stanford University.
According to So, the CDC only has $17.3 million allocated to national hepatitis B and C prevention. Congressman Mike Honda (D-CA) has introduced a Liver Cancer Bill calling for $600 million to be allocated for national interventions. The bill has 75 co-sponsors. CDC studies estimate a $300 million price tag for a comprehensive national hepatitis B and C prevention and control effort.
Dr. So, Zola and Fang are co-founders of the Hep B Free campaign in San Francisco, a community-based model for hepatitis-B-prevention now being replicated by municipalities across the country.
“Dr. So is probably right,” says Michele Peterson, MPH, Project Manager for the California Hepatitis Alliance, which has been working with the state to draft a strategic plan for viral hepatitis prevention that can be paired with healthcare reform and a plan for viral hepatitis prevention at the national level drafted by the Trust for America’s Health.
“These documents give the CDC the tools to address the problem, and make it an even more winnable battle,” adds Peterson. “But, until we having the funding, these strategies can only be guides.”
“This is the height of idiocy,” says California Hepatitis Alliance Chair, Leslie Benson. “Hepatitis C is curable, and the other two forms are vaccine-preventable at low cost. Not only is viral hepatitis one of the most winnable battles, it’s also the bargain of the century.”
“In terms of hepatitis B, sickle cell anemia is the only other disease I know of with such a huge impact on a specific ethnic group,” Benson adds. “Ignoring it like this is a deadly form of racism, and should not be tolerated.”
Some also point to a possible breakdown in communications at the CDC. The agency has a department that deals specifically with viral hepatitis. In fact, just two years ago, that department’s director, Dr. John Ward, visited San Francisco to discuss the importance of prevention efforts and announce new guidelines for hepatitis B screening at a press conference organized by the SF Hep B Free campaign.
“It makes me wonder who [CDC] leadership talked to within the organization when they were making the list, if the viral hepatitis people didn’t get any input,” says Janet Zola.
“They probably didn’t have an oncologist or a hepatologist on the panel,” adds Dr. Robert Gish, Co-Director of the Center for Hepatobiliary Disease and Abdominal Transplantation at the University of California, San Diego School of Medicine. “Moving forward, we need to make sure there is.”
“For Version 2.0 of the list, we want liver cancer to be one of the top discussion points at that meeting, and we need to keep putting pressure on them.”
“We won’t stop, of course,” says Zola. “But it’s disappointing. The head of the CDC looked right over us. That’s very discouraging, to say the least.”
So went further, issuing a challenge to the community.
“To get more money from the government, the public needs to speak up, convince policymakers that it’s important to them, and demand that something be done,” So adds. “People took to the streets for HIV.”
The problem is, the public isn’t even aware that hepatitis B poses a significant risk to public health, even though it affects millions of Americans. Further lessening the chances of a big enough stink being raised to force politicians’ hands is the fact that half of those infected with hepatitis B are Asian & Pacific Islanders, whose cultures do not encourage activism. 1 in 4 APIs diagnosed with hepatitis B will die of liver cancer unless they receive treatment.
“So there’s no public outcry and, therefore, no political will to address it,” says So. “It’s a Catch 22.”
Source
Also See:
-- CDC's 'Winnable Battles' Out of Step with Healthcare Reform and Achieving Health Equity for the American People, Says Ted Fang, Co-Founder, Hep B Free
-- NVHR: In Fighting for 'Six Winnable Battles,' CDC May Lose the Nation's Overall Public-Health War
-- CDC chief picks 6 'winnable battles' in health
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