Hepatitis Free Mongolia, Phase 2 has reached its goal! As of December 2, 2024, we have screened 94% of the 44,402 people in Sukhbaatar province. To date, 76% of those needing treatment have started, with a goal of reaching 80%. This is one of the first times in the world that such a high level of screening and treatment has been achieved at the provincial level. We are only months away from declaring the elimination of hepatitis C in Sukhbaatar province!
“Hepatitis Free Mongolia” is a community-based model that eliminates hepatitis at the provincial level. By leveraging national support systems and the national Healthy Liver Program, Hepatitis Free Mongolia systemically locates the missing people needing testing and connects them to treatment. The program is designed to be replicated across communities worldwide. We aim to eventually scale the program across Mongolia, making it the first country in the world to eliminate hepatitis.
Despite seeing a reduction in the prevalence of Hepatitis C (HCV) over the last 14 years, Mongolia has remained the world leader in mortality rates for liver cancer and prevalence of Hepatitis B (HBV) and D (HDV). In 2017, the Government of Mongolia launched its national Healthy Liver Program (HLP) to control viral hepatitis. Hepatitis Free Mongolia Phase 2 began in the Summer of 2021 with the intention of eliminating hepatitis C (HCV) across Sukhbaatar province by filling the gaps in Mongolia’s national Healthy Liver Program.
The World Health Organization’s (WHO) definition of elimination requires screening 90% of a community and treating 80% who test positive. We are there, with 91.1% tested and 76.2% starting treatment! We are now shifting our focus to connecting everyone to treatment and ensuring everyone who has begun treatment completes treatment.
As of January 2025, Phase 2 has completed the following in Sukhbaatar province since it started….
- Built a 44,402-person patient registry in Excel with 14 different tabs, one for each clinic and its assigned populations, by coordinating with several government patients and citizen registries and digital and paper records.
- Created a proven, shareable model to eliminate hepatitis at the provincial level.
- Reached the last few months of eliminating hepatitis C, with over 94% of people tested and only a couple of hundred people remaining to be treated. We expect to reach 93% by December 6.
- Directly connected 110 people to treatment; 89% of those we directly tested who were positive for HCV.
- Covered treatment costs for those in need, about 40% of the 110 people treated.
- Directly screened 7,289 people for hepatitis B and C.
- Provided 3,535 ultrasound and 1,333 FibroScan examinations. Hepatologists or oncologists saw 2,516 people, 49 people were diagnosed with liver cancer and immediately connected to specialized care in Ulaanbaatar.
- Trained 150 social and healthcare workers to be Hepatitis Coordinators, leveraging the government’s social service network, registration system, and our patient registry to find the missing people needing testing and treatment.
- Trained 83 healthcare workers on ultrasound and FibroScan techniques, advanced laboratory techniques, and liver disease prevention, diagnosis, and treatment.
Testing results have shown 11.9% were positive for HBV, still among the highest rates in the world. 5.1% were positive for HCV, a dramatic reduction from our early community testing in 2015 at 11.03%. 64% of 92 random HBsAg-positive samples in 2022 had positive HDV antibodies, among the highest rates in the world.
