June 2025 Update

From 23 June to 9 July 2025, Hepatitis B Free (HBF) conducted its third trip to South Tarawa and second trip to the outer island of Kiritimati for the year. Supported by DFAT, HBF continues to assist in strengthening the Ministry of Health and Medical Services national hepatitis program by providing clinical support, staff training, stakeholder engagement and community advocacy initiatives. The team, led by Prof. Alice Lee, Prof. David Hilmers, Co-Founder Sue Huntley, and Dr Carrie Lee were joined by an equally dedicated team from ANZGITA consisting of Dr. Mark Cornwall and RN Merrilee Williams. Central to these scheduled field visits are patient assessment (with provision of elastography and specialist care), distribution of educational materials, advancement of policy-level discussions regarding triple elimination (hepatitis B, HIV and syphilis) care pathways for antenatal mothers in the country, as well as key stakeholder updates on progress to MHMS, DFAT, WHO and colleagues at UNICEF and the Pearl Plus program. In Kiritimati island, where clinical services and infrastructure are limited, a contingent of Sue Huntley and Dr Thomas Russell spent a week and were complemented by the local Program Coordinator, Ms. Mwaari and local primary care clinic nurses in conducting hepatitis clinics at all six village clinics at London, Tabwakea, Banana, Padua, and Poland. In-clinic training and volunteer-driven home visit activities were delivered and promoted in an effort to empower local healthcare workers as they bolster their skills, knowledge and confidence to manage cases and support patients. 

Overall, the trip saw over 200 hepatitis patients reviewed and over 150 elastrographies performed. Progress was made with the drafting of what would be the first national policy on Triple elimination of mother to child transmission (EMTCT) with intentions to finalise and align a contextualised implementation of the recently released 2024-2030 Regional Roadmap for Triple EMTCT by WHO. The program in Kiribati, despite significant limitations in key areas such as human resourcing and funding, continues to make headway against the odds. Recent recruitment of a community health outreach worker (CHOW) for the program - a first of its kind for a MHMS health program - will assist in key areas such as linkage to care of patients, data collection and recording, update of the program's Tamanu electronic medical records, and patient outreach. With multiple programmatic activities in action to address hepatitis in Kiribati, the nation is somewhat of a bellwether on many fronts for the Pacific region. This has enabled HBF to provide guidance, explore support and advocate for the program through research over the years. In 2025, several publications were made as well as an upcoming presentation at a global conference. Moving forward, HBF will continue to support the program in Kiribati, particularly in the following priority areas; prevention (involving antenatal mothers and vaccine supply), enhanced collaboration/linkage with Pearl Plus, patient adherence, staff training on cirrhosis management, support of co-infected patients (HBV + delta, HBV + tuberculosis), public advocacy campaigns, improving program data monitoring, and addressing non-communicable disease and climate change impacts. The team is scheduled for its fourth trip to South Tarawa along with two other outer islands (North Tarawa & Abaiang) in late October 2025.