A $378,000, two-year grant from the Bristol-Myers Squibb Foundation to the China Foundation for Hepatitis Prevention and Control will seek to reach nearly 500 schools, more than 125,000 primary school students and over 6,000 teachers in this hard hit region in Western China. In addition schools in Beijing will also be targeted - both as a control and as a learning site to help inform public policy and help spur nationwide awareness efforts.

The project will aim at reaching parents and communities through heightening HBV awareness and prevention in schools, while also developing and testing related health education materials. Teachers will be trained, and a variety of educational channels (from posters to cartoons to songs) will be developed and tested in the schools.

Q&A with China Foundation for Hepatitis Prevention and Control (CFHPC) Secretary General

Interview with Kitty Xia, executive deputy secretary general,
Shanghai Charity Foundation >>

To provide a vehicle for the Bristol-Myers Squibb Foundation to make contributions that aid non-profit organizations in India that provide information and training about hepatitis B, the Foundation will contribute to a new donor-advised fund established by the Catholic Medical Mission Board (CMMB) to address hepatitis B in India. The CMMB is an independent, non-profit organization that is focused exclusively on international health care aimed at building the capacity of local communities and institutions to provide long-term sustainable healthcare.

A $139,000, one-year Bristol-Myers Squibb Foundation grant will support a demonstration project to counsel blood donors in Bombay who currently may test positive for hepatitis B or C, but do not currently receive treatment or counseling as a result.

Routine testing at blood banks and community blood donation drives often identify samples that test positive for hepatitis B and C. And while those donations are discarded and therefore do not enter the blood supply, donors of infected samples are not told about their status and therefore receive no counseling or treatment. In effect, such actions mitigate the possibilities for early detection, proper management and prevention.

The grant will be used to develop a demonstration project that will create counseling protocols and a referral system into care for these infected donors.

In addition to improving awareness about hepatitis B and C among the 200,000 blood donors in Bombay, the project will seek to train medical social workers and physicians at blood banks on counseling donors about hepatitis B and C even before they donate blood. And if a donor tests positive - the project will provide additional counseling services.

Such a model -- that would explore the logistics of confirmation, testing and counseling donors -- is expected to help inform a national policy on confirmation testing and counseling of blood donors. Initially, confirmation testing and counseling will be supported for some 4,000 hepatitis B positive donors and some 1,200 donors who test positive for hepatitis C. In addition, hepatitis B vaccinations will be offered to the family members of HBV positive donors to prevent further viral transmission.

About a third of the population of Tripura, one of seven states in Northeastern India, is composed of aboriginal groups, whose awareness of health needs is relatively low. And while the prevalence of hepatitis B in the state is estimated at 4-5 percent, in the aboriginal population it ranges from 12-15 percent. Especially at risk are newborns and children under ten, who comprise about 20 percent of those being targeted for community-based interventions by a $137,000, three-year grant to the Hepatitis Foundation of Tripura.

The project will support early detection of hepatitis B, enhance awareness of the virus among the general population, build capacity and training about the disease among local health care providers and community health volunteers and support existing immunization services while educating local communities about hepatitis B vaccinations.

In addition to developing standardized training materials for health care providers, the project will hold health camps and community outreach activities to support existing immunization programs through Tripura’s secondary schools, colleges and universities. Some 500 volunteers will be trained to support community based awareness and prevention. And existing hepatitis B clinics in local health centers will be served, while also opening four new hepatitis B clinics in underserved areas in the region.

The Bristol-Myers Squibb Foundation is funding “B-Rodh,” a program that focuses on students, their families and local health care providers in some 1,000 urban and rural schools in the state of Uttar Pradesh. The $270,000, three-year grant is for a community-based approach to influence attitudes and practices that might bring about a sustained reduction in hepatitis B prevalence rates.

About a third of Uttar Pradesh’s population lives below the poverty line while the state’s infant and maternal mortality rates are above the national average. In this difficult environment, B-Rodh will seek to target students as instruments of social change. HBV awareness will be targeted at this group, who, it is expected, will bring that awareness back home with them to their families and communities. For the first time, HBV education will be included in school curricula along with other major health issues.

This “school to community” approach will be modeled on similar programs used in HIV/AIDS awareness efforts. It will seek to change attitudes and practices related to risky behaviors that lead to increases in hepatitis B infections. What’s more, the project will evaluate differences in using awareness methods among resource limited districts in eastern Uttar Pradesh compared to more developed and affluent districts in the central and western parts of the state.

In India, local health care workers are often the most important sources for care, knowledge and awareness of a variety of health issues. However, liver disease and hepatitis B virus awareness among these workers today is suboptimal. As part of a program of bringing ”science to the society,” this effort will focus on coordinated improvements and capacity building in awareness and activities centered on liver disease and hepatitis B among health workers in West Bengal. Its goal is the creation and maintenance of a positive cultural and public health environment conducive to hepatitis B prevention activities.

This grant will focus on professional health care providers, as well as paramedics and lay community workers, to create awareness and incorporate training about HBV in activities already underway in maternal care, emergency care and childhood well being programs. The program will focus on “anganwadi,” lay community health workers already involved in child nutrition and village health projects -- training them to add hepatitis B education and awareness to existing programs. Village units will also be targeted with outreach efforts to expand community awareness through local government leaders and local educational and civic institutions, societies and clubs.

Rather than creating parallel health interventions, the grant will support efforts to integrate HBV awareness and education into existing health outreach programs in the community -- especially in training rural health care providers. In addition, it will organize HBV counseling services in West Bengali blood banks. Finally, as part of this program, a hepatitis B registry will be created to track and counsel infected individuals on an ongoing basis.

A three-year grant for $388,000 to Christian Medical College in Vellore will allow the college to link with 15 other mission hospitals across India through video-conferencing to train health care workers and expand awareness about hepatitis B (HBV) in a number of other populations, including students, teachers and the general public.

An expert in distance learning, Christian Medical College will use its tele-link capabilities experience initially to increase awareness about safe practices to prevent HBV infection among health care workers. A phased program will then focus on teachers in schools and universities as well as medical institutions. Technology and other educational tools will be used in an efficient and cost-effective manner to enhance HBV education among other populations as well.

Teaching sessions will be held at each of the 15 mission hospitals, targeting different audiences throughout the three year project. Included will be lectures provided on DVDs as well as interactive sessions via tele-links with senior doctors trained in HBV management. The aim is to develop capacity at participating mission hospitals to carry out public awareness campaigns about hepatitis B (by training personnel and providing technological support) in 15 localities across India.

Hepatitis B awareness campaigns will be carried out in schools, colleges and hospitals surrounding these 15 mission hospitals. Expansion of the hepatitis B education campaign to other schools, colleges and hospitals in each locality will be continue in the second and third year of the program. Ultimately, a comprehensive hepatitis B distance education curriculum for the different target audiences will be created for use in these sessions. In addition, the project will seek to develop sponsorships to offer subsidized immunizations against hepatitis B to cover a total of 30,000 students over the three-year period.