Speaker Pelosi Says Hepatitis B Prevention at Core of Healthcare Reform

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SAN FRANCISCO – In her first public appearance since the health care reform bill rollout last Thursday, House Speaker Nancy Pelosi addressed the need for community-based health care reform in a press conference at the Chinese Hospital on Oct. 31, highlighting the San Francisco Hep B Free campaign as a model for the nation.

With one in ten Asian American Pacific Islanders (AAPIs) chronically infected with the hepatitis B virus, Hep B Free is a citywide campaign to turn San Francisco into the nation’s first city free of the disease.

Joined by local, state and federal officials, community and health care leaders, citizen activists, corporate executives and family associations, Pelosi lauded the Hep B Free campaign’s success as an inspiration and blueprint for the national campaign.

“It certainly would not be possible without the local leadership as models for us in San Francisco,” Pelosi said. “The campaign has led thousands of individuals to get screened and treated.”

Hepatitis B is responsible for up to 80 percent of all liver cancers worldwide, and AAPIs have the highest rates of liver cancer for any racial or ethnic group.

“The Hep B campaign hits the core of our national drive for health insurance,” Pelosi said. “The hepatitis B virus is preventable and treatable. Yet too many in the AAPI community across the nation suffer from this disease. We must protect everyone from hepatitis B.”

Pelosi underscored the need for culturally sensitive health care that ends discrimination against individuals with pre-existing conditions, such as hepatitis B. The end of this type of discrimination is one of the proposed bill’s three main principles, along with affordable health care and fiscal responsibility.

Assemblywoman Fiona Ma has chronic hepatitis B infection and is a leading advocate for legislation to reduce the disease.

“Hepatitis B is a pre-existing condition,” Ma said. “We desperately need policy reform to make sure nobody gets kicked off health insurance for pre-existing conditions.”

Congresswoman Jackie Speier (D-CA) echoed Pelosi’s sentiment regarding health care discrimination at the press conference.

“It is very appropriate that we send a message to everyone in the city that you have nothing to fear about hepatitis B,” Speier said. “Pre-existing conditions will no longer be a fear for anyone, whether they have hepatitis B, HIV, cancer, or bunions – you name it.”

Additionally, Pelosi discussed how the proposed reforms will remove health disparities among ethnic communities, such as hepatitis B, the greatest health disparity for Asians.

“With reform in place when we pass this legislation, the AAPI community will have access to treatments, the vaccine, screening and care that will help end those disparities, keep families healthy, and ensure our success in fighting hepatitis B and making San Francisco a hepatitis B-free city.”

The spotlight on health disparities affecting ethnic communities, such as hepatitis B for Asian Americans, is part of a growing national awareness from health care reform to the White House.

On Oct. 14, President Obama re-established the advisory commission and White House initiative created by President Clinton ten years ago to address concerns affecting AAPIs. While acknowledging the many contributions of AAPI communities to the country, Obama recognized the challenges faced by AAPIs in health disparities like hepatitis B.

“The more than 16 million AAPIs across our country have helped build a strong and vibrant America,” Obama said. “It’s tempting, given the strengths of AAPI communities, for us to buy into the myth of the ‘model minority,’ and to overlook the very real challenges that certain AAPI communities are facing: from health disparities like higher rates of diabetes and hepatitis B.”

Under the House Democrats’ proposed health care legislation, the government will give new grants for prevention and wellness services to communities with special emphasis on health disparities, expand coverage for vaccines, and eliminate co-payments and deductibles for preventive services such as the hepatitis B vaccine.

“We will have an opportunity in San Francisco and across the country to change our health insurance system for the better, whether it’s making this city as a hepatitis B-free city or expanding access to quality, affordable, accessible health care for all Americans,” Pelosi said.

Dr. Garth Graham, deputy assistant secretary for minority health for the Department of Health and Human Services, said the department supported a national strategy aiming to address the issues of prevention of new infections by promoting screening, immunization, education; promotion of early detection; appropriate follow-up and clinical management of individuals with chronic hepatitis B infection with linguistically and culturally appropriate prevention care and treatment; and increased awareness and support of hepatitis B and liver cancer research among national and state policymakers.

“We recognize chronic hepatitis B’s disproportionate impact on the AAPI community is a national problem,” Graham said.

Since the San Francisco Hep B Free Campaign’s inception in 2007, the campaign has developed significant partnerships with over 50 public and private health care organizations, businesses, and educational institutions, as well as Major League Baseball’s San Francisco Giants. It has created seven low-cost public access hepatitis B screening and vaccination sites.

“Our goal is to try to get everyone screened and tested in San Francisco,” Ma said. “We wanted to spread the message we can eradicate hepatitis B, just like smallpox. But we had no money when we started, just a goal. Now two and a half years later, all our community partners, public and private hospitals, doctors, insurance and pharmaceutical companies, non-profit organizations and the community have gotten together to ensure that everyone can get screened, tested and treated here in San Francisco.”

The campaign’s success has inspired other communities to follow its model.

“It is a model that is being replicated in San Mateo, San Jose, Orange County and Los Angeles,” Ma said. “We believe that we are on the way to a movement.”

Graham lauded the campaign’s use of community partnerships, academia, community-based organizations and local government to increase education and awareness and recommended adoption of its model as part of a national strategy.

“The San Francisco Hep B Free Campaign is an excellent demonstration of what the Department of Health and Human Services is trying to see happen across the country,” Graham said. “We want to broaden this model, use it as a model of community engagement and go across the country in terms of national strategy.”

Pelosi added that it was no surprise the Centers for Disease Control and Prevention would look to San Francisco for leadership and to take its success as a blueprint for the national campaign.

Officials and leaders urged the public to get tested, treated and vaccinated for hepatitis B at the press conference.

“We are so fortunate in spite of the extraordinary infection rates that there is a hepatitis B vaccine that the World Health Organization has called the world’s first anti-cancer vaccine,” said Senator Mark Leno.

“It is treatable, it is preventable, we can eradicate it,” Ma said. “We just need everybody’s help.”

David Chiu, San Francisco Board of Supervisors President, voiced the hope that the day will soon come when San Francisco will be a hepatitis B-free city.

“We are all here today united in the Hep B Free Campaign,” Chiu said. “Chinatown in San Francisco is the Asian American capital of not just our city, not just California, but the entire country. Half of the deaths that arise from hepatitis B come from our community. This is our disease, this is our campaign, and this is our cause.”

Pelosi urged everyone to “take the (Hep B Free) campaign theme to heart: B a Hero. See a doctor who tests for Hepatitis B.”

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About San Francisco Hep B Free Campaign:
The San Francisco Hep B Free Campaign is a “first-in-the-nation” effort calling on the collaboration of a wide spectrum of organizations to educate the public about the health risks of the hepatitis B virus (HBV) and to promote routine HBV screenings and vaccinations for the city’s Asian and Pacific Islander (API) population. For more information, please visit www.sfhepbfree.org.

About the Hepatitis B Virus (HBV):
Hepatitis B is a serious disease of the liver caused by the hepatitis B virus (HBV) that can lead to acute illness and chronic infection including cirrhosis, liver failure or liver cancer. It is a silent killer affecting approximately 1.4 million Americans, of which more than half are of API descent.

HBV is an epidemic within San Francisco’s API community. An estimated one in ten APIs have an undiagnosed infection. APIs are up to 100 times more likely to suffer from chronic HBV infection and four times more likely to die from liver cancer compared with the general population. Hepatitis B is responsible for 80 percent of all liver cancers among APIs, who have the highest rates of liver cancer for any racial or ethnic group. San Francisco’s liver cancer rate is the highest in the U.S.

Hepatitis B is 100 times more infectious than HIV and is easily transmitted – from an infected mother to her child at birth, through unprotected sex or by contaminated blood.

For more information, please visit www.sfhepbfree.org.

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