May is National Hepatitis B Awareness Month! In the spirit of hep B awareness, this blog entry will focus on hepatitis B and the role of marketing, particularly in China. After working at the Asian Liver Center (a nonprofit that addresses the high incidence of hep B in the Asian Pacific Islander population) for two years, I am now always alert to anything hep B-related, and I noticed the significant shortage of hepatitis B marketing when I went to China fall quarter. I’m not the only one who’s noticed. When the founder of the Asian Liver Center went to China a couple years ago, he was disappointed to find that there were no advertisements, billboards, or public service announcements to be found on the topic of hepatitis B. HIV/AIDS, SARS, and avian bird flu posters, on the other hand, were remarkably visible.
In addition to the coverage that is lacking in physical spaces (airports, streets, subways, etc)there is also little news reporting on the subject of hepatitis B. After a quick search of ‘hepatitis B’ on the major online Chinese newspapers that are in English, I found that the number of results that came up were far fewer than other diseases. On the China Daily website, ‘hepatitis B’ returned 465 results in which the term was mentioned. ‘HIV/AIDS’ returned 2322 documents, ‘SARS’ returned 8043 documents, and ‘bird flu’ returned 3701. Similarly, the People’s Daily English website had 1911 documents for ‘HIV/AIDS’, 415 documents for ‘SARS’, and 3016 documents for ‘bird flu.’. Granted, HIV/AIDS, SARS, etc are all serious public health crises that warrant public attention. However, my experience thus far has definitely made me feel that there is a much heavier emphasis on HIV/AIDS than on hepatitis B despite the fact that more people in China are affected by the latter in China.
Television programming plays another important role for public health advocates. Television ads addressing the public about a public health crisis is very popular nowadays, and celebrity endorsement of the cause is also commonly used. A few years back, the United Nations Development Program and the Beijing-based Epin Media company created a program to increase awareness about HIV/AIDS and fight discrimination against HIV carriers and AIDS patients. The public service announcement included Yao Ming and Magic Johnson, “calling on the public not to fear or discriminate against those with HIV/AIDS.” It was aired in Beijing’s buses, taxis, and local TV channels. A search for similar TV ads related to hepatitis B did not return any results, and according to the ALC, there are currently no hepatitis B public service announcements running in China. In the analysis of hepatitis B and Chinese media, the absence of media products speaks just as loudly of the level of public awareness and the country’s attitude toward the issue.
In order to understand why hepatitis B should be prioritized higher in China, we must look at the severity of the disease’s effects on the population. As of 2002, about 170 million Chinese are infected with the hepatitis B virus, which makes up 13% of the entire Chinese population. The hepatitis B virus (HBV) can cause liver damage, liver cirrhosis, and liver cancer. Liver cancer in association with the high HBV infection rate ranks second among the total cancer mortality in China, and about half a million mainland Chinese die each year from HBV related illnesses. In comparison, HIV affects .05% of the Chinese population with 650,000 people living with the virus. A hot topic in past years, avian bird flu, has had significant media coverage in China and the United States. China has had a total of 30 cases of avian bird flu, and 20 deaths. Given the above media coverage analysis, these numbers point to a significant problem in the public health of China today. Hepatitis B, as a major contributor to cancer deaths, is being neglected in the media, thus contributing to the problem of public ignorance of the disease. This ignorance creates significant challenges for hepatitis B patients, who are often discriminated in employment and education.
Though hepatitis B awareness has nowhere near reached the same celebrity status, it has a lot to learn and a lot to gain from the precedents set by the HIV/AIDS movement. Many of the tactics that the HIV/AIDS movement used were very successful, including their use of big name endorsement and corporate support. The universality of the disease became the resounding message. Anybody could be affected, so everybody is responsible. Hepatitis B in China definitely carries the same notion- anybody and everybody is at risk, so a collective effort should be made to fight the disease. What has supported that statement is the emergence of celebrities who have come forward to acknowledge their hepatitis B status. Television actor Cheng Lei discovered eight years ago that he was positive for the virus and has since then worked to lessen discrimination linked to hepatitis B. Celebrity endorsement is one step in bringing positive popular attention to the disease. The more attention there is, the more the media will respond to stories related to hepatitis B, and the more the government will take notice and actively combat the problem. The HIV/AIDS movement has opened a lot of doors for other public health campaigns in China. Just ten years ago, all condom advertisements were banned from television programming, but condom ads aimed at AIDS-prevention are now allowed. There is now a much more open attitude towards discussing infectious diseases than there was before, so the hepatitis B campaigns are well-situated to make a big impact through the media. Let’s hope China and other relevant countries take advantage of this opportunity to positively change the course of hepatitis B.
In other news, LIVERight 5k run/walk is this Saturday, May 2. Hosted, by the Asian Liver Center, LIVERight is the first event of its kind in the US that celebrates the fight against hepatitis B and liver cancer! Find out more at http://liver.stanford.edu.
Resources:
Asian Liver Center at Stanford University: http://liver.stanford.edu
Sun, Zongtang, et al. “Prevention and Control of Hepatitis B in China.” Journal of Medical Virology 67 (2002): 447-50.
UNAIDS, and WHO. “New HIV data show growing AIDS epidemic in China.” WHO Media Centre. 25 Jan. 2006. World Health Organization. 3 Dec. 2008 <http://www.who.int/mediacentre/news/releases/2006/china_hiv_aids/en/>.
”
Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO.” WHO Media Centre. 10 Sept. 2008. World Health Organization. 3 Dec. 2008 <http:// www.who.int/csr/disease/avian_influenza/country/cases_table_2008_09_10/en/index.html>
I didn’t realize the severity of the epidemic in China–affecting 13% of the population! it is surprising that it receives less attention. I wonder if the adds about HIV, SARS and the avian flu are funded by local or international groups. If international, then it may be that the international community perceive the other diseases as greater threats. I also found your post very relevant to today and the power of media to affect public health responses. As we can see from the swine flu, significant media attention can lead to quick and decisive action on media outbreaks, including dispersing Tamiflu, closing schools etc. Similarly, in Uganda, progressive actions taken by the government to educate citizens about HIV and promote condom use lowered rates of HIV infection greatly as compared to the increase in HIV infection after the government, and hence the media, did not provide correct information to the public about how to protect oneself. I hope the government and/or public health organizations will take more action on raising awareness about Hep B soon!
I agree that Hepatitis B deserves more media attention- not only in China, but everywhere else as well. I think it is ironic that diseases such as SARS and the Swine Flu can receive so much global attention within a relatively short amount of time while other diseases that are consistently affecting more people are not. Yes, SARS and the Swine Flu are serious matters, but there are other diseases that deserve more attention. The media does such an affective job of hyping certain diseases up that it draws attention away from other illnesses.