World Hepatitis Day: Towards Transitional Health Justice

Executive Summary:

World Hepatitis Day (July 28) represents a strategic opportunity for Syrian civil society to leverage a chronic health issue as a gateway to reshaping the relationship between citizens and the collapsed health system after the liberation phase.

The paper presents a policy approach based on the principles of transitional health justice and the right to health. It calls for institutionalizing this occasion within institutional recovery plans and local governance, given the absence of a central authority and the continued disintegration of the health infrastructure.

Theoretical and Methodological Framework: .1
The paper relies on a synthetic analytical approach based on:

• Principles of international human rights law, particularly Article 12 of the International Covenant on Economic, Social and Cultural Rights.
• Concepts of health equity in post-conflict situations, as defined by the World Health Organization and Médecins du Monde.
• A review of the literature on community governance and health accountability in areas outside state control. A multi-level political-health approach was adopted, linking the individual right to access health services with the collective role of civil society in building institutional legitimacy for health, and reshaping the health landscape in Syria after the fall of the regime.

2. The Syrian Context After Liberation: A Dual Health and Structural Crisis
   Since December 2024, Syria has entered a decentralized transitional phase characterized by a multiplicity of local actors, the collapse of more than 70% of the health infrastructure, the absence of unified legislation, and diminishing community trust in existing health institutions.
   Hepatitis C poses a particular challenge, given:

• Lack of early diagnosis and screening (less than 20% of infected people are detected).
• Low vaccination coverage, particularly against hepatitis B among children.
• The prevalence of social stigma associated with the disease, particularly in rural areas.
• Ongoing international sanctions and their impact on the supply of medicines and diagnostic technologies.

3. World Hepatitis Day as an Introduction to Community Health Governance:
   The importance of World Hepatitis Day emerges as a symbolic and practical community mechanism that allows for the following:

• Consolidating health awareness based on rights, not charity.
• Rebuilding trust between citizens and health practitioners through tangible services.
• Empowering civil society to play a monitoring and policy role in the health sector.
• Strengthening partnerships with international bodies through a clear and seasonal entry point.

4. Health Response Gaps and Policy Opportunities:
   4.1 Key Gaps:

• Lack of national mechanisms for documenting infections and the epidemiological impact.
• Lack of local policies for early screening and vaccination.
• Weak coordination between local actors and international institutions.
• Limited use of digital tools for awareness-raising and documentation.

4.2 Opportunities for Policy Development After Liberation:

• There is a growing societal desire to reshape the service system based on rights and accountability.
• Civil society has become an alternative institutional actor in areas outside state control.
• A number of international organizations are prepared to reposition themselves in Syria through community health programs.

5. Policy proposals for the celebration:
   

5.1 Transitional health governance:

• Designate July 28 as an informal national celebration managed by civil society, with international institutional support.
• Draft an “ethical code for the right to health” to be adhered to by local actors in awareness-raising and screening programs.

5.2 Community empowerment through local tools.

• Organize recurring community awareness campaigns, tailored to cultural and regional contexts.
• Establish mobile health teams to provide screening and vaccination services in remote areas.
• Train local staff on international health protocols for managing hepatitis.

5.3 Partnerships with international organizations:

• Sign health cooperation agreements with organizations such as Médecins Sans Frontières and Médecins du Monde to provide screening and treatment kits.
• Include the occasion in health response reports of the United Nations and human rights organizations.

6. Proposed Model: “Liver Justice”:
   The paper proposes launching a pilot initiative titled “Liver Justice,” which aims to:

• Provide screening and vaccination services to 5,000 citizens in the first year.
• Train 100 community health volunteers on awareness and monitoring tools.
• Produce an annual report including interactive maps of disease prevalence and response efforts.
• Build alliances with at least seven international health organizations to ensure funding and sustainability.

7. Challenges and Ways to Overcome Them:

• Local Politicization: The paper recommends developing an administratively independent model, overseen by an independent health committee.
• Funding: A blended funding policy is proposed, combining community donations and international grants.
• Weak Legal Infrastructure: The paper recommends launching a participatory process to draft new health legislation that includes the right to free screening and vaccination.

Conclusion:

World Hepatitis Day represents a rare opportunity to rebuild the relationship between citizens and the right to health, moving away from previous authoritarian frameworks and in line with Syria’s political transformations during the transitional justice phase. Civil society can transcend its service role to become an institutional partner in re-establishing health governance based on rights, accountability, and participation.

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