Global targets for reducing deaths from viral hepatitis will
not be met without massively accelerating universal access to testing and
treatment, the World Health Organization said yesterday in a review of progress
towards elimination of hepatitis B and C.
provides a snapshot of recent statistics on viral hepatitis testing and
treatment, as well as recommendations for actions to accelerate progress
towards elimination of viral hepatitis.
Around 1.1 million people died from viral hepatitis, 1.5
million people were newly infected with hepatitis C and 1.5 million people were
newly infected with hepatitis B in 2019, the World Health Organization has estimated.
The report reveals that rates of viral hepatitis diagnosis
remain low in all regions of the world. Two percent of people with hepatitis B
in Africa and 2% of people with hepatitis B in the South-East Asia region have
been diagnosed, compared with 18% in the Americas and Western Pacific regions.
Although hepatitis C diagnosis rates are higher in some regions
– 22% in the Americas, 24% in the European region and 37% in the Eastern Mediterranean
region – WHO estimated that only 21% of people with hepatitis C knew their
hepatitis C status at the end of 2019.
WHO estimates that 9.4 million people had received treatment for
chronic hepatitis C virus infection by the end of 2019, a more than nine fold
increase since 2015.
WHO estimates that $6 billion a year needs to be spent on
the global viral hepatitis response each year to achieve the elimination
targets by 2030. Innovations in point-of-care testing are also needed to
improve access to testing and to simplify linkage to care.
Lack of finance for viral hepatitis testing and treatment
remains a major challenge for many countries but WHO points to successes in the
development of national strategies for hepatitis elimination in Asia and the
Eastern Mediterranean region, as well as the inclusion of hepatitis B treatment
in China’s national insurance scheme.
The report emphasises the value of integrating services for
diagnosis and treatment of viral hepatitis, HIV and sexually transmitted
infections. Integrating diagnostic capacity through use of integrated diagnostic platforms such as GeneXpert and achieving triple elimination of mother-to-child
transmission of HIV, hepatitis B and syphilis by using common service delivery
platforms are two examples of ways in which programmes can work more closely to
achieve elimination targets.
Achieving universal health coverage will be critical for
elimination efforts, especially for key populations such as people who inject
drugs who may lack access to healthcare. Advocacy for domestic investment in
viral hepatitis elimination is also a key action, WHO says, but it acknowledges
that for many middle-income countries that cannot access generics, the high
cost of direct-acting antivirals remains a barrier to scaling up treatment.
Improved data collection will be key to achieve elimination
of viral hepatitis. More complete reporting will allow better monitoring of
progress. Although reporting on viral hepatitis is improving, it lags behind
HIV in most countries and policy-makers and advocates lack information on
under-served populations and gaps in national responses.
“The accountability report would have looked very different
a year ago, before COVID-19”, said Dr Meg Doherty, Director of WHO’s Department
of Global HIV, Hepatitis and STI Programmes.
“Our progress to date demonstrates that we have the
interventions and approaches to make a great impact and build back stronger
against COVID-19, HIV, viral hepatitis, and STIs. The report is a call to
action – we have 9 years to reach our SDG targets – we need all stakeholders to
accelerate action across the three diseases to achieve our ambitious yet
achievable goals by 2030.’’
Note: this report has been updated to correct statistics on diagnosis and treatment coverage.