WHO says 2030 hepatitis elimination targets will not be met without massive scale-up of testing and treatment

21 May 2021 Keith Alcorn
Originally published on www.infohep.org

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.

The report 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.