Global hepatitis response gains ground – More action needed to achieve universal health coverage targets
11 April 2019, VIENNA – The World Health Organization (WHO) reports that more people are receiving life-saving services for viral hepatitis; however, a more ambitious global investment is needed to attain the elimination targets by 2030. The report is being presented at the largest conference of global hepatitis specialists: the International Liver Congress 2019. The conference is organized by the European Association for the Study of the Liver (EASL) and is taking place in Vienna, Austria on 10–14 April.
While the global hepatitis response is gaining ground – with more countries reporting progress on increasing prevention, testing, treatment and care services – it is also facing complex challenges, such as shortages in funding.
We have seen good news on the prevention front, with the proportion of children under 5 years with hepatitis B infection declining from 1.3% in 2015 to 0.8% in 2017.
And more lives are being saved through hepatitis C cure, with 5 million people treated with direct-acting antivirals (DAAs) by the end of 2017, according to data compiled by WHO and the Center for Disease Analysis.
Globally, price barriers for DAAs have reduced dramatically. Developing countries can now procure pangenotypic hepatitis C curative therapy for as little as US$ 89 through the United Nations Development Programme. Developing countries are home to 62% of all people living with hepatitis C.
Uptake of hepatitis B treatment has also been increasing, reaching 4.5 million people by the end of 2016. Innovations such as the new global scientific strategy to cure hepatitis B – launched by ICE-HBV (International Coalition to Eliminate Hepatitis B) at the International Liver Conference – provide renewed hope and commitment in accelerating global progress towards the elimination targets.
An increasing number of countries are taking action to address hepatitis. Of the 194 countries that signed the elimination strategy, 124 have developed or are in the process of developing national hepatitis plans, as of February 2019.
A persistent challenge in the global hepatitis response is the lack of focus on harm reduction and prevention services for people who inject drugs. This population group accounts for the highest number of new infections – 23%.
This is also the area where we have seen the least progress – only half of countries report some syringe distribution or 1 or more clinics providing opioid substitution therapy. At the end of 2017, 33 safe syringe needle sets were attributed per person who inject drugs per year – only 1 tenth of the global target of 300.
Despite efforts, most people living with viral hepatitis lack access to hepatitis testing, treatment and care. Funding remains a key barrier. Only 58% of countries included domestic funding for hepatitis scale-up.
WHO data show that if hepatitis elimination was added to WHO’s ambitious universal health coverage plan, the global health price tag would increase by 1.5%. The return on this investment, however, would be far greater, including a reduction of about 5% in deaths and an increase of about 10% in healthy life years by 2030.
At the International Liver Congress 2019, WHO and EASL will hold two joint symposia events. The first symposium on “Promoting access to DAAs for children, adolescents and experience of use in pregnant women” will take place at 11:00–12:30 on Friday, 12 April. The second symposium on “Best practices and lessons learned from global viral hepatitis scale-up” will take place at 14:00–16:00 on Saturday, 13 April.