By IDSE News Staff
The number of lives lost due to viral hepatitis is increasing, making it the second leading infectious cause of death globally—with 1.3 million deaths per year, according to a new report by the World Health Organization.
Despite better and less expensive tools for diagnosis and treatment, treatment coverage rates have stalled, according to the 2024 Global Hepatitis Report, released at the World Hepatitis Summit 2024, in Lisbon, Portugal.
But reaching the WHO elimination goal by 2030 could still be done if countries act now, the WHO said.
New data from 187 countries show that the estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, 83% were caused by hepatitis B virus (HBV) and 17% by hepatitis C virus (HCV). Every day, 3,500 people are dying globally due to HBV and HCV infections.
Updated WHO estimates indicate that 254 million people were living with HBV and 50 million HCV in 2022. Half the burden of chronic HBV and HCV infections is among people 30 to 54 years of age, with 12% among children under 18 years of age. Men account for 58% of all cases.
New incidence estimates indicate a slight decrease compared with 2019, but the overall incidence of viral hepatitis remains high. In 2022, there were 2.2 million new infections, down from 2.5 million in 2019.
These include 1.2 million new HBV infections and nearly 1 million new HCV infections. More than 6,000 people are getting newly infected with viral hepatitis each day.
The revised estimates are derived from enhanced data from national prevalence surveys. They also indicate that prevention measures such as immunization and safe injections, along with the expansion of HCV treatment, have contributed to reducing the incidence.
“This report paints a troubling picture: Despite progress globally in preventing hepatitis infections, deaths are rising because far too few people with hepatitis are being diagnosed and treated,” said WHO Director-General Tedros Adhanom Ghebreyesus, MSc, PhD. “WHO is committed to supporting countries to use all the tools at their disposal—at access prices—to save lives and turn this trend around.”
Global Progress and Gaps
Across all regions, only 13% of people living with chronic HBV infection had been diagnosed, and approximately 3% (7 million) had received antiviral therapy at the end of 2022. Regarding HCV, 36% had been diagnosed and 20% (12.5 million) had received curative treatment.
These results fall well below the global targets to treat 80% of people living with chronic HBV and HCV by 2030. However, they indicate slight but consistent improvement in diagnosis and treatment coverage since the last reported estimates in 2019. Specifically, HBV diagnoses increased from 10% to 13% and treatment from 2% to 3%, and HCV diagnoses from 21% to 36% and treatment from 13% to 20%.
The burden of viral hepatitis varies regionally. Africa bears 63% of new HBV infections, yet despite this burden, only 18% of newborns in the region receive the hepatitis B birth-dose vaccination.
In the Western Pacific Region, which accounts for 47% of HBV deaths, treatment coverage stands at 23% among people diagnosed, which is far too low to reduce mortality.
Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation and Vietnam collectively shoulder nearly two-thirds of the global burden of HBV and HCV. Achieving universal access to prevention, diagnosis and treatment in these 10 countries by 2025, alongside intensified efforts in Africa, is essential to get the global response back on track to meet the Sustainable Development Goals.
Disparities
Despite the availability of affordable generic viral hepatitis medicines, many countries fail to procure them at these lower prices. Pricing disparities persist both across and within WHO regions, with many countries paying above global benchmarks, even for off-patent drugs or when included in voluntary licensing agreements. For example, although tenofovir for treatment of HBV is off patent and available at a global benchmark price of $2.4 per month, only seven of the 26 reporting countries paid prices at or below the benchmark.
Similarly, a 12-week course of pangenotypic sofosbuvir-daclatasvir (Darvoni, Sovodak) to treat HCV is available at a global benchmark price of $60, yet only four of 24 reporting countries paid prices at or below the benchmark.
Service delivery remains centralized and vertical, and many affected populations still face out-of-pocket expenses for viral hepatitis services.
Only 60% of reporting countries offer viral hepatitis testing and treatment services free of charge, either entirely or partially, in the public sector. Financial protection is lower in the African Region, where only about one-third of reporting countries provide these services free of charge.
The report outlines a series of actions to advance a public health approach to viral hepatitis, designed to accelerate progress toward ending the epidemic by 2030. They include:
- expanding access to testing and diagnostics;
- shifting from policies to implementation for equitable treatment;
- strengthening primary care prevention efforts;
- simplifying service delivery, optimizing product regulation and supply;
- developing investment cases in priority countries;
- mobilizing innovative financing;
- using improved data for action; and
- engaging affected communities and civil society and advancing research for improved diagnostics and potential cures for HBV.
Funding for viral hepatitis at the global level or within dedicated country health budgets is not sufficient to meet the needs. This arises from a combination of factors, including limited awareness of cost-saving interventions and tools, as well as competing priorities in global health agendas. This report seeks to shed light on strategies for countries to address these inequities and access the tools at the most affordable prices available.
