World Hepatitis Day 2019

Top 10 messages for policymakers

1. Viral hepatitis B and C is a leading infectious killer, yet the majority of global leaders and the public remain unaware. Viral hepatitis B and C affect 325 million people worldwide, leading to about 1.4 million deaths a year. It is the second major killer infectious disease after tuberculosis, and 9 times more people are infected with hepatitis than HIV. Deaths from hepatitis have been increasing over the past 2 decades, which points to a lack of global awareness and action, including among top decision-makers.

2.  Despite this situation, much can be done: hepatitis can be prevented, diagnosed, treated and managed well. The hepatitis B vaccine is 98-100% effective in preventing new infections. For hepatitis B, people should be tested and if found positive and eligible, provided with lifelong treatment. For hepatitis C, people can be cured with a simple 2-3 month treatment with direct acting antiviral (DAA) drug.

3. However, most of the people living with hepatitis - over 80% - lack access to testing or treatment.  Among people living with hepatitis B, only 10% (27 million) knew their infection status in 2016. Of these diagnosed people, only 17% (4.5 million) received treatment. Among people living with hepatitis C, 19% (13.1 million) knew their infection status in 2017, of which 15% (2 million) received cure in that same year. Overall, between 2014 and 2017, 5 million people have received hepatitis C cure worldwide.

4.  At the same time, people are becoming newly infected due to a lack of prevention services. In 2017, 1.1 million people were newly infected and developed chronic hepatitis B infection and 1.75 million people developed chronic hepatitis C infection. Together, hepatitis B and C account for the highest number of new infections from among other major infectious diseases such as HIV and tuberculosis. Improved harm reduction, blood and infection control services and hepatitis B vaccination efforts are urgently needed.

5. Achieving hepatitis elimination by 2030 will require a major increase in funding for hepatitis prevention, testing and treatment services as part of achieving universal health coverage (UHC). A new WHO costing analysis underlines that an additional funding of US$ 6 billion per year will be needed in low- and middle-income countries (LMIC) between 2016 and 2030, in order to achieve hepatitis elimination targets. The analysis is aligned with WHO’s SDG Health Price Tag from 2017. Only US$ 0.5 billion were invested in 2016, and this sum primarily consisted of domestic financing.

6. Countries need to ensure that national hepatitis testing and treatment plans include dedicated funding and investments. As of April 2019, 124 countries have developed, or were developing, national hepatitis plans and strategies. But many of these plans lack funding. In 2017, only 58% of the 82 reported LMIC had included domestic funding in their national hepatitis plans. Greater progress is possible when countries invest in hepatitis testing and treatment services.

7. Countries should seek most optimal prices for medicines and diagnostics. WHO’s new analysis shows that hepatitis testing and treatment are high-impact interventions that can help countries accelerate progress towards UHC. But prices for medicines and tests are very uneven and they can be very expensive in some countries. For example, hepatitis C medicines can cost as high as US$120 000 in some high-income countries. But in Pakistan the same curative treatment can be obtained at US$20. Countries and partners need to work together to achieve the most optimal prices for hepatitis drugs and diagnostics to make access possible for more people. 

8. Investing in hepatitis is a smart decision for broader health outcomes. Investments in hepatitis elimination would lead to a 1.5% increase in the global health price tag, but such investments would bring greater returns on better general health outcomes. Funding hepatitis testing and treatment services as part of UHC efforts can cut global deaths by 5% and increase healthy life years by about 10% by 2030.

9.   Investing in hepatitis testing and treatment means preventing liver cancer. Chronic infections of hepatitis B and C viruses may not show symptoms for a long period, sometimes years or decades. They slowly and silently damage the liver, eventually causing cancer. Over 60% of liver cancer cases are due to late testing and treatment of viral hepatitis B and C infections. Two thirds of these cancer cases are caused by hepatitis B, and one third by hepatitis C.

10. On World Hepatitis Day 2019, join the cause to help 325 million people. Stop ignorance and neglect of viral hepatitis – share information about it. Educate yourself and others to learn risks for viral hepatitis, and access testing services. If you have been diagnosed with hepatitis B or C, speak with health workers about potential treatment, monitoring or curative therapy. If detected early, the risk of chronic illnesses and financial burden for you and your family can be averted. Take action today.

WHO hepatitis guidelines and reports