In May 2016, the World Health Assembly adopted the first "Global health sector strategy on viral hepatitis, 2016-2021". The strategy highlights the need for a radical change in hepatitis care from individualized specialist care to adopting a public health approach aligned to universal health coverage and the Sustainable Development Goals.
The strategy has a vision to eliminate viral hepatitis as a public health problem by 2030. This is encapsulated in the ambitious global targets to reduce new viral hepatitis infections by 90% and reduce deaths due to viral hepatitis by 65% by 2030. Actions to be taken by countries and the WHO Secretariat to reach these targets are outlined in the strategy.
To support countries in achieving the global hepatitis elimination targets under the 2030 Agenda for Sustainable Development, WHO is working to:
- raise awareness, promote partnerships and mobilize resources;
- formulate evidence-based policy and data for action;
- prevent transmission; and
- scale up screening, care and treatment services.
WHO recently published the “Progress report on HIV, viral hepatitis and sexually transmitted infections, 2019”, outlining progress towards elimination. The report sets out global statistics on viral hepatitis B and C, the rates of new infections, the prevalence of chronic infections and mortality caused by these two high-burden viruses, and coverage of key interventions, all current as at the end of 2016 and 2017.
Since 2011, together with national governments, partners and civil society, WHO has organized annual World Hepatitis Day campaigns (as one of its nine flagship annual health campaigns) to increase awareness and understanding of viral hepatitis. The date of 28 July was chosen because it is the birthday of Nobel-prize winning scientist Dr Baruch Bloomberg, who discovered the hepatitis B virus and developed a diagnostic test and vaccine for it.
For World Hepatitis Day 2019, WHO focused on the theme “Invest in eliminating hepatitis” to highlight the need for increased domestic and international funding to scale up hepatitis prevention, testing and treatment services, in order to achieve the 2030 elimination targets.
WHO hepatitis guidelines and other global goods
In March 2015, WHO launched its first "Guidelines for the prevention, care and treatment of persons living with chronic hepatitis B infection". In 2018, WHO’s updated 2018 guidelines recommended therapy with pan-genotypic direct-acting antivirals (DAAs).
Other documents include Guidelines on hepatitis B and C testing (2017) and consolidated strategic information guidelines for viral hepatitis (2019) and the online platform Global Reporting System on viral hepatitis (GRSH)
Further WHO response
In 2016, the threat of viral hepatitis led the 47-Member States of the WHO African Region to endorse the global strategy for elimination of viral hepatitis as a public health threat by 2030, setting intermediate targets for 2020.
On 14 June 2019, WHO in the African Region launched its first hepatitis scorecard to measure progress in six of the 10 regional targets. It found that 28 countries have developed national hepatitis strategic plans, 25 more than the baseline of three countries in 2015. However, the scorecard showed that most plans remain in draft form, and only three countries have secured significant domestic funding to eliminate the disease that affects one in 15 people in the Region.
The scorecard found that the highest burden of hepatitis B infection in children under 5 years is seen in countries without hepatitis B birth-dose vaccination, while this gap is further compounded by suboptimal coverage (under 90%) of the childhood pentavalent vaccine. It also found that testing and treatment as a public health approach remains the most neglected aspect of the response.
Administration of the hepatitis B vaccination at birth and in early infancy is the most effective way to halt the transmission of the virus because 95% of the burden of chronic disease is due to infections among children, acquired before their fifth birthday, including mother-to-child transmission.
Despite the low cost of birth dose vaccination – less than US$ 0.20 per child – only 11 countries in the Region are following this protocol.