About Hepatitis Elimination
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About Hepatitis Elimination

As of 2019, 354 million persons are living with chronic hepatitis B (HBV) or C (HCV) virus infection. Of these 354 million persons, 87% are unaware of their infection and 95% have not been treated.

Hepatitis can be eliminated

  • Hepatitis B vaccines prevent 95% of infections with protection lasting 35+ years. 

  • Reliable tests detect infections before persons become severely ill. 

  • Early treatment with effective medications can cure hepatitis C, and prevent liver failure and liver cancer caused by hepatitis B. 

Global hepatitis elimination goals

In 2016, the World Health Assembly (WHA) unanimously adopted the resolution that viral hepatitis should be eliminated by 2030. In the same year, the World Health Organization (WHO) published the Global Health Sector Strategy (GHSS) on viral hepatitis to reach this goal, defining elimination as a 90% reduction in incidence and 65% reduction in mortality for hepatitis B and C from 2015 to 2030.

The International Task Force for Disease Eradication (ITFDE) adapted and endorsed the elimination goals of WHO, and HBV and HCV infections are recognized as feasible targets for elimination. Achievement of the WHO elimination goals would avert 1.5 million deaths from HCV alone over the next decade.

The original relative hepatitis elimination goals that were endorsed by the WHA were:

  • 30% reduction in new cases of chronic viral hepatitis B and C infections by 2020, 90% reduction by 2030
  • 10% reduction in viral hepatitis B and C deaths by 2020, 65% reduction by 2030
  • Reduction in HBV (HBsAg+) prevalence among children less than five years of age to < 1.0% by 2020, < 0.1% by 2030

WHO interim guidance

In 2021, WHO developed interim guidance and a framework for countries and other stakeholders seeking validation of elimination of HBV and HCV. This guidance was updated in 2023 [See here]. 

The guidance suggests the use of absolute impact targets to validate elimination at the national level (instead of, but still equivalent to, the relative reduction targets originally defined in the 2016 GHSS), in combination with a set of programmatic targets. More details on the impact and programmatic targets is provided below.

The Coalition for Global Hepatitis Elimination (CGHE) is working towards the acceleration of hepatitis B and C elimination by strengthening the capacity of national and sub-national elimination programs through advocacy, technical assistance, research, knowledge generation and dissemination among partners united in a community of practice. For more about our activities, see About the Coalition.

 

In 2021, WHO developed interim guidance and a framework for countries and other stakeholders seeking validation of elimination of HBV and HCV. This guidance was updated in 2023 [See here]. 

The guidance suggests the use of absolute impact targets to validate elimination at the national level (instead of, but still equivalent to, the relative reduction targets originally defined in the 2016 GHSS), in combination with a set of programmatic targets. More details on the impact and programatic targets is provided below.

This shift was based on consultation with key stakeholders and an assessment that absolute impact targets could be more feasibly measured given the paucity of data for a baseline year in 2015 and would offer a more standardized approach across countries.

The main absolute impact indicators and targets for measuring elimination were then defined as: 

  • An absolute annual HCV incidence of ≤5 per 100 000 persons and of ≤2 per 100 people who inject drugs (PWID) 
  • An HBV- and HCV-related annual mortality rate of ≤4 and ≤2 per 100 000 persons, respectively (combined HBV/HCV ≤6 per 100 000 persons)
  • ≤0.1% HBsAg prevalence in those aged 5 years or less

To achieve the global elimination goals, WHO set key services delivery targets for 2030 at the national level:

  • 100% of blood donations screened in a quality-assured manner
  • 100% safe injections in health facilities
  • ≥ 90% coverage of hepatitis B virus birth dose vaccine for infants
  • ≥ 90% coverage of hepatitis B virus vaccine (third dose) for infants
  • 300 sterile needles and syringes provided per person who injects drugs per year
  • ≥ 90% of chronic viral hepatitis B and C infections diagnosed
  • ≥ 80% of eligible people with chronic hepatitis B and C virus infection treated
Page last updated: 08 February 2024