The Coalition for Global Hepatitis Elimination (CGHE)

In July 2019, to catalyze progress toward achievement of the goals for viral hepatitis elimination globally, the Task Force for Global Health (TFGH) launched the Coalition for Global Hepatitis Elimination (CGHE).

Modeled after other TFGH disease elimination programs, the CGHE provides services to assist the planning, implementation and evaluation of national and sub-national programs to eliminate hepatitis B virus (HBV) and hepatitis C virus (HCV) transmission and disease.

The Task Force for Global Health (TFGH)

The TFGH is an ideal home for CGHE. Started in 1984 by Dr. William Foege, a former CDC director and a leader of the successful global campaign to eradicate smallpox, the TFGH is the organization with the greatest experience  in supporting global disease elimination initiatives. From the start of the TFGH, Dr. Foege, joined by Drs. Walt Dowdle, Alan Hinman and other TFGH senior scientists led development of disease elimination and eradication as a field of public health. Their academic work established standard definitions for disease elimination and eradication, criteria for selecting feasible targets and essential components of successful programs. This academic work led to a global consensus that disease elimination and eradication are the ultimate goals of public health resulting in large benefits in lives saved and assuring health equity.

Why eliminate viral hepatitis?

While significant progress has been made in reducing mortality from many communicable diseases, deaths due to viral hepatitis continue to increase, ranking now as the sixth leading cause of mortality and overtaking deaths due to HIV, malaria, and tuberculosis.(1)  Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection caused an estimated 1.1 million deaths in 2019 from cirrhosis and liver cancer. Approximately 354 million persons are living with HBV or HCV infection and an estimated 3 million new chronic infections occur annually (2). 

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 on viral hepatitis to reach this goal and defined 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.

WHO defines elimination as:

• 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

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

HBV and HCV Service Coverage Targets 

• 100% coverage of blood unit screening with quality assurance.
• 90% of injections administered with safety-engineered devices in and out of health facilities. 
• 300 syringe and needle sets distributed per person who inject drugs.
• 95% of blood donations screened in a quality-assured manner by 2020, 100% screened by 2030
• 50% of injections administered with safety-engineered devices in and out of health facilities by 2020, 90% by 2030
• 90% coverage of hepatitis B virus vaccine (third dose) by 2020
• 50% coverage of prevention of mother-to-child transmission of hepatitis B virus by 2020, 90% coverage by 2030
• 200 sterile needles and syringes provided per person who injects drugs per year by 2020, 300 by 2030
• 30% of chronic viral hepatitis B and C infections diagnosed by 2020, 90% by 2030
• 80% of eligible people with chronic hepatitis B and C virus infection treated by 2030, respectively