To take stock of our progress on this World Hepatitis Day 2020, the Coalition released an interim report card for global hepatitis elimination. Compiled from publicly available sources of data for over 190 countries available on our country dashboards, the report card brings together the latest trends in HBV and HCV burden, progress toward the interim targets for hepatitis elimination and the status of planning and implementing interventions for prevention of HBV and HCV transmission and disease.

A few takeaways:

• Over 300 million persons are living with HBV and HCV infection. HCV prevalence appears to be decreasing in countries such as Egypt with strong testing and treatment programs. Preliminary modeled data suggests that HBV prevalence may be on decline. Data from additional years of observation will help confirm these trends, preferably from public health surveillance. 
• The estimated number of HCV related deaths is now approaching the number of deaths related to HBV infection. With the availability of affordable, safe curative therapies, this trend must be a call to action.
• The global burden is concentrated in a limited number of countries. All countries will benefit from HBV and HCV elimination.  Achievement of global elimination targets will depend on the scale-up of hepatitis prevention care and treatment in the heavily burdened countries.
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• For 68 countries, HBsAg prevalence is less than 1%, the 2020 interim target, for children < 5 years of age. This is a great success in scaling up HepB vaccination coverage beginning at birth, particularly for countries with high HBV prevalence in un-vaccinated cohorts. The priority now is to help other countries achieve similar success and for all countries to move toward participating in triple elimination strategies for HIV, syphilis and HBV and as appropriate Chagas Disease.
• Few countries have achieved the 2020 interim targets of a 10% decline in HBV and HCV mortality.  Inadequate national budget-based planning, policy development and insufficient clinical capacity limit the scale-up of hepatitis testing and treatment.  Most countries have access  to generic HBV and HCV medications. However, the costs of hepatitis diagnostics and therapies remain variable.  For example, HCV RDT and HCV PCR can vary in costs for LMIC from $0.30 to $2.10 and $9.00- $70, respectively. HCV treatments are typically affordable but can vary from $28 to $ 1,347 for a curative course of therapy.  

• Substantial progress has been made in scaling up hepatitis B vaccination globally. In most regions, the majority of countries have reached the 2020 interim targets for HepB 3 dose. However the scale-up of HepB birth dose coverage remains a challenge particularly in the African Region. 
• Harm reduction services are inadequate in almost all countries. This is HCV prevention's greatest challenge. HCV prevalence remains unacceptably high among persons who inject drugs ( PWID) in most countries. The lack of HCV testing and treatment for PWID contributes to this high prevalence.

• Effective hepatitis elimination initiatives are in progress. The dashboards place side-by-side programmatic information and strategic data for the first time. The Coalition provides opportunities to share lessons learned particularly for new programs.
• The data reveal the scarcity of primary national data to track progress toward goals for reduced HBV and HCV incidence and mortality. Reliable strategic information from vital records, clinical care and other systems can improve the precision of these estimates to monitor progress and verify achievement of hepatitis elimination goals.
• Data on the country dashboards are dynamic. The sites are intended to be current updated with information from credible. If you believe there are errors in the Coalition data or are out of date, please contact the Coalition at globalhep [at] taskforce.org

The health benefits of hepatitis elimination are immense.  If successful, over 26 million deaths can be averted, including over 4 million deaths by 2030. Wiht a small increase in investment of funds for the SDGs, these improvements in health can be achieved. To move forward and achieve hepatitis elimination, let's recognize the progress to date and how it was achieved, and work together as a Coalition to provide the funding support, technical assistance, and knowledge to overcome the current gaps in prevention, testing and treatment.

On World Hepatitis Day, the Coalition for Global Hepatitis Elimination thanks over 100 partners in the Coalition’s community of practice and commemorates  the hard work of the thousands committed to hepatitis prevention, testing, care and treatment.