Geneva, April 10, 2024 — According to the World Health Organization (WHO) World hepatitis report 2024, the number of lives lost due to viral hepatitis is increasing. The disease is the second infectious cause of death worldwide, with 1.3 million deaths per year, the same number as tuberculosis, a leading cause of infectious death.
The report, released at the World Hepatitis Summit, highlights that despite better tools for diagnosis and treatment and declining product prices, testing and treatment coverage rates have stagnated. But it should still be possible to reach the WHO’s elimination target by 2030, if rapid action is taken now.
New data from 187 countries show that the estimated number of deaths from viral hepatitis increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, 83% were caused by hepatitis B and 17% by hepatitis C. Every day, there are 3500 people die worldwide due to hepatitis B and C infections.
«This report presents a worrying picture: despite global progress in preventing hepatitis infections, deaths are increasing because too few people with hepatitis are diagnosed and treated,» said WHO Director-General Dr. Tedros Adhanom Ghebreyesus. «WHO is committed to helping countries use all the tools at their disposal – at affordable prices – to save lives and change this trend.»
Updated WHO estimates indicate that in 2022, 254 million people will be living with hepatitis B and 50 million with hepatitis C. Half of the burden of chronic hepatitis B and C infections occurs among people aged 30 to 54 years, and 12% among children under 18 years of age. . Men represent 58% of all cases.
The new incidence estimates indicate a slight decrease compared to 2019, but the overall incidence of viral hepatitis remains high. In 2022, there were 2.2 million new infections, up from 2.5 million in 2019.
These include 1.2 million new hepatitis B infections and almost 1 million new hepatitis C infections. More than 6,000 people contract viral hepatitis every day.
The revised estimates are derived from improved data from national prevalence surveys. They also indicate that prevention measures such as immunization and safe injections, along with expanded hepatitis C treatment, have contributed to reducing the incidence.
Global progress and gaps in diagnosis and treatment
Across all regions, only 13% of people living with chronic hepatitis B infection had been diagnosed and approximately 3% (7 million) had received antiviral therapy by the end of 2022. For hepatitis C, 36 % had been diagnosed and 20% (12.5 million) had received curative treatment.
These results fall well short of global targets of treating 80% of people living with chronic hepatitis B and hepatitis C by 2030. However, they indicate a slight but steady improvement in diagnosis and treatment coverage since the latest estimates reported in 2019. Specifically, hepatitis B diagnosis increased from 10% to 13% and treatment from 2% to 3%, and hepatitis C diagnosis from 21% to 36% and treatment from 13% to 20%.
The burden of viral hepatitis varies regionally. The WHO African Region accounts for 63% of new hepatitis B infections; However, despite this burden, only 18% of newborns in the region receive the hepatitis B vaccine at birth. In the Western Pacific Region, which accounts for 47% of hepatitis B deaths, treatment coverage is 23% among people diagnosed, too low to reduce mortality.
Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation and Viet Nam collectively bear almost two-thirds of the global burden of hepatitis B and C. Achieving universal access to prevention, Diagnosis and treatment in these ten countries by 2025, together with intensified efforts in the African Region, is essential to get the global response back on track towards meeting the Sustainable Development Goals.
Disparities in prices and service provision
Despite the availability of affordable generic medications for viral hepatitis, many countries are unable to acquire them at these lower prices.
Price disparities persist both between and within WHO regions, with many countries paying above global benchmarks, even for off-patent medicines or when included in voluntary licensing agreements. For example, although tenofovir for the treatment of hepatitis B is off-patent and available at a global reference price of US$2.4 per month, only 7 of the 26 countries that reported paid prices at or below the price of reference.
Similarly, a 12-week course of pangenotypic sofosbuvir/daclatasvir to treat hepatitis C is available at a global reference price of US$60, but only 4 of the 24 reporting countries paid prices at or below the reference price. .
Service delivery remains centralized and top-down, and many affected populations still face out-of-pocket costs for viral hepatitis services.
Only 60% of reporting countries offer free viral hepatitis testing and treatment services, in whole or in part, in the public sector. Financial protection is lower in the African Region, where only about a third of reporting countries provide these services free of charge.
Recommendations to accelerate the elimination of hepatitis.
The report outlines a series of actions to promote a public health approach to viral hepatitis, designed to accelerate progress towards ending the epidemic by 2030. They include:
- expand access to testing and diagnostics;
- move from policy to implementation to achieve equitable treatment;
- strengthen prevention efforts in primary care;
- simplify service provision, optimize regulation and product supply;
- develop investment cases in priority countries;
- mobilize innovative financing;
- use improved data for action; and
- involve affected communities and civil society and promote research to improve diagnoses and possible cures for hepatitis B.
Financing remains a challenge
Funding for viral hepatitis, both globally and within country-specific health budgets, is not sufficient to meet needs. This arises from a combination of factors, including limited awareness of cost-saving interventions and tools, as well as competing priorities in global health agendas. This report seeks to shed light on strategies for countries to address these inequalities and access tools at the most affordable prices available.
