At least 3 500 lives are lost daily due to viral hepatitis infections, according to the World Health Organisation (WHO) 2024 Global Hepatitis Report, with diagnosis as well as funding for drugs in some regions still being a struggle, hampering treatment.
The disease is the second leading infectious cause of death globally – with 1.3m deaths annually, the same as tuberculosis, a top infectious killer.
The report, released at the World Hepatitis Summit, highlights that despite better tools for diagnosis and treatment, and decreasing product prices, testing and treatment coverage rates have stalled.
However, reaching the WHO elimination goal by 2030 should still be achievable if swift actions are taken now, the agency said.
New data from 187 countries show that the estimated number of deaths from viral hepatitis increased from 1.1m in 2019 to 1.3m in 2022. Of these, 83% were caused by hepatitis B, and 17% by hepatitis C. Every day, 3 500 people around the globe die from hepatitis B and C infections.
“This report is troubling … despite progress globally in preventing infections, deaths are rising because far too few people are being diagnosed and treated,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
Updated estimates indicate that 254m people had hepatitis B and 50m had hepatitis C in 2022. Half the burden of chronic hepatitis B and C infections is among people between 30 and 54, with 12% among children under. Men account for 58% of all cases.
New incidence estimates indicate a slight decrease compared to 2019, but the overall incidence of viral hepatitis remains high.
Gaps in diagnosis, treatment
Across all regions, only 13% of people with chronic hepatitis B infection had been diagnosed and 3% (7m) had received antiviral therapy at the end of 2022. Regarding hepatitis C, 36% had been diagnosed and 20% (12.5m) had received curative treatment.
These results fall well below the global targets to treat 80% of people with chronic hepatitis B and hepatitis C by 2030. However, they indicate slight but consistent improvement in diagnosis and treatment coverage since the last reported estimates 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 WHO African Region bears 63% of new hepatitis B infections, yet despite this burden, only 18% of newborns in the region receive the hepatitis B birth-dose vaccination. In the Western Pacific Region, which accounts for 47% of hepatitis B deaths, treatment coverage stands at 23% among people diagnosed, which is far too low to reduce mortality.
Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation and Vietnam, collectively shoulder nearly two-thirds of the global burden of hepatitis B and C. Achieving universal access to prevention, diagnosis, and treatment in these countries by 2025, alongside intensified efforts in the African region, is essential to get the global response back on track to meet the Sustainable Development Goals.
Disparities in pricing and service delivery
Despite the availability of affordable generic viral hepatitis medicines, many countries fail to procure them at these lower prices.
Pricing disparities persist both across and within WHO regions, with many countries paying above global benchmarks, even for off-patent drugs or when included in voluntary licensing agreements. For example, although tenofovir for treatment of hepatitis B is off patent and available at a global benchmark price of US$2.4 per month, only seven of the 26 reporting countries paid prices at or below the benchmark.
Similarly, a 12-week course of pangenotypic sofosbuvir/daclatasvir to treat hepatitis C is available at a global benchmark price of US$60, yet only four of 24 reporting countries paid prices at or below the benchmark.
Only 60% of reporting countries offer viral hepatitis testing and treatment services free of charge, either entirely or partially, in the public sector. Financial protection is lower in the African region, where only about one-third of reporting countries provide these services free.
Recommendations for elimination
The report outlines a series of actions to advance a public health approach to viral hepatitis, designed to accelerate progress towards ending the epidemic by 2030. They include expanding access to testing and diagnostics and mobilising innovative financing, among other suggestions.
Funding both at a global level or within dedicated country health budgets is insufficient to meet needs, and the report seeks to shed light on strategies for countries to address these inequities and access the tools at the most affordable prices available.
global hepatitis report
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World Hepatitis Summit urges elimination of viral hepatitis as paediatric cases rise
New vaccines offer hope for Hepatitis B treatment in SA
Experts call for hepatitis B birth-dose vaccine
Millions of unnecessary deaths from hepatitis globally