WHO report reveals global increase in deaths from viral hepatitis

According to the World Health Organization's (WHO) Global Hepatitis Report 2024, the number of lives lost to viral hepatitis is increasing. The disease is the second leading cause of infectious death worldwide, killing 1.3 million people a year, the same as tuberculosis, the leading infectious killer.

The report, presented at the World Hepatitis Summit, highlights that testing and treatment uptake remains stagnant despite improved tools for diagnosis and treatment and lower product prices. . But if we act now, reaching the WHO elimination goal by 2030 is still within reach.

The estimated number of deaths from viral hepatitis has increased from 1.1 million in 2019 to 1.3 million in 2022, according to new data from 187 countries. Of these, 83% were caused by hepatitis B and 17% by hepatitis C. Hepatitis B and C infections cause 3,500 deaths worldwide.

The report paints an alarming picture: despite global progress in preventing hepatitis infection, too few people are being diagnosed with hepatitis and receiving treatment, resulting in an increasing number of deaths. ing. WHO is committed to helping countries make available all the tools at their disposal, at accessible prices, to save lives and change this trend. ”

AS Dr Tedros Adhanom Ghebreyesus, WHO Director-General

The latest WHO estimates show that 254 million people will have hepatitis B and 50 million people will have hepatitis C in 2022. Half of the burden of chronic hepatitis B and C infection is between the ages of 30 and 54 years, and 12% is among children under 18 years of age. . Men account for 58% of all cases.

Although new incidence estimates indicate a slight decrease compared to 2019, the overall incidence of viral hepatitis remains high. The number of new infections in 2022 will be 2.2 million, down from 2.5 million in 2019.

These include 1.2 million new hepatitis B infections and nearly 1 million new hepatitis C infections. More than 6,000 people are newly infected with viral hepatitis every day.

The revised estimates are derived from enhanced data from national prevalence surveys. They also show that preventive measures such as vaccination and safe injections, as well as expanded hepatitis C treatment, are contributing to reducing incidence.

Global advances and gaps in diagnosis and treatment

Across all regions, only 13% had been diagnosed with chronic hepatitis B infection at the end of 2022, and about 3% (7 million people) were receiving antiviral therapy. Regarding hepatitis C, 36% had been diagnosed and 20% (12.5 people) were receiving antiviral therapy. million people) were receiving curative treatment.

These results fall well short of the global goal of treating 80% of people with chronic hepatitis B and C by 2030. However, since the last reported estimates in 2019, they show small but consistent improvements in diagnostic and treatment coverage. Hepatitis B diagnosis increased from 10% to 13% and treatment increased from 2% to 3%, and hepatitis C diagnosis increased from 21% to 36% and treatment increased from 13% to 20%.

The burden of viral hepatitis varies by region. The WHO Africa Region is responsible for 63% of new hepatitis B infections, but despite this burden, only 18% of newborns in the region receive hepatitis B vaccination at birth. In the Western Pacific region, where hepatitis B accounts for 47% of deaths, treatment coverage for people diagnosed with hepatitis B is just 23%, too low to reduce mortality rates.

Bangladesh, China, Ethiopia, India, Indonesia, Nigeria, Pakistan, the Philippines, Russian Federation, and Vietnam collectively bear almost two-thirds of the global burden of hepatitis B and C. Achieving universal access to prevention, diagnosis and treatment By 2025, in parallel with strengthening efforts in the African region, to get the global response back on track to achieve the Sustainable Development Goals. Achieving the goals in these 10 countries is essential.

Differences in pricing and service delivery

Despite the availability of affordable generic drugs for viral hepatitis, many countries fail to procure drugs at such low prices.

Price disparities continue to exist both within and within WHO regions, with many countries paying prices above global standards, even for drugs that are off-patent or included in voluntary licensing agreements. are paying. For example, tenofovir for the treatment of hepatitis B is off-patent and available at the global standard price of $2.40 per month, but only seven of the 26 reporting countries paid below the standard price. It was only.

Similarly, a 12-week course of pan-genotypic sofosbuvir/daclatasvir to treat hepatitis C is available at a global reference price of $60, but out of 24 reporting countries paid less than the reference price. in only four countries.

Service delivery remains intensive and vertical, and many affected people still face out-of-pocket costs for viral hepatitis services.

Only 60% of reporting countries provide testing and treatment services for viral hepatitis completely or partially free of charge in the public sector. Economic protection is low in the African region, with only about one-third of reporting countries providing these services free of charge.

Recommendations to facilitate the elimination of hepatitis

This report outlines a series of actions to advance a public health approach to viral hepatitis, with the aim of accelerating progress towards ending the epidemic by 2030. Its contents include:

• Expand access to testing and diagnosis.
• Moving from policy to implementation for fair treatment.
• Strengthen primary care prevention efforts.
• Simplify service delivery and optimize product regulation and supply.
• Development of investment projects in priority countries.
• Mobilize innovative financing.
• Use improved data for action.and
• We work with affected communities and civil society to advance research to improve diagnosis and potential treatments for hepatitis B.

Funding remains a challenge

Funding for viral hepatitis, both at the global level and in dedicated national health budgets, is insufficient to meet the needs. This results from a combination of factors, including limited awareness of cost-reducing interventions and tools and competing priorities in the global health agenda. This report aims to identify strategies for countries to address these inequalities and access tools at the most affordable prices.