Advancing public health policies to combat Hepatitis B in Africa: Challenges, advances, and recommendations for meeting 2030 targets

Abstract

Hepatitis B virus (HBV) infection poses a significant public health threat globally, with Africa carrying a disproportionate burden. The region faces alarming figures, including approximately 4.5 million African children affected, accounting for 70% of global cases among those under five. Challenges include low awareness, cultural barriers, and inadequate surveillance systems, hindering timely interventions. The impact of HBV extends beyond mortality, contributing to severe liver diseases and economic burdens. Efforts to eradicate face hurdles such as low testing rates and limited treatment coverage, with only 10% of HBV-positive individuals diagnosed. Advances, including vaccination and antiviral therapies, show promise, but persistent challenges like stigma, discrimination, and limited awareness persist. Collaborative strategies involving stakeholders, improved surveillance, public health policies, and integrated care pathways are crucial to achieving the WHO's 2030 elimination goals for HBV in Africa. Addressing co-infections, particularly HIV–HBV, and considering regional variations in HBV genotypes are vital aspects. Important insights into current gaps in healthcare coverage and knowledge, therapeutic approaches, and new developments in HBV research have been identified. An increase in the scope of primary preventive programs, making use of the current infrastructure for eliminating mother-to-child transmission while also integrating accurate diagnostics for access to treatment and prevention, is advocated. The review emphasizes the importance of community engagement, innovative diagnostics, financial structures, and international collaboration to enhance eradication efforts. In conclusion, the urgent need for effective public health policies, preventive measures, accurate diagnosis, and collaborative efforts is emphasized to achieve the ambitious 2030 targets for Hepatitis B elimination in Africa.