Abstract
In 2016, WHO member states at the World Health Assembly adopted a Global Health Sector Strategy that included a policy of eliminating viral hepatitis. Clear targets were established to assist in achieving this by 2030. The strategy, while achievable, has exposed existing global disparities in healthcare systems and their ability to implement such policies. Compounding this, the regions with most disparity are also those where the hepatitis B prevalence and disease burden are the greatest. Foundational to hepatitis B elimination is the identification of both those with chronic infection and crucially pregnant women, and primary prevention through vaccination. Vaccination, including the birth dose and full three-dose coverage, is key, but complete mother-to-child transmission prevention includes reducing the maternal hepatitis B viral load in the third trimester where appropriate. Innovations and simplified tools exist in order to achieve elimination, but what is desperately required is the will to implement these strategies through the support of appropriate investment and funding. Without this, disparities will continue.
Highlights
An estimated 296 million people are chronically infected with hepatitis B virus (HBV) [1]
Innovations and simplified tools exist in order to achieve elimination, but what is desperately required is the will to implement these strategies through the support of appropriate investment and funding
In hyperendemic regions of the world, HBV chronicity is established in early childhood in the absence of an effective prevention of mother-to-child-transmission (PMTCT), timely hepatitis B birth dose vaccination, and a full three-dose HBV vaccine coverage
Summary
An estimated 296 million people are chronically infected with hepatitis B virus (HBV) [1]. A total of 30 of the 47 WHO AFRO region countries have a HBsAg prevalence >5% and 70% of all new HBV infections occur in the WHO AFRO region. Given the variance in global hepatitis B prevalence, many countries will be able to achieve these targets for HBV and several are already on target. The prevention of mother-to-child transmission programs, timely birth dose vaccination, full HBV vaccination coverage, diagnosis, and linkage to care and treatment is varied, but is worrying in world regions with the greatest prevalence of chronic HBV (central, east, and south-east Asia, sub-Saharan Africa), where the lowest rates of HBV diagnosis and treatment exist. If progress is to be achieved, a vast amount of multilateral effort, funding, and, importantly, government investment and will is required
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