New WHO guidance for country validation of viral hepatitis B and C elimination

Abstract

The 2016 WHO Global Health Sector Strategy (GHSS) on viral hepatitis provided a roadmap for the elimination of viral hepatitis as a public health problem by 2030. 1 WHOGlobal health sector strategy on viral hepatitis 2016–2021: towards ending viral hepatitis. World Health Organization, Geneva2016https://apps.who.int/iris/handle/10665/246177Date accessed: May 20, 2021 Google Scholar Elimination is defined as a 90% reduction in incidence (95% for hepatitis B virus [HBV] and 80% for hepatitis C virus [HCV] infection) and a 65% reduction in mortality by 2030, compared with a 2015 baseline, that can be achieved through scale-up of five key synergistic preventive approaches (HBV birth-dose and infant vaccination, blood and injection safety, and harm reduction measures) alongside testing and treatment interventions. New estimates for viral hepatitis based on data from 130 countries in the latest global progress report on HIV, viral hepatitis, and sexually transmitted infections 2 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. World Health Organization, GenevaJuly 15, 2021https://www.who.int/publications/i/item/9789240027077Date accessed: July 26, 2021 Google Scholar show that in 2019 there were 296 million people living with chronic HBV infection and 58 million people living with chronic HCV infection, and 3 million new infections and 1·1 million deaths from viral hepatitis B and C combined. The 2020 Sustainable Development Goals and GHSS target of reducing the incidence of hepatitis B has been met (as measured by a global HBsAg prevalence in 2019 among children younger than 5 years of less than 1%, at 0·94%). 2 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. World Health Organization, GenevaJuly 15, 2021https://www.who.int/publications/i/item/9789240027077Date accessed: July 26, 2021 Google Scholar However, most other global 2020 targets have been missed, and accelerated action is needed to reach elimination, especially in access to timely HBV birth-dose vaccination (coverage of 42% in 2019), harm reduction for people who inject drugs, and testing and treatment coverage (testing coverage of 10%, of whom 22% have been treated, for chronic HBV infection, and testing coverage of 21%, of whom 62% have been treated, for chronic HCV infection). 2 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. World Health Organization, GenevaJuly 15, 2021https://www.who.int/publications/i/item/9789240027077Date accessed: July 26, 2021 Google Scholar Around 124 countries have developed national viral hepatitis plans 2 WHOGlobal progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. World Health Organization, GenevaJuly 15, 2021https://www.who.int/publications/i/item/9789240027077Date accessed: July 26, 2021 Google Scholar and several countries have already made substantial progress and requested guidance from WHO on criteria and processes for validation of elimination.