WHO Warns Global Progress on Hepatitis Elimination Too Leisurely to Meet 2030 Targets
The World Health Organization (WHO) has issued a stark warning: the world is falling behind in its efforts to eliminate viral hepatitis as a public health threat by 2030. Despite notable progress in some regions, global action remains insufficient to meet the ambitious targets set by the WHO Global Health Sector Strategies and the Regional Action Plans for the WHO European Region. With just four years left to achieve these goals, health experts emphasize the urgent necessitate for accelerated interventions, particularly among underserved populations.
Progress and Gaps: A Mixed Picture
Recent reports from the WHO highlight both achievements and critical shortcomings in the fight against viral hepatitis. While some countries have made significant strides in diagnosis, treatment, and prevention, others—particularly in Eastern Europe and Central Asia—continue to struggle with high infection rates and limited access to care. The European AIDS Treatment Group notes that while latest infections have declined in parts of Western Europe, Eastern Europe remains a hotspot for hepatitis B and C, driven by factors such as injection drug use, inadequate healthcare infrastructure, and stigma.
Diagnosis and Treatment: The 90-90-90 Challenge
The WHO’s elimination strategy hinges on the “90-90-90” targets for hepatitis B and C: diagnosing 90% of people living with the virus, treating 90% of those diagnosed, and achieving a 90% reduction in new infections. However, current data suggests that many countries are far from meeting these benchmarks. For example:
- Hepatitis B: Only an estimated 10% of people with chronic hepatitis B are aware of their infection, and just 22% of those diagnosed receive treatment (WHO Global Hepatitis Report, 2024).
- Hepatitis C: While direct-acting antivirals (DAAs) have revolutionized treatment, only 21% of people with hepatitis C have been diagnosed globally, and just 13% have received curative treatment (WHO, 2024).
These gaps are particularly pronounced among marginalized groups, including people who inject drugs, migrants, and incarcerated populations, who often face barriers to testing and care.
Regional Disparities: Eastern Europe and Central Asia Lag Behind
The WHO European Region has made progress in reducing hepatitis-related mortality, but disparities between sub-regions persist. According to the Regional Action Plan for Ending AIDS and the Epidemics of Viral Hepatitis and Sexually Transmitted Infections (2022–2030), countries in Eastern Europe and Central Asia account for a disproportionate share of new hepatitis B and C infections. Key challenges include:
- Limited access to affordable diagnostics and treatment.
- Weak healthcare systems and underfunded public health programs.
- Stigma and discrimination against people living with hepatitis, particularly among key populations.
- Insufficient harm reduction services for people who inject drugs.
In contrast, countries like Germany, France, and the United Kingdom have implemented comprehensive national hepatitis elimination programs, resulting in significant reductions in new infections and hepatitis-related deaths.
The Path Forward: Accelerating Progress Toward 2030
To meet the 2030 elimination targets, the WHO and its partners are calling for a multi-pronged approach that addresses both systemic and population-specific challenges. Key strategies include:
1. Scaling Up Testing and Treatment
Expanding access to affordable, point-of-care diagnostics and treatment is critical. The WHO recommends integrating hepatitis testing into existing healthcare services, such as HIV and tuberculosis programs, to reach underserved populations. Community-based testing initiatives, including mobile clinics and self-testing kits, can also help bridge gaps in access.
2. Strengthening Harm Reduction Services
For people who inject drugs, harm reduction services—such as needle and syringe programs, opioid substitution therapy, and safe injection sites—are essential for preventing new infections. The WHO emphasizes that these services must be scaled up and destigmatized to effectively reduce hepatitis transmission in this high-risk group.
3. Improving Vaccination Coverage
The hepatitis B vaccine is highly effective at preventing infection, yet global coverage remains uneven. The WHO urges countries to strengthen routine immunization programs, particularly in regions with low vaccination rates, and to ensure that all infants receive the birth dose of the hepatitis B vaccine within 24 hours of delivery.
4. Enhancing Surveillance and Data Collection
Investing in robust surveillance systems is essential for tracking progress and identifying gaps in the response. The WHO recommends that countries adopt standardized reporting mechanisms and leverage digital health tools to improve data accuracy and timeliness.
5. Mobilizing Political Commitment and Funding
Sustained political will and increased funding are critical to scaling up hepatitis elimination efforts. The WHO calls on governments, international organizations, and donors to prioritize viral hepatitis in their health agendas and allocate sufficient resources to support national elimination programs.
Frequently Asked Questions
What is viral hepatitis, and why is it a public health threat?
Viral hepatitis refers to inflammation of the liver caused by one of five hepatitis viruses: A, B, C, D, and E. Hepatitis B and C are the most concerning from a public health perspective because they can lead to chronic infection, liver cirrhosis, and liver cancer. Together, these two viruses cause approximately 1.1 million deaths annually, making hepatitis a leading cause of liver-related mortality worldwide (WHO, 2024).
How is hepatitis transmitted?
Hepatitis B and C are primarily transmitted through contact with infected blood. Common routes of transmission include:
- Sharing needles or other drug-injection equipment.
- Unsafe medical procedures, such as blood transfusions or organ transplants with unscreened blood.
- Mother-to-child transmission during childbirth (for hepatitis B).
- Unprotected sexual contact (less common for hepatitis C).
Hepatitis A and E are typically spread through contaminated food or water, while hepatitis D only occurs in people already infected with hepatitis B.
Is there a cure for hepatitis?
There is no cure for hepatitis B, but antiviral medications can control the virus and reduce the risk of liver damage. Hepatitis C, however, can be cured with direct-acting antivirals (DAAs), which are highly effective and have minimal side effects. Treatment typically lasts 8–12 weeks and results in a sustained virologic response (SVR), meaning the virus is no longer detectable in the blood.
Who is most at risk for hepatitis?
Certain populations are at higher risk for hepatitis B and C, including:
- People who inject drugs.
- Men who have sex with men.
- People living with HIV.
- Migrants from high-prevalence countries.
- Incarcerated individuals.
- Healthcare workers exposed to blood or bodily fluids.
The WHO recommends that these groups be prioritized for testing and prevention services.
What can individuals do to protect themselves from hepatitis?
Prevention strategies vary depending on the type of hepatitis:
- Hepatitis A and E: Practice good hygiene, such as washing hands thoroughly, and avoid consuming contaminated food or water.
- Hepatitis B: Acquire vaccinated, use condoms during sex, and avoid sharing needles or personal items like razors or toothbrushes.
- Hepatitis C: Avoid sharing needles or other drug-injection equipment, and ensure that any tattoos or piercings are done with sterile equipment.
Regular testing is also key, particularly for individuals in high-risk groups.
Conclusion: A Call to Action
The WHO’s latest reports serve as a wake-up call: the world is not on track to eliminate viral hepatitis by 2030. While progress has been made, particularly in high-income countries, significant gaps remain in diagnosis, treatment, and prevention. To close these gaps, governments, healthcare providers, and communities must work together to scale up testing, expand access to treatment, and address the systemic barriers that perpetuate the epidemic.
As Dr. Meg Doherty, Director of the WHO’s Global HIV, Hepatitis, and STI Programmes, stated in a recent address, “Eliminating hepatitis is not just a health goal—it is a moral imperative. Every person living with hepatitis deserves access to life-saving care, and every country has a role to play in making that a reality.” With just four years left to meet the 2030 targets, the time for action is now.
Key Takeaways
- The world is falling behind in its efforts to eliminate viral hepatitis as a public health threat by 2030.
- Only 10% of people with hepatitis B and 21% of those with hepatitis C are aware of their infection.
- Eastern Europe and Central Asia remain hotspots for new hepatitis infections due to limited access to care and stigma.
- Barriers to elimination include inadequate funding, limited access to testing and treatment, stigma, and weak surveillance systems.
- Key strategies to accelerate progress include scaling up testing and treatment, strengthening harm reduction services, improving vaccination coverage, and enhancing data collection.
- Individuals can protect themselves by getting vaccinated (for hepatitis B), practicing safe injection practices, and avoiding risky behaviors.