80 percent of people with viral hepatitis lack access to services for prevention, testing & treatment. To address this gap, the World Health Organization calls on countries to invest in scaling up hepatitis services as part of their universal health coverage (UHC) plans.

On the occasion of World Hepatitis Day (28 July), WHO raised alarm over the lack of sufficient access to hepatitis services and funding to fight the disease, and in a press release made the case for increased investment by countries as well as affordable access to hepatitis medicines.

“On World Hepatitis Day, we’re calling for bold political leadership, with investments to match. We call on all countries to integrate services for hepatitis into benefit packages as part of their journey towards universal health coverage,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, quoted in the release.

While member states broadly supported WHO’s 2016 hepatitis elimination strategy, with 124 out of 194 countries developing hepatitis plans, WHO noted in the release that there has been insufficient domestic investment to fight the disease – “over 40% of country plans lack dedicated budget lines to support elimination efforts.”

“By investing in diagnostic tests and medicines for treating hepatitis B and C now, countries can save lives and reduce costs related to long-term care of cirrhosis and liver cancer that result from untreated hepatitis,” the release said.

According to a WHO study published in The Lancet Global Health earlier this year, investing US$ 58 billion in hepatitis elimination through 2030 could avert 4.5 million premature deaths and lead to a gain of 51.5 million healthy life-years by 2030. It notes that this amount is small in relation to the overall cost of UHC, and compared to the cost of inaction.

The study also found that access to affordable medicines will be key to reaching targets for hepatitis elimination, noting that “if affordable HCV medicines remained inaccessible in 13 countries where medicine patents are protected, the additional cost of the ambitious scenario would increase to $118 billion.”

In the release, WHO highlighted the actions some countries are taking to scale up their public health services for hepatitis. “The Government of India, for example, has announced that it will offer free testing and treatment for both hepatitis B and C, as part of its universal health coverage plan.” WHO noted that this investment in hepatitis services was facilitated through the reduction in prices of hepatitis medicines.

Pakistan, a country with one of the highest rates of new hepatitis C infections, has also just launched a new infection control and injection safety plan aimed at stopping transmission, according to the release. It noted that Pakistan was also able to procure hepatitis C treatments at low prices.

Insufficient Access to Prevention, Testing & Treatment

There are five types of viral hepatitis infections – A, B, C, D and E – but over 95 percent of deaths are caused by chronic hepatitis B and C infections, according to the WHO release.

“Of the estimated 257 million living with hepatitis B infection:

• 5% (27 million) knew their infection status in 2016.
• Of those people diagnosed, only 17% (4.5 million) received treatment in 2016.
• In 2016, 1.1 million people newly developed chronic hepatitis B infection—a primary cause of liver cancer.

Of the estimated 71 million people living with chronic hepatitis C infection in 2015:

• 19% (13.1 million) knew their infection status in 2017.
• Of those people diagnosed, 15% (2 million) received curative treatment in that same year. Overall, between 2014 and 2017, 5 million people have received hepatitis C curative treatment.
• In 2017, 1.75 million people newly developed chronic hepatitis C infection.”

Image Credits: PKLI .