Ahead of World Hepatitis Day (28 July), the World Health Organization (WHO) calls on countries to take advantage of recent reductions in the costs of diagnosing and treating viral hepatitis and scale up investments in disease elimination.
A new study by WHO, published today in Lancet Global Health, has found that investing US$6bn per year in eliminating hepatitis in 67 low- and middle-income countries would avert 4.5 million premature deaths by 2030, and more than 26 million deaths beyond that target date.
A total of US$58.7 billion is needed to eliminate viral hepatitis as a public health threat in these 67 countries by 2030. This means reducing new hepatitis infections by 90% and deaths by 65%.
“Today 80% of people living with hepatitis can’t get the services they need to prevent, test for and treat the disease,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “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.”
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.
Some countries are already taking action. 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. This has been facilitated through the reduction in prices of medicines. In India, a hepatitis C cure costs less than US$40 and a year of hepatitis B treatment costs less than US$30. At these prices, hepatitis C cure will result in healthcare cost savings within three years.
The Government of Pakistan has also been able to procure hepatitis C curative treatment at similarly low prices. Providing curative treatment to all those currently diagnosed with hepatitis C could also reduce healthcare costs in Pakistan within three years. Meanwhile, Pakistan is faced with one of the highest new annual infection rates of hepatitis C virus and is launching a new infection control and injection safety plan on the occasion of World Hepatitis Day to stop transmission.
No access to prevention, testing and treatment for most
For the vast majority of the 325 million people living with hepatitis B and/or C, accessing testing and treatment remains beyond reach.
Of the estimated 257 million living with hepatitis B infection:
- 10.5% (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.
World Hepatitis Day
WHO’s global hepatitis strategy, endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90% and deaths by 65% between 2016 and 2030.
On World Hepatitis Day 2019, WHO calls on all countries to “Invest in eliminating hepatitis” through costing, budgeting and financing of elimination services within their universal health coverage plans. While there has been broad support among WHO Member States in adopting the WHO hepatitis elimination strategy, with 124 out of 194 countries developing hepatitis plans, over 40% of country plans lack dedicated budget lines to support elimination efforts.
WHO has also released online calculators (www.hepccalculator.org and www.hepbcalculator.org) designed to help decision makers to evaluate the cost-effectiveness of their hepatitis treatment programmes.
There are five types of viral hepatitis infections – A, B, C, D and E. Over 95% of deaths are caused by chronic hepatitis B and C infections, while hepatitis A and E rarely cause life-threatening illnesses. Hepatitis D is an additional infection occurring in people living with hepatitis B.
Editor’s note: For World Hepatitis Day 2019 “Invest in eliminating hepatitis”, WHO will be joining the Government of Pakistan in inaugurating the Prime Minister’s Initiative for hepatitis in Islamabad, Pakistan. This is a country with one of the fastest growing hepatitis C epidemics in the world, but also in the process of adopting progressive policies to reverse the tide.
WHO World Hepatitis Day 2019 campaign: https://www.who.int/campaigns/world-hepatitis-day/2019
SDG Health Price Tag
In 2017, the SDG Health Price Tag study estimated the investments needed to reach 16 health-related targets of the Sustainable Development Goals in 67 low- and middle-income countries that account for 75% of the world’s population. This study did not include the costing for hepatitis.
The new study published today is based on the same modelling scenarios and methods to estimate the costs of reaching global hepatitis elimination targets.