Growing Rates of Hepatitis B and C Infections
According to the World Health Organization (WHO) 2024 Global Hepatitis Report, there has been a rise in deaths due to viral hepatitis, the second leading infectious cause of death globally. There are about 1.3 million deaths annually, almost tied with tuberculosis, which is the other top infectious killer. Even with improved tools for diagnosis and treatment, testing and treatment coverage rates have stopped. It is still possible to reach the WHO elimination goal by 2030 with quick and effective actions being taken now until then.
From 187 countries, there has been new data portraying that the approximate number of deaths has increased from 1.1 million in 2019 to 1.3 million in 2022. Of these, about 83% were a result of hepatitis B, and 17% of hepatitis C. Daily, 3,500 people are dying internationally with both of these infections. In addition, the WHO asserts that about 254 million people live with hepatitis B and 50 million with hepatitis C in 2022. Of the people who have chronic hepatitis B and C, these people are between 30-54 years old, while 12% of chronic hepatitis occurs in children. Even with these high numbers, there has been a decrease in the rates. For instance, there were 2.5 million new infections in 2019, which decreased to 2.2 million in 2022. Prevention measures such as immunizations and more hepatitis C treatment have lessened the number of cases overall, but they still are not enough.
Global Burden: Advances and Obstacles in Diagnosis and Treatment
Among all the regions with hepatitis, about 13% of people have been detected living with chronic hepatitis B infection, and only 3% have received proper antiviral treatment at the end of 2022. For hepatitis C, 36% have been detected, and only 20% have gotten treatment. These data points are under the Sustainable Developmental Goals to successfully treat 80% of everyone living with chronic hepatitis B and C by 2030. There have been more diagnoses and treatment options for both hepatitis B and C, but there needs to be more to ensure the global goal is met.
Additionally, the burden of viral hepatitis is different across regions. In Africa, there are about 63% of new hepatitis B cases, but only 18% of the newborns in this region have the hepatitis B vaccination. In the Western Pacific region, which includes about 47% of hepatitis B deaths, treatment coverage is only 23% among people diagnosed, which is not adequate to reduce mortality. Countries such as Bangladesh, China, India, Indonesia, and Vietnam all share about ⅔ of the global burden of hepatitis B and C. As a result, there needs to be universal access to prevention, diagnosis, and treatment in all of these areas by 2025, as well as extra efforts in regions of Africa to meet the Sustainable Developmental Goal mentioned earlier.
Health Inequalities in Prices and Services
Even with affordable generic viral hepatitis medications, many other regions fail to obtain and offer them at lower prices. For instance, tenofovir is a treatment option for hepatitis B at an international price of US $2.4; however, only 7 of the 26 reporting countries paid prices at this benchmark or lower. Another example is the 12-week course of pangenotypic sofosbuvir/daclatasvir, which is medication for hepatitis C, is available at the international price of US $60, but only 4 of the 24 reporting countries paid this price or lower. Many affected populations have to deal with expenses that are not covered by viral hepatitis services. It is estimated that 60% of reporting countries give viral hepatitis testing and treatment services free publically. Financial protection is even lower in regions of Africa, with only ⅓ of reporting countries stating these services are free at all.
Methods to Eliminate Hepatitis Permanently
The WHO report provides some actions to be taken to ensure elimination by 2030. These include access to testing and diagnosing, policies on equal treatment, prevention efforts, less complicated service delivery, investments in burdened countries, and more engagement from affected communities.
While many of the methods listed above have a common issue of funding, there will have to be more awareness of how to be cost-effective and set more funds for burdened countries. It will have to be a global health effort to treat 80% of those living with chronic hepatitis B and C, but it is possible.
Thank you for reading,
Siri Nikku
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