Global progress on the elimination of viral hepatitis as a major public health threat: An analysis of WHO Member State responses 2017

Abstract

In 2016, the World Health Assembly passed a resolution to eliminate viral hepatitis as a public health threat by 2030. We aimed to examine the status of the global viral hepatitis response.

Methods: In 2017, the World Health Organization (WHO) asked the Ministries of Health in all 194 Member States to complete a Country Profile on Viral Hepatitis policy uptake indicators, covering national plans/funding, engagement of civil society, testing guidance, access to treatment, and strategic information.

Results: Of 194 Member States, 135 (70%) responded, accounting for 87% of the global population infected with hepatitis B virus (HBV) and/or C virus (HCV). Of those responding, 84 (62%) had developed a national plan, of which, 49 (58%) had dedicated funding, and 62 (46%) had engaged with civil society; those engaged with civil society were more likely to have a funded plan than others (52% vs. 23%, p = 0.001). Guidance on testing pregnant women (for HBV) and people who inject drugs (for HCV) was available in 70% and 46% of Member States, respectively; 59% and 38% of Member States reported universal access to optimal therapies for HBV and HCV, respectively.

Conclusions: Most people living with hepatitis B and C reside in a country with a national hepatitis strategy. Governments who engaged with civil society were more advanced in their response. Member States need to finance these national strategies and ensure that those affected have access to hepatitis services as part of efforts to achieve universal health coverage.

Lay summary: The World Health Organization's goal to eliminate viral hepatitis as a public health threat by 2030 requires global action. Our results indicate that progress is being made by countries to scale-up national planning efforts; however, our results also highlight important gaps in current policies.

Keywords: HBV; HCV; Public health; direct-acting antivirals; global health; universal health coverage; viral hepatitis.

Graphical abstract

Fig. 1

WHO Member States providing viral hepatitis country profile responses, 2016-2017. (n = 135, 70% of all WHO Member States and 87% of the 325 million persons infected with viral hepatitis globally). ¹Univariate comparisons using the Pearson Chi-square test with Yates’ continuity correction for categorial variables. WHO, World Health Organization.

Fig. 2

Association between viral hepatitis indicators (including having a national plan, a plan with dedicated funding, observed World Hepatitis Day, and laws/policies on stigma and discrimination) and engagement with civil society as reported by responding Member States¹.¹Univariate comparisons using the Pearson Chi-square test with Yates’ continuity correction for categorial variables. MS, Member States.