Towards the elimination of viral hepatitis
14 of the 20 countries with the highest burden of viral hepatitis have made progress towards eliminating it, according to a policy index developed by the Lancet Commission on Viral Hepatitis Elimination, led by the Barcelona Institute of Global Health (ISGlobal), a center supported by the La Caixa Foundation.
However, greater investment is needed to support health personnel, scientists and local activists in implementing and monitoring national plans in all countries.
Most of the cargo is concentrated in 20 countries.
Twenty countries account for more than 75% of the global burden of viral hepatitis (HBV and CHB). This means that global eradication targets set for 2030 (a 90% reduction in disease incidence and a 65% reduction in mortality) will not be achieved without an effective response in these 20 countries.
“By burden, we mean not only the number of infections in these countries, but also the years lived with disability due to them,” says Jeffrey W. Lazarus, an ISGlobal researcher who led the three-year study with three other global experts. Lancet Commission on Progress in Eliminating Viral Hepatitis.
To track the country’s progress in eliminating hepatitis, the Commission developed index based on 11 policies the key to elimination. The first assessment was carried out in 2018, and the second in 2023. The analysis, carried out with the participation of national experts from each of the 20 countries, shows that countries with stronger policies In 2018 (Brazil, Egypt and the USA) they continued their offensive. Egypt remains an example of what can be achieved with limited resources, with one of the most ambitious screening programs in the world and free provision of HBV vaccine at birth. In the same way, Brazil has been advocating for free and sustainable access to HCV therapy since 2015.
National plans, screening and antiviral drugs
All in all, 14 out of 20 countries have made progress since 2018, largely thanks to national action plans, government screening and subsidized antiviral treatment. The most significant progress has been made in Bangladesh, India, Indonesia, Japan and Russia. Ukraine, Myanmar and Ethiopia have made little progress due to political unrest and war. And some countries, such as Pakistan and the Philippines, saw their economic policy index scores decline.
From conversations with national experts, some key topicsfor example, greater emphasis on simplified care modelsAccess to correct diagnoses And care financing hepatitis A. Some have also been identified lessons from the pandemic COVID-19, for example, use telemedicineHe automatic diagnostics And decentralization attention. Other important measures include setting global prices for antiviral drugs and decriminalizing drug use in many of these countries.