Disclaimer: This post is for academic purposes only. Please read the original document if you intend to use them for clinical purposes.
This document summarises the WHO Global Hepatitis Report 2026: Progress, Challenges, and the Road to 2030 Elimination. The global effort to eliminate viral hepatitis as a public health threat by 2030 is currently off track. While the tools and strategies for elimination are firmly established, progress remains slow, uneven, and disproportionate to the scale of the challenge. This underscores an urgent need for political recalibration, increased investment, and the integration of hepatitis services into primary health care (PHC) to save millions of lives.
Advertisement:
1. Global Burden:
Viral hepatitis is one of the most significant public health challenges worldwide. While five distinct viruses (A, B, C, D, and E) cause the disease, HBV and HCV are responsible for over 95% of all hepatitis-related mortality.
1.1 Viral Profiles and Transmission:
- Hepatitis A (HAV): Usually transmitted via contaminated food or water. It does not cause chronic infection, and a vaccine is available.
- Hepatitis B (HBV): Transmitted through infected blood, bodily fluids, and from mother to child. In highly endemic areas, most infections occur in children under five. Chronic infection can lead to cirrhosis and liver cancer. Vaccine is available.
- Hepatitis C (HCV): Transmitted via contact with infected blood, often through unsafe medical procedures or injecting drug use. It can lead to serious liver illness but is curable with a 12-week anti-viral regimen.
- Hepatitis D (HDV): A “defective” virus that only replicates in the presence of HBV. HBV-HDV co-infection is the most aggressive form of viral hepatitis.
- Hepatitis E (HEV): Transmitted via the fecal-oral route. While usually self-resolving, it can lead to acute liver failure.
1.2 Impact on Global Health (2024 estimates):
- Chronic HBV Infections: 240 million people (2.9% of the global population).
- Viremic HCV Infections: 47 million people.
- Annual Mortality: 1.34 million total deaths (1.1 million from HBV; 240,000 from HCV).
- New Infections: 1.8 million annually (0.9 million HBV; 0.9 million HCV).
2. Framework for Elimination:
The global response is guided by the WHO Global Health Sector Strategy (GHSS) 2022–2030, which aligns with the UN Sustainable Development Goals (SDG).
2.1 The 5 Core Interventions:
To achieve elimination, countries must scale up 5 evidence-based interventions:
- Vaccination: Specifically the HBV birth dose followed by infant doses.
- PMTCT (Prevention of Mother-to-Child Transmission): Including anti-viral prophylaxis for pregnant women.
- Blood and Injection Safety: Ensuring 100% screening of donated blood and safe medical practices.
- Harm Reduction: Providing sterile needles and syringes for people who inject drugs (PWID).
- Testing and Treatment: Expanding access to diagnostics and affordable antiviral therapies.
3. Epidemic Trends and Progress Assessment (2015–2024):
Progress toward the 2030 impact targets is mixed, with significant disparities between HBV and HCV outcomes:
| Indicator: | 2030 Target: | Status (2024): | Trend: |
| HBV New Infections | 95% Reduction | 32% Reduction | Improving but slow |
| HCV New Infections | 80% Reduction | 8.1% Reduction | Significantly off track |
| HBV Deaths | 65% Reduction | 17% Increase | Moving in wrong direction |
| HCV Deaths | 65% Reduction | 12% Reduction | Improving but slow |
| Child HBV Prevalence | 0.1% | 0.6% | Off track |
3.1 Hepatitis B: Persistence of Childhood Infection
Despite the 32% decline in new infections, HBV mortality is rising because millions infected decades ago are only now progressing to cirrhosis and liver cancer. The WHO African Region bears 68% of new HBV infections. A critical barrier is the low coverage of the HBV birth-dose vaccine in Africa (17%), where 20 out of 47 countries have yet to implement the intervention.
3.2 Hepatitis C: Transmission Drivers
HCV incidence has declined only by 8.1% since 2015.
- Injecting Drug Use: Accounts for approximately 44% of new HCV infections globally.
- Unsafe Medical Injections: Responsible for an estimated 14% of new HCV infections, with the highest contributions in the South-East Asia (21%) and European (18%) regions.
- Harm Reduction Gap: The global average of needles distributed per PWID is 35, far below the 2030 target of 300.
4. Service Coverage and Access Gaps:
The “cascade of care”—the path from diagnosis to treatment—shows profound deficiencies.
4.1 Diagnosis and Treatment Status (2024):
- HBV: Only 27% of people with chronic HBV are diagnosed. Of those eligible for treatment, only 4.3% are receiving it.
- HCV: 36% of the cumulative total of people with HCV have been diagnosed. Only 20% of the eligible population has been treated. Approximately 11 million diagnosed individuals are alive but remain untreated.
4.2 Economic Barriers:
The cost of treatment varies significantly by market:
- HBV (Tenofovir): US$ 34 to US$ 300 per person annually.
- HCV direct-acting antivirals (DAAs): US$ 55–100 in “access markets” (generic) versus US$ 300–500 in non-access markets.
5. Geographic Distribution:
The burden of viral hepatitis is concentrated in specific regions and countries, necessitating targeted intervention.
- HBV Concentration: 10 countries account for 69% of global HBV deaths: China, India, Indonesia, Nigeria, South Africa, Vietnam, Bangladesh, Ethiopia, Ghana and Philippines.
- HCV Dispersion: HCV deaths are more geographically dispersed. 10 countries account for 58% of the global deaths: China, India, Indonesia, Nigeria, South Africa, Vietnam, Pakistan, Russia, USA and Japan.
- Regional Successes: 85 countries have already achieved the childhood HBV prevalence target of <0.1%, primarily in the WHO European region and the region of the Americas.
6. Priorities:
To meet the 2030 targets, the report calls for a renewed urgency and coordinated action in the following areas:
- Scaling Up the HBV Birth Dose: Particularly in the African region, to halt mother-to-child transmission.
- Integrating Services: Moving hepatitis care into PHC settings to reach affected communities more effectively.
- Expanding Harm Reduction: Rapidly increasing the distribution of sterile needles and syringes and addressing the global opioid epidemic.
- Improving Data Systems: Closing data gaps, especially in the African and South-East Asia regions, to better track transmission drivers and program impact.
- Universal Access: Leveraging generic manufacturing and voluntary licensing to make diagnostics and medicines affordable in all settings.
The tools for elimination—vaccines with 95% efficacy and cures with 95% success rates—exist. The challenge remains the political and financial commitment required to deploy them at the necessary scale.
Citation: Global hepatitis report 2026. Geneva: World Health Organization; 2026. Licence: CC BY-NC-SA 3.0 IGO.
