Only 11 countries are on course to meet their goals for
elimination of hepatitis C by 2030, while five countries with the
highest burdens of hepatitis C are unlikely to achieve elimination before 2050,
Sarah Blach of the Center for Disease Analysis Foundation reported at last
week’s AASLD Liver Meeting in Washington DC.
The countries currently on track to reach the 2030 targets
for hepatitis C include Australia, Canada, Denmark, Egypt, Finland, France,
Georgia, Japan, Norway, Spain and the United Kingdom.
Concerningly, China, India, Pakistan, Brazil and the United States are
each unlikely to achieve the critical targets for hepatitis C elimination before
2050, according to projections and plans analysed by the Center for Disease
To achieve hepatitis C elimination, countries must meet the following
targets set by the World Health Organization:
- 80% reduction in incidence or hepatitis C
incidence below 5 per 100,000
- 65% reduction in hepatitis C-related mortality
or mortality below 2 per 100,000
- 90% of people with hepatitis C are diagnosed
- 80% of diagnosed people are treated.
Sarah Blach said that some countries that had appeared to be on
track in previous surveys were falling behind.
“There were countries that we thought were going to be a
shoo-in, but the number of treatments has just dropped, so it changes from year
to year,” said Sarah Blach. Sustaining the rate of testing and treatment will
be critical for achieving the targets in each country. Although many countries
have expanded criteria for treatment, most countries have not expanded
prescribing beyond hepatitis specialists, leaving limited capacity to increase
the number of people receiving treatment, she explained.
No countries are on track to achieve targets for reducing
hepatitis B-related deaths or infections by 2030 and none will reach the
targets before 2050, current projections show.
However, more than 80 countries will achieve the target to
reduce hepatitis B prevalence in children under five years to below 5% by 2030.
This target will be achieved as a result of greater availability and uptake of
the hepatitis B birth dose vaccination.
Most countries that reach the target for reducing hepatitis
B prevalence in children by 2030 are higher-income or middle-income countries.
Most of the lower-income countries in sub-Saharan Africa will not reach the
target before 2050, although countries in east Africa, together with India and
Pakistan, are all expected to reach the target at some point between 2031 and
Progress towards the targets is affected by financing and
political will. The Center for Disease Analysis Foundation carried out a review
of national policies that were in place between 2020 and 2022, to assess the
degree of political will and the level of financing available for the
elimination of viral hepatitis.
The researchers identified 61 national policy surveys, of
which 30% demonstrated a high level of political will to eliminate hepatitis B,
according to qualitative interviews with local stakeholders. Forty-two per cent
demonstrated a high level of political will to eliminate hepatitis C.
Just over half of countries received high scores for
financing of their elimination programmes.
Hepatitis B policies lag behind hepatitis C. No countries
are on track for elimination and expanded screening and treatment for hepatitis
B are needed, Sarah Blach concluded.