Letter to the Editor Open Access
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2021; 27(47): 8199-8200
Published online Dec 21, 2021. doi: 10.3748/wjg.v27.i47.8199
Progress on global hepatitis elimination targets
Yasir Waheed
Yasir Waheed, Multidisciplinary Laboratory, Foundation University Medical College, Foundation University Islamabad, Islamabad 44000, Pakistan
ORCID number: Yasir Waheed (0000-0002-5789-4215).
Author contributions: Waheed Y solely contributed to the article.
Conflict-of-interest statement: The authors declare having no conflicts of interest in relation to this publication.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yasir Waheed, PhD, Associate Professor, Multidisciplinary Laboratory, Foundation University Medical College, Foundation University Islamabad, Defense Avenue, DHA 1, Islamabad 44000, Pakistan. yasir_waheed_199@hotmail.com
Received: July 13, 2021
Peer-review started: July 13, 2021
First decision: August 19, 2021
Revised: August 24, 2021
Accepted: December 7, 2021
Article in press: December 7, 2021
Published online: December 21, 2021

Abstract

In 2016, the World Health Assembly adopted a Global Health Sector Strategy on viral hepatitis, with targets set for the years 2020 and 2030 to achieve hepatitis elimination. The main target of hepatitis elimination strategy is to reduce the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) by 90% and mortality by 65% in 2030. In last 5 years, the number of people receiving HCV treatment has increased from 1 million to 9.4 million; however, this number is far from the 2030 target of 40 million people receiving HCV treatment. HBV and HCV incidence rates are down from 1.4 million to 1.1 million annual deaths but this is far from the 2030 target of < 0.5 million deaths. The coronavirus disease 2019 pandemic has severely affected the efforts in the fight against hepatitis. No major donor has committed to investing in the fight against hepatitis. Time is running out. There is a need to speed up efforts in the fight against hepatitis to achieve hepatitis elimination by 2030.

Key Words: Hepatitis elimination, Blood donations, Safe injections, Hepatitis B vaccination, Harm reduction

Core Tip: In 2020, progress was made in improving blood donations, hepatitis B and C treatments, and decreasing the incidence of hepatitis B and C. Some of the 2020 targets for hepatitis elimination were achieved but the 2030 targets are very ambitious and need strong political and financial support.



TO THE EDITOR

I read articles from Tijera et al[1], and Pisano et al[2], on viral hepatitis update, progress, challenges, and ways to elimination. Both articles are discussing important points on viral hepatitis but both are missing the actual progress on hepatitis elimination targets set by World Health Organization (WHO).

In this article, I am presenting the latest data on targets set by the WHO to achieve hepatitis elimination by 2030. In last 5 years, the incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) has decreased from 8 million infections to 3 million infections per year and mortality has decreased from 1.4 million deaths to 1.1 million deaths per year[3]. Only 17 countries had a national hepatitis strategic plans in 2012, but this increased to 124 by 2019[3].

The WHO Global Health Sector Strategy on viral hepatitis has shown five areas in which progress is requested to achieve hepatitis elimination by 2030. These areas are: HBV vaccination, birth dose HBV vaccination, safe injection, harm reduction, and diagnosis and treatment of HBV and HCV[4].

From 2015 to 2020, the worldwide coverage of the third dose of HBV vaccine has increased from 82% to 85% and administration of birth dose of HBV vaccine has increased from 38% to 43%. The number of safe blood donations has increased from 89% to 97% and only 3.9% of injection equipment are still reused. The number of clean syringes given to each person who inject drugs per year has increased from 20 to 33. The HBV diagnosis rate has increased from < 5% to 10% and 22% of diagnosed cases received treatment. The HCV diagnosis rate has increased from < 5% to 21%, and 62% of diagnosed cases received treatment[3,4].

New data shows progress with reference to 2020 hepatitis elimination targets for blood donation screening, HBV and HCV treatments, reduction in drug pricing, and decreasing the incidence of HBV and HCV[3]. However, the 2030 targets of hepatitis elimination are very ambitious and need a strong political and financial commitment[5].

Hepatitis elimination targets needs an investment of US $6 billion per year[3]. No major donor has committed to the fight against hepatitis[3]. Many countries with well-developed hepatitis control programs are lacking financial resources to achieve targets.

The coronavirus disease 2019 (COVID-19) pandemic has severely affected the hepatitis elimination targets. Outpatient departments/liver clinics have remained closed in many countries due to lockdown restrictions. Many countries have spent a major proportional of their health budget on COVID-19 and the nascent viral hepatitis programs are being held back due to a lack of funding[3].

This is the time to put money into the fight against hepatitis and increase HBV and HCV diagnosis and treatment rates[5]. There is a strong need to obtain a cure for HBV and further develop and simplify hepatitis screening tests and make them available in primary health care settings[3]. It is the time to set interim hepatitis elimination targets for 2026 as a milestone towards 2030 targets.

Footnotes

Provenance and peer review: Invited article; Externally peer reviewed.

Peer-review model: Single blind

Specialty type: Gastroenterology and hepatology

Country/Territory of origin: Pakistan

Peer-review report’s scientific quality classification

Grade A (Excellent): A

Grade B (Very good): 0

Grade C (Good): C

Grade D (Fair): 0

Grade E (Poor): 0

P-Reviewer: Komatsu H, Poustchi H S-Editor: Wang LL L-Editor: Filipodia P-Editor: Wang LL

References
1.  Tijera FH, Servin-Caamano A, Servin-Abad L. Progress and challenges in the comprehensive management of chronic viral hepatitis: key ways to achieve the elimination. World J Gastroenterol. 2021;27:4004-4017.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 1]  [Cited by in F6Publishing: 1]  [Article Influence: 1.0]  [Reference Citation Analysis (3)]
2.  Pisano MB, Re VE. Viral hepatitis update: progress and perspectives. World J Gastroenterol. 2021;27:4018-4044.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 9]  [Cited by in F6Publishing: 6]  [Article Influence: 9.0]  [Reference Citation Analysis (4)]
3.  World Health Organization 2021  Global progress report on HIV, viral hepatitis and sexually transmitted infections. [cited 13 July 2021]. Available from: https://www.who.int/publications/i/item/9789240027077.  [PubMed]  [DOI]  [Cited in This Article: ]
4.  World Health Organization 2016  Global Health Sector Strategies on Viral Hepatitis 2016-2021. [cited 13 July 2021]. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_32-en.pdf?ua=1.  [PubMed]  [DOI]  [Cited in This Article: ]
5.  Waheed Y, Siddiq M, Jamil Z, Najmi MH. Hepatitis elimination by 2030: Progress and challenges. World J Gastroenterol. 2018;24:4959-4961.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 49]  [Cited by in F6Publishing: 41]  [Article Influence: 12.3]  [Reference Citation Analysis (0)]