Ten countries, including India, shoulder nearly two-thirds of the global burden of hepatitis B and C, the World Health Organisation said in its Global Hepatitis Report, sounding an alarm on viral hepatitis infections that globally claimed 3,500 lives a day.

The disease is the second-leading infectious cause of death globally, with 1.3 million deaths annually — the same as tuberculosis, a top infectious killer. Despite generic medicines and other options being available for diagnosis and treatment, countries were failing to procure them at lower prices, the report noted. If swift action is taken, the goal to eliminate hepatitis by 2030 should still be achievable, the WHO said.

The report called for universal access to prevention, diagnosis, and treatment in the ten countries mentioned by 2025, besides intensifying efforts in the African region, to get the global response on track. The countries included Bangladesh, China, Ethiopia, Indonesia, Nigeria, Pakistan, the Philippines, the Russian Federation, and Vietnam.

Generic options

Countries are failing to procure affordable generic viral hepatitis medicines at lower prices, despite their availability, the WHO said, adding that countries were paying above global benchmarks, even for off-patent drugs or those included in voluntary licensing agreements.

Though tenofovir for hepatitis B treatment is off-patent and available at a global price of $2.4 per month, “only seven of the 26 reporting countries paid prices at or below the benchmark,” the WHO said. “Similarly, a 12-week course of pangenotypic sofosbuvir/daclatasvir to treat hepatitis C is available at a global benchmark price of $60, yet only four of the 24 reporting countries paid prices at or below the benchmark,” it added.

The report calls for strengthening primary care prevention efforts, simplifying service delivery, and optimising product regulation and supply, among other things, towards the end goal. Pointing to other challenges, the report said that funding for viral hepatitis at a global and country level was not sufficient. This was due to limited awareness of cost-saving interventions and tools, as well as competing priorities on global health agendas, it noted.

Updated WHO estimates indicate that 254 million people live with hepatitis B and 50 million with hepatitis C in 2022. Across all regions, only 13 per cent of those living with chronic hepatitis B infection had been diagnosed, and approximately 3 per cent (seven million) had received antiviral therapy at the end of 2022. Regarding hepatitis C, 36 per cent had been diagnosed, and 20 per cent (12.5 million) had received curative treatment, the report said.

These results fall well below the global targets to treat 80 per cent of people living with chronic hepatitis B and hepatitis C by 2030, the report said, adding, however, that they did indicate a slight but consistent improvement in diagnosis and treatment coverage since 2019.