In 2016, the global community at the World Health Assembly, adopted the first ever Global Health Sector Strategy for the elimination of Viral Hepatitis (HIV and STIs ) as a disease of public health importance by 2030. This endorsement was done by over 130 countries Ministries of Health on behalf of their governments and citizens, in Geneva Switzerland. The GHS 2016-2021 was developed to guide the health sector in implementing strategically focused responses to achieve the goals of ending AIDS, viral hepatitis B and C and sexually transmitted infections by 2030.

The strategy outlined a global vision, a global goal a set of global targets that are outlined with the 2030 Sustainable Development and relevant World Health Assembly Resolutions.

The ambitious targets were:

• To reduce by 90% new cases of chronic hepatitis B and C infections (this includes Hep B Birth Dose vaccination and other Prevention of Mother to Child transmission of HBV)

• To reduce mortality from hepatitis B and C by 65%

• To diagnose 90% of undiagnosed persons with hepatitis B and C

• To provide treatment to 80% of eligible persons diagnosed with Hepatitis B and C.

• To ensure 100% blood donations are safe (screened in quality assured standards)

Viral hepatitis and tuberculosis were the second leading causes of death among communicable diseases in 2022, after COVID-19. At the end of 2019, the major achievement of the global targets was reduction in incidence as the estimated number of people newly infected by viral hepatitis declined from 2.5 million in 2019 to 2.2 million in 2022. Of the 2.2 million new infections, 1.2 million were hepatitis B and nearly 1.0 million hepatitis C. Data from across the world based on the WHO regions varied, however the region with slow pace and high burden of infections is Africa, my mother land.

How much progress in Africa:

The data for Africa is sobering. 63% of HBV infections are in Africa. Only 18% of babies have received the hepatitis B birthdose vaccines, despite the high burden. Only 2% (WHO 4.2%) people with HBV and 10% HCV have been diagnosed while 0.1% and 12% HBV and HCV diagnosed individuals have received treatment across Africa.

Dying from viral hepatitis in Africa is becoming a bigger threat than dying from HIV/AIDS, malaria or tuberculosis. Yet, a new analysis shows that the disease remains neglected in many parts of the continent.

In Africa, chronic viral hepatitis affects over 70 million Africans (60 million with hepatitis B and 10 million with hepatitis C).

Major barriers to elimination in Africa:

• Poor political will and commitment from national governments leading to poor investments in health care services

• Low visibility and awareness of viral hepatitis

• Poor adoption of public health approach in hepatitis care

• Access to viral hepatitis treatment has not yet shifted to a public health approach. Countries have adopted WHO guidelines, but implementation lags behind and the availability of affordable and simplified regimens is limited, especially in primary health care.

Hepatitis B infection is preventable, treatable and hepatitis C virus infection (HCV) is now curable. Yet, despite the availability of diagnostic tools and effective treatment, over 90% of people living with hepatitis B and C in Africa lack much needed care.  The result is at least 200 000 deaths a year in Africa, often among the continent’s most youthful and productive population.

Fewer than 1 in 10 people in Africa have access to testing and treatment, so the disease often progresses to advanced liver disease with its associated catastrophic financial burden as well as emotional distress and stigmatization.

To improve access to hepatitis care in Africa, we must adopt the public health approach of simplification and decentralization of care, leaving no populations, including children and adolescents in the cascade of care.

We must simplify our medical and scientific language and ensure patients are properly educated and informed in the most simple and non-stigmatizing way possible each time they visit the clinic.

We must end stigma against affected populations and engage patients as equal partners in the healthcare eco-system in co-creating person centred care.

We must expand testing and linkage to care to secondary and primary levels and community settings, identifying populations at risk of developing liver cancer and linking them to care as early as possible.

We must all put on the garment of advocacy, as clinicians, researchers or patients to increase the visibility of viral hepatitis in Africa.

We must all invest in advocacy, and awareness activities to generate demand for services.

With adequate commitment from everyone, including the healthcare community, improved financial investments and resources and strong political commitment, this disease can be eliminated by 2030 in Africa and the rest of the world.