Every year on 28 July, World Hepatitis Day is held to increase the awareness and understanding of viral hepatitis as a global priority.
Viral hepatitis caused by hepatitis B and C is an important cause of morbidity and mortality globally, including in the European region. It is estimated that in the European Union (EU) and European Economic Area (EEA), approximately 4.7 million people are living with chronic hepatitis B virus (HBV) infection, 3.9 million people with chronic hepatitis C virus (HCV) infection and that each year there are around 64,000 deaths from liver cancer, cirrhosis, or other chronic liver diseases that can be attributed to HBV and HCV.
In 2015, the United Nations Member States adopted the Sustainable Development Goals (SDGs) for 2030. The SDGs are comprised of 17 goals and 179 targets, including goal 3, to promote health and wellbeing, and target 3.3: “End the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, waterborne and other communicable diseases”. In 2016, the 69th World Health Assembly endorsed the first Global Health Sector Strategy (GHSS) for viral hepatitis, with the goal of eliminating viral hepatitis as a major threat to public health by 2030 in alignment with the SDGs. Elimination is defined as a 65% reduction in hepatitis-related deaths and a 90% reduction in new chronic HBV and HCV infections compared to the 2015 baseline.
ECDC coordinates the European Hepatitis B and C Network, which is a well-established network of public health and clinical contact points from all EU/EEA countries who work together on the surveillance, monitoring, prevention and control of hepatitis. ECDC also works in close collaboration with partner organisations including the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the European Association for the Study of the Liver (EASL) and WHO to support countries in their work towards the goal of viral hepatitis elimination.
On this World Hepatitis Day, ECDC publishes its annual epidemiological reports on Hepatitis B and C, which reveal the overall trends in the EU/EEA countries in 2019 (https://www.ecdc.europa.eu/en/publications-data/hepatitis-b-annual-epidemiological-report-2019 and https://www.ecdc.europa.eu/en/publications-data/hepatitis-c-annual-epidemiological-report-2019). These reports indicate a continued decline in the notifications of acute hepatitis B, which can be largely attributed to the impact of vaccination against HBV in the region.
ECDC has established a monitoring system to support countries in monitoring their progress towards the elimination targets and is currently collecting data from EU/EEA countries to determine progress towards the 2020 interim targets of the WHO European Action Plan for hepatitis. The monitoring system was rolled out in 2019 and a first report based on the data was published last year (https://www.ecdc.europa.eu/sites/default/files/documents/hepatitis-B-C-monitoring-responses-hepatitis-B-C-epidemics-EU-EEA-Member-States-2019_0.pdf). This report indicated that the EU will not meet the 2030 targets unless the following gaps are addressed:
- Prevention gap. Primary prevention must be scaled up, with evidence of sub-optimal implementation of universal childhood HBV vaccination programmes and harm reduction measure to prevent transmission among people who inject drugs
- Diagnosis and treatment gap. A high proportion of people infected with hepatitis B and C remain undiagnosed and are not treated with the highly effective antiviral treatments that are now available. People living with hepatitis should not have to wait until their chronic liver disease reaches an advanced stage such as cirrhosis and liver cancer. Testing and diagnostics for hepatitis needs to be accessible NOW, so people can be diagnosed in a timely manner and receive life-saving treatment.
- Gaps in the data. Data gaps need to be addressed as a priority through strong political commitment to improve country monitoring systems ensuring adequate resources for public health information as well as greater collaboration between clinical and public health bodies. Robust information for action is the starting point for the development of sound strategic responses to the epidemics.
World Hepatitis Day has been observed annually since 2011 on 28 July, the birthday of Nobel-prize winning scientist Dr Baruch Blumberg, who discovered the Hepatitis B virus in 1967. COVID-19 has demonstrated what can be achieved in a short time in communicable disease control highlighting the potential for achieving the hepatitis elimination targets by 2030 given the highly effective diagnostic and therapeutic tools that are now available.