Global hepatitis report 2024: action for access in low- and middle-income countries

Globalhepatitisreport2024 Actionforaccessinlow-andmiddle-incomecountries Globalhepatitisreport2024 Actionforaccessinlow-andmiddle-incomecountries Globalhepatitisreport2024:actionforaccessinlow-andmiddle-incomecountriesISBN978-92-4-009167-2(electronicversion) ISBN978-92-4-009168-9(printversion) ©WorldHealthOrganization2024 Somerightsreserved.ThisworkisavailableundertheCreativeCommonsAttribution-NonCommercial-ShareAlike3.0IGOlicence(CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Underthetermsofthislicence,youmaycopy,redistributeandadapttheworkfornon-commercialpurposes,providedtheworkisappropriatelycited,asindicatedbelow.Inanyuseofthiswork,thereshouldbenosuggestionthatWHOendorsesanyspecificorganization,productsorservices.TheuseoftheWHOlogoisnotpermitted.Ifyouadaptthework,thenyoumustlicenseyourworkunderthesameorequivalentCreativeCommonslicence.Ifyoucreateatranslationofthiswork,youshouldaddthefollowingdisclaimeralongwith thesuggestedcitation:“ThistranslationwasnotcreatedbytheWorldHealthOrganization(WHO).WHOisnotresponsibleforthecontentoraccuracyofthistranslation.TheoriginalEnglisheditionshallbethebindingandauthenticedition”. AnymediationrelatingtodisputesarisingunderthelicenceshallbeconductedinaccordancewiththemediationrulesoftheWorldIntellectualPropertyOrganization(http://www.wipo.int/amc/en/mediation/rules/). Suggestedcitation.Globalhepatitisreport2024:actionforaccessinlow-andmiddle-incomecountries.Geneva:WorldHealthOrganization;2024.Licence:CCBY-NC-SA3.0IGO. Cataloguing-in-Publication(CIP)data.CIPdataareavailableathttps://iris.who.int/. Sales,rightsandlicensing.TopurchaseWHOpublications,seehttps://www.who.int/publications/book-orders.Tosubmitrequestsforcommercialuseandqueriesonrightsandlicensing,seehttps://www.who.int/copyright. Third-partymaterials.Ifyouwishtoreusematerialfromthisworkthatisattributedtoathirdparty,suchastables,figuresorimages,itisyourresponsibilitytodeterminewhetherpermissionisneededforthatreuseandtoobtainpermissionfromthecopyrightholder.Theriskofclaimsresultingfrominfringementofanythird-party-ownedcomponentintheworkrestssolelywiththeuser. Generaldisclaimers.ThedesignationsemployedandthepresentationofthematerialinthispublicationdonotimplytheexpressionofanyopinionwhatsoeveronthepartofWHOconcerningthelegalstatusofanycountry,territory,cityorareaorofitsauthorities,orconcerningthedelimitationofitsfrontiersorboundaries.Dottedanddashedlinesonmapsrepresentapproximateborderlinesforwhichtheremaynotyetbefullagreement. Thementionofspecificcompaniesorofcertainmanufacturers’productsdoesnotimplythattheyareendorsedorrecommendedbyWHOinpreferencetoothersofasimilarnaturethatarenotmentioned.Errorsandomissionsexcepted,thenamesofproprietaryproductsaredistinguishedbyinitialcapitalletters. AllreasonableprecautionshavebeentakenbyWHOtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallWHObeliablefordamagesarisingfromitsuse. Contents iii 1 2 3 4 5 Foreword iv Acknowledgements v Abbreviations vi Executivesummary vii 1.Introduction 2 2.Globalprogresstowardsimpact 10 2.1Diseaseburden 11 2.2Testingandtreatmentcoverage 22 2.3Forecastsfor2025and2030 34 3.Globalstatusofaccesstohealthproducts 40 3.1Normativeguidance 40 3.2Accesstodiagnostics 51 3.3Accesstomedicines 69 3.4Accesstovaccination 109 4.Regionallandscapeofaccesstohealthproducts 114 4.1AfricanRegion 114 4.2RegionoftheAmericas 131 4.3South-EastAsiaRegion 144 4.4EuropeanRegion 159 4.5EasternMediterraneanRegion 174 4.6WesternPacificRegion 186 5.Lookingahead:publichealthactiontoeliminateviralhepatitisin low-andmiddle-incomecountriesby2030204 References213 Annex.Low-andmiddle-incomecountriesandterritoriesnotincludedin atleastonevoluntarylicensingagreementforviralhepatitismedicines,2023220 WebAnnex.MethodforglobalreportingondiseaseburdenandservicecoveragedataforviralhepatitisBandC ivGlobalhepatitisreport2024:Actionforaccessinlow-andmiddle-incomecountries Foreword In2023,IhadthehonourofpresentingEgyptwithanofficialcertificationforbecomingthefirstcountrytoachievegoldtierstatusonthepathtoeliminationforhepatitisC.Thistremendousachievementcouldbewithinthereachofmanyothercountries.Wehavetheknowledgeandtoolstoprevent,diagnoseandtreatviralhepatitis,andtheabilitytodeliverservicesattheprimaryhealthcarelevel-closertocommunitiesinneed.Yetdespite thisprogress,mostpeoplearoundtheworldwithchronichepatitisBandCarestillwaitingtoaccesstheservicestheyneed,anddeathsareontherise. ThisfirstconsolidatedWHOglobalreportonviralhepatitisisacalltoactionforasimplifiedandequitablepublichealthapproachtoeliminateviralhepatitis. Thegoalisfeasible.MorecountriesareadoptingWHOguidelines,developingnationalplans,andincludingviralhepatitisservicesinuniversalhealthcarepackages.Vaccines,rapiddiagnostictestsandgenericmedicinesareavailableataffordableprices;andlocalproductionismakingitpossibleto