Viral hepatitis is a major contributor to the global burden of disease, causing an estimated 1·34 million deaths per year—a figure comparable with other major infectious diseases such as HIV/AIDS, tuberculosis, and malaria.1Despite this burden, policies to reduce the impact of viral hepatitis have lagged behind those for the other major communicable diseases. The Sustainable Development Goals, adopted in September, 2015, recognised the importance of addressing viral hepatitis, and in addition to pledging to end the epidemics of HIV/AIDS, tuberculosis, malaria, and other neglected tropical diseases by 2030, also promised to combat hepatitis and other communicable diseases.2In 2016, WHO’s Global Health Sector Strategy outlined plans to eliminate viral hepatitis as a threat to public health, setting a target of a 90% reduction in new infections and a 65% reduction in viral hepatitis-related mortality by 2030.3
These targets are ambitious and require concerted collaboration and innovation to be achieved. With these targets in mind, The Lancet Gastroenterology & Hepatology launched our first Commission in 2016 to gather a team of experts to assess the current global situation and to identify priorities for action—at a national, regional, and global level—to accelerate progress towards the elimination of viral hepatitis.4
Led by Graham Cooke (Imperial College London, London, UK) and involving representatives of the European Association for the Study of the Liver, the American Association for the Study of Liver Diseases, the Asian Pacific Association for the Study of the Liver, and the Latin American Association for the Study of the Liver, the Commission identifies the 20 countries with the heaviest burden of disease related to hepatitis B virus (HBV) and hepatitis C virus (HCV), assessed as disability-adjusted life-years. Together, these countries represent 75% of the global burden, the vast majority of which falls in low-to-middle-income countries, predominantly in Asia and sub-Saharan Africa. Investment—either by leverage of existing donors and agencies or via innovative financing measures—will be essential to support countries to develop elimination plans and to put them into action.
Global support for elimination efforts has been meagre compared with that for HIV/AIDS, malaria, and tuberculosis, and the case for such investment must be made much more forcefully to policy makers to ensure progress. As discussed in an accompanying Comment, the involvement of civil society is essential here.5