As the world marks World Hepatitis Day on July 28, it is essential to remind ourselves of the silent but devastating war hepatitis has waged against global public health. Recognised by the World Health Organization (WHO) as one of the leading causes of death worldwide, hepatitis is responsible for 1.3 million deaths every year, rivalling major killers like HIV/AIDS, tuberculosis, and malaria. Despite its scale, hepatitis remains under-diagnosed, underfunded, and widely misunderstood. Hepatitis refers to inflammation of the liver, commonly caused by viral infections. There are five main hepatitis viruses: A, B, C, D, and E. Of these, hepatitis B and C are the most dangerous and cause chronic liver disease, liver cancer, and death. Together, these two viruses are responsible for the majority of hepatitis-related fatalities. Across continents, hepatitis has left a trail of destruction.
Africa bears a disproportionate share of the global hepatitis burden. According to WHO, over 100 million Africans are living with chronic hepatitis B or C. In Nigeria, the most populous African country, around 20 million people are infected with hepatitis B alone. The disease is often transmitted from mother to child at birth, during unsterile medical procedures, or through unsafe blood transfusions. What makes the situation worse is the lack of awareness, inadequate testing facilities, and limited access to treatment. In rural areas, many people die without even knowing they had hepatitis. Governments are making efforts, but challenges such as poor healthcare infrastructure and competing health priorities tend to hamper progress.
Asia accounts for the highest number of hepatitis cases globally. Countries like India, Pakistan, Indonesia, and Bangladesh see millions of new infections annually. In India, an estimated 40 million people are chronically infected with hepatitis B, and another 6-12 million with hepatitis C. The situation is compounded by poor sanitation, unsafe injection practices, and the reuse of medical equipment. The lack of robust national screening programmes means that a large portion of the infected population remains undiagnosed until complications arise. However, some progress is being made, with increasing vaccine coverage and improved access to antiviral drugs.
China has one of the world’s largest populations affected by hepatitis B. Nearly 90 million people live with chronic hepatitis B infection. While the country has made remarkable strides by implementing a nationwide hepatitis B vaccination programme for newborns since the 1990s, those born before then remain vulnerable. Thanks to government-led initiatives, the prevalence of hepatitis B in children under five has dropped from 10% in the 1990s to less than 1% today. Yet, adult cases remain high, and many are unaware of their status until it is too late. Chronic hepatitis B and C are leading causes of liver cancer in China, making the disease a priority area for public health intervention.
In Japan, hepatitis C remains a significant health problem. Historically, transmission occurred through blood transfusions and contaminated needles, particularly before 1990 when screening of blood donors for hepatitis C began. Although Japan has a well-developed healthcare system, hepatitis C still causes a high number of liver cancer deaths. The availability of direct-acting antiviral has revolutionised treatment, allowing most patients to be cured within 8-12 weeks. However, challenges remain in identifying undiagnosed cases, especially among the elderly population. In the wider Far East, countries like Vietnam, Thailand, and the Philippines report high levels of hepatitis B and C, largely due to insufficient vaccination coverage and limited public health funding.
In Europe, the epidemiological picture of hepatitis is more varied. Eastern and southern Europe face higher infection rates compared to western countries. The European Centre for Disease Prevention and Control reports that an estimated 4.7 million people in the EU/EEA live with chronic hepatitis B, and another 3.9 million with hepatitis C. Migrant communities and people who inject drugs are among the most affected populations. While healthcare infrastructure is stronger than in many parts of the world, stigma, low awareness, and underreporting continue to hinder effective disease control.
The medical community has made significant progress in the fight against hepatitis, particularly with the development of vaccines and antiviral therapies. The hepatitis B vaccine, introduced in the 1980s, has become a cornerstone of prevention efforts. Many countries now include it in their national immunisation schedules. For hepatitis C, the advent of direct-acting antiviral marked a turning point. These medications can cure more than 95% of infected individuals with minimal side effects. However, access to these drugs is not uniform globally. High treatment costs, lack of health insurance, and weak health systems limit availability in low-income countries. WHO has set a target to eliminate hepatitis B and C as public health threats by 2030, which includes reducing new infections by 90% and deaths by 65%. Achieving this goal will require concerted global efforts, political commitment, and massive investment in screening, vaccination, and treatment.
Hepatitis testing
On this World Hepatitis Day, there are critical actions that individuals, organisations, and governments can take to contain the spread and impact of hepatitis. Individuals must get tested, get vaccinated, practice safe hygiene, avoid sharing needles, razors, or toothbrushes, and ensure that any blood transfusion is from a certified source. Staying informed about how hepatitis is transmitted and prevented is equally important. Organisations should promote testing and awareness campaigns within workplaces, schools, and communities. They should also support affected employees with healthcare benefits and medical leave, and partner with NGOs and public health agencies to sponsor hepatitis-related programmes. Governments must integrate hepatitis screening and treatment into national healthcare services, subsidise the cost of antiviral treatments, and expand access to lifesaving medications. Strengthening healthcare infrastructure to handle widespread testing and monitoring and enforcing regulations on medical practices are essential steps to prevent iatrogenic transmission.
Hepatitis is not a disease of the poor or the distant. It is a global public health issue that affects every continent, every class, and every demographic. It destroys lives quietly, often undiagnosed until it causes irreversible liver damage. On World Hepatitis Day, the global community must recognise that silence and inaction are the disease’s strongest allies. By investing in education, prevention, and treatment, we can move from awareness to elimination. The goal is achievable. The tools are available. What is needed now is political will, international cooperation, and collective responsibility. Let July 28 serve as a reminder that in the fight against hepatitis, we are not alone. Together, we can end this silent epidemic and protect future generations from its deadly grip.
