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In 2016, the World Health Assembly adopted the Global Health Sector Strategy (GHSS) on viral hepatitis. The GHSS called for elimination of viral hepatitis B and C infection as a public health problem (defined as a 90% reduction in incidence [95% for HBV and 80% for HCV] and 65% reduction in mortality by 2030, compared with the 2015 baseline). A broad range of countries have now developed national viral hepatitis plans, and several countries also requested guidance from the World Health Organization (WHO) on the establishment of global criteria for measuring elimination of viral hepatitis and a standardized process for validation of elimination. WHO has developed this interim guidance for countries and other stakeholders seeking validation of elimination of viral hepatitis as a public health problem, with a specific focus on hepatitis B virus (HBV) and hepatitis C virus (HCV). It provides a global framework for the processes and standards for validation of elimination, and overall proposes the use of absolute impact targets to validate elimination at the national level (instead of, although equivalent to, the relative reduction targets originally defined in the 2016 GHSS) in combination with a set of programmatic targets.
Triple elimination of mother-to-child transmission (MTCT) of HIV, syphilis and hepatitis B virus (HBV) requires a person- centred service delivery approach that meets the needs of and supports the rights of women, newborns, children and families and requires building cross-programmatic efficiencies that leverage and strengthen existing platforms for HIV, syphilis and HBV prevention, testing, treatment and care. With the recent release of guidance for validation of triple elimination and the 2023 guidance on country validation of viral hepatitis elimination and the path to elimination, WHO and partners have developed an accompanying 4 pillars framework for triple elimination implementation. The new framework will guide efforts to expand the focus of service delivery from elimination of MTCT of HIV to triple elimination of HIV, syphilis and HBV. The 4 pillars are: 1. Primary prevention of infection and vertical transmission; 2. SRH linkages and integration; 3. Essential maternal EMTCT services; and 4. Infant, child and partner services.
This publication summarizes the approach proposed by WHO to collect, analyse, report, disseminate and use strategic information on viral hepatitis at the subnational, national and global levels. These guidelines strengthen person-centred monitoring – with a priority for indicators that support person-centred health services, the core prevention, diagnosis and treatment interventions. The guidelines describe the use of strategic information at various stages of the response in the context of strengthening broader health information systems. Strategic information can be defined as data collected at all service delivery and administrative levels to inform policy and programme decisions. The guidelines recommends the stepwise guidance to build country health information systems so countries use data to strengthen the scaling up of viral hepatitis programmes. The key new additions to the guidelines are: - an updated strategic information framework for chronic viral hepatitis B & C; - a new section on person-centred data monitoring for chronic viral hepatitis B & C; - a stepwise recommendation for strengthening country surveillance for viral hepatitis; and - consolidated metadata tables for viral hepatitis indicators.
This report is the first of a series of biennial progress reports on the implementation of the Global health sector strategies on HIV, viral hepatitis and sexually transmitted infections for the period 2022–2030. It draws attention to areas of progress and gaps in preparation for the mid-term review of the strategies in 2026.
This is the first consolidated WHO report on viral hepatitis epidemiology, service coverage and product access, with improved data for action. This report presents the latest estimates on the disease burden and the coverage of essential viral hepatitis services from 187 countries across the world. The report also updates progress made since 2019 in improving access to health products for both hepatitis B and C in low- and middle-income countries, with information from 38 countries that together comprise nearly 80% of global viral hepatitis infections and deaths. The report provides a regional perspective, analysing the barriers and opportunities for countries in each of the 6 WHO regions to expand access to health products for viral hepatitis. It presents actions for countries and stakeholders to accelerate the scaling up of effective viral hepatitis interventions within a public health approach.
The global community has committed to elimination of mother-to-child transmission, or vertical transmission, of HIV, syphilis and hepatitis B virus (HBV) as a public health priority and reducing global disease burden, quality reproductive, maternal and child health services to a level no longer a public health concern. Achieving and maintaining elimination requires strong political and public health commitment. Strengthened, resilient health systems improve a broad range of services and outcomes while similarities in prevention interventions add to the benefit of an integrated approach. Validation is an attestation that a country has successfully met standard criteria for elimination, or for being at one of the 3 levels of achievement on the ‘Path to Elimination’ while delivering quality services for women, girls and their children, through the life-course, respecting human rights and ensuring gender equality and community engagement. It requires systems that comprehensively identify and monitor new infections and infant outcomes. Establishment of criteria for validation began in 2007 with global consultations while lessons learnt advised publication of 2 editions of global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis (the ‘Orange Book’). This document, the third version, adds on EMTCT of HBV, bringing together a package of interventions and metrics to support integrated management and monitoring of vertical transmission across a wide range of epidemiological and programmatic contexts.
In this issue of Infectious Disease Clinics of North America, guest editors Dr. Daniel A. Solomon and Paul E. Sax bring their considerable expertise to the topic of Advances in the Management of HIV. Top experts in the field review the state of the art in HIV treatment and prevention, discuss challenges and opportunities in reaching especially vulnerable populations, identify treatment challenges in an aging population, and look into the future of antiretroviral therapy, vaccine development, and training the next generation of the HIV workforce. - Contains 14 relevant, practice-oriented topics including the pipeline of antiretroviral therapy; HIV pre-exposure prophylaxis; HIV vaccine: promise and challenges; progress in the search for an HIV cure; HIV in the South: an epidemic within an epidemic; and more. - Provides in-depth clinical reviews on advances in the management of HIV, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to receive the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviors and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination. These are the first WHO guidelines on testing for chronic HBV and HCV infection and complement published guidance by WHO on the prevention, care and treatment of chronic hepatitis C and hepatitis B infection. These guidelines outline the public health approach to strengthening and expanding current testing practices for HBV and HCV, and are intended for use across age groups and populations.