A global investment framework for the elimination of hepatitis B

• Published in: Journal of hepatology 2021-03, Vol.74 (3), p.535-549
• Main Authors: Howell, Jessica, Pedrana, Alisa, Schroeder, Sophia E., Scott, Nick, Aufegger, Lisa, Atun, Rifat, Baptista-Leite, Ricardo, Hirnschall, Gottfried, ‘t Hoen, Ellen, Hutchinson, Sharon J., Lazarus, Jeffrey V., Olufunmilayo, Lesi, Peck, Raquel, Sharma, Manik, Sohn, Annette H., Thompson, Alexander, Thursz, Mark, Wilson, David, Hellard, Margaret
• Format: Article
• Language: English
• Subjects: Adult; Antiviral Agents - economics; Antiviral Agents - therapeutic use; Child; Cirrhosis; Cost-Benefit Analysis; Cost-effectiveness; Disease elimination; Disease Eradication - economics; Female; Global Health - economics; Health financing; Healthcare Financing; Hepatitis B; Hepatitis B Vaccines - therapeutic use; Hepatitis B virus; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - economics; Hepatitis B, Chronic - prevention & control; Hepatitis B, Chronic - virology; Humans; Investments; Liver cancer; Liver cirrhosis; Liver diseases; Morbidity; Public health; Public Health - economics; Treatment Outcome; Universal health coverage; Vaccination - methods; Viral hepatitis; World Health Organization
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2020.09.013

More than 292 million people are living with hepatitis B worldwide and are at risk of death from cirrhosis and liver cancer. The World Health Organization (WHO) has set global targets for the elimination of viral hepatitis as a public health threat by 2030. However, current levels of global investment in viral hepatitis elimination programmes are insufficient to achieve these goals. To catalyse political commitment and to encourage domestic and international financing, we used published modelling data and key stakeholder interviews to develop an investment framework to demonstrate the return on investment for viral hepatitis elimination. The framework utilises a public health approach to identify evidence-based national activities that reduce viral hepatitis-related morbidity and mortality, as well as international activities and critical enablers that allow countries to achieve maximum impact on health outcomes from their investments – in the context of the WHO's 2030 viral elimination targets. Focusing on hepatitis B, this health policy paper employs the investment framework to estimate the substantial economic benefits of investing in the elimination of hepatitis B and demonstrates how such investments could be cost saving by 2030. Hepatitis B infection is a major cause of death from liver disease and liver cancer globally. To reduce deaths from hepatitis B infection, we need more people to be tested and treated for hepatitis B. In this paper, we outline a framework of activities to reduce hepatitis B-related deaths and discuss ways in which governments could pay for them. [Display omitted] •The WHO has set global targets for elimination of hepatitis B by 2030.•To date, global investment in hepatitis B elimination activities has been limited.•We have developed a global investment framework for the elimination of hepatitis B to guide domestic and international investment.•This Health Policy paper outlines evidence to support the financial returns on investment in hepatitis B elimination, identifies national and international activities to achieve hepatitis B elimination targets and identifies potential funding sources.•The goal of this investment framework is to pave the way for countries to build the economic case for investment in national hepatitis B elimination programmes.