A global investment framework for the elimination of hepatitis B

J. Howell*, A. Pedrana, S.E. Schroeder, N. Scott, L. Aufegger, R. Atun, R. Baptista-Leite, G. Hirnschall, E. 't Hoen, S.J. Hutchinson, J.V. Lazarus, L. Olufunmilayo, R. Peck, M. Sharma, A.H. Sohn, A. Thompson, M. Thursz, D. Wilson, M. Hellard

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background & Aims: 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.Methods: 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.Results: 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.Conclusion: 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.Lay summary: 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. (C) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Original languageEnglish
Pages (from-to)535-549
Number of pages15
JournalJournal of Hepatology
Issue number3
Publication statusPublished - 1 Mar 2021


  • Cost-effectiveness
  • Disease elimination
  • Health financing
  • Hepatitis B
  • Universal health coverage
  • Viral hepatitis
  • alcohol rates


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