World Hepatitis Day 2024 Message from Charles Gore

Hepatitis C medical camp set up at village Malerkotla, Punjab, India to test and treat people from disadvantaged communities.

28 July 2024  – 

I want to apologise in advance for doing something I shouldn’t be doing. I’m going to put on my old advocacy hat. As the Executive Director of the Medicines Patent Pool (MPP), that’s not really my role. But it’s my history and still my passion. For 18 years up until I joined MPP in 2018, I tried to raise the profile and priority of viral hepatitis, first in the UK, then in the whole of Europe, and from 2008, globally. Hepatitis has always felt like the poor relative in infectious diseases, living off scraps and ignored in favour of HIV, TB and malaria. People living with hepatitis have been continually left behind. 

With increasing stridency and urgency, I have been calling for action from governments. Yet, with some notable and highly praiseworthy exceptions, action has been so slow as to be barely perceptible, if there has been any at all. And now, with the publication of the WHO Global Hepatitis Report 2024, we see the consequences. Mortality is 1.3 million per year and rising. It will shortly be the most deadly infectious disease. That means we are wildly off course to meet the 2030 target of less than 500,000 deaths per year. 

This is a tragedy because we have the tools in the form of an excellent vaccine for hepatitis B and wonderful treatments for both hepatitis B and C, and they are eminently affordable. Putting back on my MPP hat, we have licences for key hepatitis C drugs and had a licence for tenofovir for hepatitis B (it is now off-patent, so a licence is not needed), but the uptake has been unconscionably low. It has to be said, however, that many countries are paying far more than the lowest available prices. This makes no sense, and I implore governments to reach out to us to advise them on how to achieve the lowest prices. 

As the WHO 2024 report makes clear, one of the key reasons for the low treatment uptake is the lack of diagnosis. Hepatitis C diagnosis has improved to 36% from the 20% baseline of 2015 set in the first WHO 2017 report , but it is still far below the target of 90% set for 2030. In hepatitis B, the picture is alarming. Only 13% of the 254 million people living with hepatitis B have been diagnosed, a completely insignificant increase over the 9% 2015 baseline. If you are not diagnosed, you can’t access treatment and therefore prevent the cirrhosis and/or liver cancer that are causing the increasing death toll.  

How can we go on letting this happen? We have the tools. We just don’t use them. It’s like standing by a flooded river watching someone drown. Instead of throwing them the life belt we hold in our hands, we’re simply waving at them. 

The sad truth is that the underlying cause of the inaction is a profound lack of political will in many countries. Even where there are national plans, they are not implemented. It is 2024.   2030 is just around the corner. We need to act NOW – in the next year – to have any hope of getting back on track to reach the agreed global targets. It is not too late now but very soon it will be. I implore countries to take note. 

Charles Gore