Hepatitis B elimination in Africa by 2030 requires urgent scale up of birth dose vaccination, maternal antiviral prophylaxis and political action

Abstract

Hepatitis B elimination in Africa is unlikely to be achieved by 2030 unless prevention and care systems are urgently strengthened. Despite progress in infant vaccination, the World Health Organization (WHO) African Region continues to have very low timely hepatitis B birth-dose coverage and major gaps in diagnosis and treatment. Routine antenatal screening for hepatitis B surface antigen (HBsAg), timely birth-dose vaccination, and access to maternal antiviral prophylaxis remain insufficient, allowing mother-to-child transmission of hepatitis B virus (HBV) to sustain new chronic infections. Elimination therefore requires an integrated package: vaccination within 24 h of birth, including community delivery for non-facility births; maternal screening and tenofovir prophylaxis where indicated; decentralized diagnosis and treatment; reliable financing and supplies; and surveillance. Recent international support for hepatitis B birth-dose introduction creates an important implementation opportunity, but political commitment will be essential to translate policy into coverage.