A global investment framework for the elimination of hepatitis B

Jessica Howell*, Alisa Pedrana, E. Sophia Schroeder, Nick Scott, Lisa Aufegger, Rifat Atun, Ricardo Baptista-Leite, Gottfried Hirnschal, Ellen ‘t Hoen, Sharon J. Hutchinson, Jeffrey V. Lazarus, Lesi Olufunmilayo, Raquel Peck, Manik Sharma, Annette H. Sohn, Alexander Thompson, Mark Thursz, David Wilson, Margaret Hellard

*Corresponding author for this work

Research output: Contribution to journalArticle


Background and Aims: More than 292 million people are living with hepatitis B worldwide and are at risk of death from liver 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 utilizes 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 investment to achieve WHO 2030 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 ways in which Governments could pay for them.
Original languageEnglish
Number of pages40
JournalJournal of Hepatology
Publication statusAccepted/In press - 25 Aug 2020


  • viral hepatitis, hepatitis B, disease elimination, health financing, universal health coverage, cost-effectiveness

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    Howell, J., Pedrana, A., Schroeder, E. S., Scott, N., Aufegger, L., Atun, R., Baptista-Leite, R., Hirnschal, G., ‘t Hoen, E., Hutchinson, S. J., Lazarus, J. V., Olufunmilayo, L., Peck, R., Sharma, M., Sohn, A. H., Thompson, A., Thursz, M., Wilson, D., & Hellard, M. (Accepted/In press). A global investment framework for the elimination of hepatitis B. Journal of Hepatology.