NHS England must act now to eliminate hepatitis B by 2030
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4 min read
World Hepatitis Day, on 28 July, serves as a timely reminder of progress made but also the persistent disparities in the UK’s response to the World Health Organization’s (WHO) goal of eliminating viral hepatitis by 2030.
The UK has made great progress on the WHO’s 2030 elimination goals for hepatitis C as a result of increased testing and curative treatments. Yet hepatitis B remains in the shadows – poorly understood, underdiagnosed, and too often neglected in policy and clinical practice.
According to the latest UK Health Security Agency (UKHSA) report published last summer, up to 268,000 people may be living with chronic hepatitis B in the UK – a figure 30 per cent higher than previously thought. Yet, it’s estimated that over half remain undiagnosed. This cannot be acceptable in a modern health system.
As NHS England transitions into the Department for Health we must ensure we take action to deliver on the WHO elimination goals.
Hepatitis B is a blood-borne virus that can lead to cirrhosis and liver cancer. It disproportionately affects some of our most vulnerable and marginalised communities including people born in at-risk countries, minority ethnic groups, migrants, and people experiencing homelessness.
There is significant stigma and misunderstanding surrounding hepatitis B, both among the public and within parts of the health system. There are too many myths about the disease and the vast majority of cases are transmitted from mother to child during birth. These barriers are compounded by systemic health inequalities, variations in care and a lack of effective pathways and programmes to diagnose adults living with hepatitis B.
At a recent parliamentary roundtable hosted by Kevin McKenna MP, MPs heard directly from NHS England, leading clinicians, and charities like the British Liver Trust and Terrence Higgins Trust about the life-saving potential of opt-out testing in emergency departments.
Since its introduction in April 2022, opt-out testing has identified more than 10,000 people living with a blood-borne virus and half of those had hepatitis B. These are individuals who might otherwise never have been diagnosed and may have only been diagnosed at a late stage when they develop liver cancer.
Opt-out testing has been a game-changing programme, which helps reach populations often disconnected from routine care. But while the programme has expanded to 90 hospitals, it remains underfunded and geographically inconsistent. Funding must be extended to continue one of the most cost-effective and impactful NHS England programmes.
The communities most affected by this virus are the same communities who face the greatest barriers in accessing care
The British Liver Trust’s recent report, Hepatitis B: Break the Silence, launched in Parliament, makes clear that the UK is not on track to meet the WHO goals for hepatitis B.
To meet these goals, they are calling for significant action from government and NHS England. This includes implementing testing and vaccination of family members with hepatitis B; expanding opt-out testing to all emergency departments and funding it long-term; delivering community-based testing and vaccinations in at-risk communities; launching a national public awareness campaign to reduce stigma and improve uptake; and investing in peer support, outreach, and culturally competent care.
A new national clinical lead has been appointed for hepatitis B by NHS England and now is the time for urgent action.
Eliminating hepatitis B is not only a matter of public health – it is a matter of health equity. The communities most affected by this virus are the same communities who face the greatest barriers in accessing care. If we are serious about tackling health inequalities and delivering on the promise of social justice, hepatitis B must be made a political and clinical priority.
The UK has a choice: continue on our current path and fall short of the 2030 elimination goals – or take bold, strategic action now to change the story for tens of thousands of people.
Let’s break the silence – let’s eliminate hepatitis B.
Dr Beccy Cooper is the Labour MP for Worthing West and chair of the APPG on Liver Disease and Liver Cancer
