Over 91 Million Africans living with chronic viral hepatitis – WHO

More than 91 million people across Africa are living with chronic viral hepatitis, according to new data from the World Health Organisation (WHO), raising concerns over the low levels of testing, treatment, and prevention across the continent.

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The figure includes 82 million people with chronic hepatitis B and nine million with hepatitis C, highlighting a major but often neglected public health crisis.

Despite the availability of effective diagnostic tools and treatment, WHO estimates that more than 90 per cent of people living with hepatitis B and C in Africa do not receive the care they need.

This contributes to around 125,000 hepatitis-related deaths every year, mostly among young and economically productive populations.

Low Diagnosis

According to WHO, only two per cent of people with hepatitis B in the African region are diagnosed.

In 2019 alone, the region recorded 990,000 new hepatitis B infections and 210,000 hepatitis C infections.

The coverage of the hepatitis B birth dose vaccine in the African region remains alarmingly low, standing at just 17 per cent in 2021, compared to the global average of 42 per cent.

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Nigeria, Africa’s most populous country, had a hepatitis B prevalence of six per cent in the general population in 2021, with 40 per cent coverage for the hepatitis B vaccine by the third dose (HepB3).

Also, 18 African countries had hepatitis B prevalence rates above the high endemic threshold of eight per cent. Chad topped the list at 19 per cent, while Sudan followed closely at 18 per cent. Notably, Sudan also had one of the lowest vaccine birth dose coverage rates at 50 per cent.

In contrast to this gap, Nigeria has made notable progress in other immunisation campaigns.

According to the National Primary Health Care Development Agency (NPHCDA), over 61.5 million Nigerians have been vaccinated against diseases such as malaria, yellow fever, and human papillomavirus (HPV) as of July 2025.

Health experts say this success shows that high coverage is achievable, but they warn that hepatitis B remains under-prioritised.

Without significant scale-up in testing and birth-dose vaccination, Nigeria may continue to face avoidable liver-related deaths and childhood infections.

Risk Factors and Transmission

Hepatitis is a general term that refers to inflammation of the liver. It is usually caused by a viral infection, but can also result from other factors such as excessive alcohol use, certain medications, toxins, or autoimmune conditions where the body’s immune system attacks the liver.

Viral hepatitis is caused by five main viruses, of which hepatitis A, B, C, D and E are most significant.

In Africa, hepatitis A and E are commonly spread through faecal-oral transmission due to poor sanitation and unsafe water sources.

Hepatitis B, C and D are primarily transmitted through blood and body fluids. This includes unsafe medical procedures, sharing of contaminated sharp instruments, sexual contact, unsafe blood transfusions, and mother-to-child transmission during birth.

Hepatitis D is rare but can worsen liver disease in people already infected with hepatitis B.

Meanwhile, Hepatitis E poses a higher risk of death in pregnant women.

Children at Risk

The WHO noted that all 47 countries in the African region are currently off track to meet the global target of reducing hepatitis B prevalence among children under five to less than 0.1 per cent by 2030.

However, 14 countries have exceeded the interim regional target of one per cent.

Countries such as South Sudan, Chad, Guinea and Equatorial Guinea recorded both low birth dose vaccine coverage and high hepatitis B prevalence among children.

In Nigeria, the prevalence among children under five stood at 0.3 per cent, slightly above the 2025 regional target. The country also ranks among those with the highest number of chronic child carriers, estimated at more than 10,000.

The WHO recommends that all newborns receive the hepatitis B vaccine within 24 hours of birth, followed by two or three additional doses to ensure full protection. This protection lasts for at least 20 years and is likely lifelong.

The use of antiviral prophylaxis during pregnancy can help prevent mother-to-child transmission of hepatitis B. For hepatitis C, there is no vaccine, but prevention depends on reducing exposure through safer healthcare practices and harm reduction strategies for high-at-risk populations.

The WHO called on African countries to integrate viral hepatitis into their broader health systems and adopt comprehensive approaches to prevention, diagnosis, treatment and care.