ECDC: Prevention gaps leave Europe off track for 2030 viral hepatitis elimination

Europe has achieved notable reductions in hepatitis B transmission through long-standing prevention programmes, yet uneven implementation of key measures leaves the region set to miss the World Health Organization’s 2030 target of eliminating viral hepatitis as a public health threat, according to new data released by the European Centre for Disease Prevention and Control (ECDC) on World Hepatitis Day (ECDC).

Prevalence of hepatitis B among children under five years old has reached near-zero levels. Routine screening for hepatitis B in pregnancy is established across all 30 European Union and European Economic Area (EU/EEA) countries and has reduced mother-to-child (vertical) transmission to below 2%. Sustained declines in acute hepatitis B infections have been recorded since 2006. Among people younger than 25 years, the proportion of acute hepatitis B cases fell from 11% in 2015 to 8% in 2024, reflecting the impact of childhood vaccination and other measures (ECDC; EurekAlert).

Comprehensive screening systems for blood, tissues and cells are in place in many countries to prevent transfusion-related transmission, aligning with updated EU standards on substances of human origin.

Despite these gains, viral hepatitis remains a major public health challenge. An estimated five million people in the EU/EEA are living with chronic hepatitis B or C infections, and almost 60,000 people die each year from linked liver disease, including cirrhosis and liver cancer (ECDC).

Bruno Ciancio of ECDC stated: “No one should die from a disease that is preventable, diagnosable and treatable, yet millions of Europeans are living with chronic hepatitis B or C infections – often without knowing it – which can lead to severe long-term consequences such as liver failure or liver cancer. ... Our collective challenge is to ensure that these life-saving interventions are accessible to everyone who needs them.”

Key gaps persist at community level. A minority of countries—nine out of 25 reporting—have reached the WHO target of fully vaccinating 95% of children against hepatitis B. Some countries have reported declines in coverage in recent years. Access to vaccination for adult high-risk groups, including healthcare workers, people who inject drugs, men who have sex with men and people in prison, remains variable and often poorly documented (ECDC prevention report).

Injecting drug use accounts for most hepatitis C cases with a known transmission route. Harm reduction measures such as opioid agonist treatment and sterile needle-and-syringe programmes are effective, yet coverage is inadequate: only seven countries meet the WHO target for distribution of sterile injection equipment to people who inject drugs. Fifteen countries meet the coverage target for opioid agonist treatment (ECDC; ECDC prevention report).

ECDC and the European Union Drugs Agency have issued guidance on interventions for people who inject drugs and an online toolkit to support hepatitis elimination efforts in prisons. Strengthening healthcare in these settings could substantially cut transmission.

A companion ECDC monitoring report concludes that the EU/EEA is not on track to meet several of the 2025 interim prevention targets in the WHO European Regional Action Plan. Progress is strongest on vertical transmission prevention, but gaps in childhood and high-risk adult vaccination coverage and harm reduction services continue to sustain transmission, particularly among key populations. Incomplete data further hinder assessment and targeting of interventions. Priority actions identified include investigating barriers to vaccination uptake, expanding harm-reduction services (especially needle-syringe programmes), addressing sexual transmission routes, and improving monitoring systems (ECDC prevention report).

Existing tools—vaccination against hepatitis B, harm reduction, infection control, testing, curative treatments for hepatitis C and long-term control of hepatitis B—are effective when fully implemented. Closing the remaining gaps is required if the 2030 elimination goal is to be met.