Africa’s Silent Humanitarian Crisis: Why Viral Hepatitis Must No Longer Be Ignored

Abstract

Viral hepatitis remains a neglected public health challenge in Africa despite effective tools for prevention, treatment, and cure. A major gap persists between global and regional elimination commitments and the limited availability of hepatitis services across the continent. The World Health Organization’s Global Hepatitis Report 2024 reports that viral hepatitis causes approximately 1.3 million deaths annually, making it the second leading infectious cause of death worldwide. Mortality is now comparable to tuberculosis and exceeds that of HIV and malaria, with hepatitis B and C responsible for most hepatitis-related cirrhosis and liver cancer deaths. Sub-Saharan Africa carries one of the highest burdens of chronic hepatitis B infection globally, yet diagnosis, treatment, and timely birth-dose vaccination coverage remain among the lowest. Consequently, hundreds of thousands of Africans die each year from hepatitis-related liver disease, often without diagnosis or care.

This opinion piece applies Farmer’s (2004) framework of structural violence to explain how social, political, and health system inequalities restrict access to life-saving hepatitis services. It argues that the gap between elimination commitments and implementation represents a “violence of negligence,” whereby policies and declarations fail to translate into accessible care for people living with hepatitis B and C. The article calls for urgent expansion of testing, diagnosis, treatment, birth-dose vaccination, and Triple Elimination initiatives through strengthened primary healthcare systems and Universal Health Coverage. It also highlights the feasibility of elimination through Egypt’s nationally coordinated hepatitis C programme (Waked et al., 2020) and urges African leaders to prioritize implementation to prevent avoidable deaths.