Europe is falling behind in the fight to eliminate viral hepatitis by 2030, according to the European Centre for Disease Prevention and Control. Despite decades of progress, the region remains off track to meet the United Nations’ elimination goals.
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, said Bruno Ciancio, Head of Unit for Directly Transmitted and Vaccine-Preventable Diseases at ECDC.
Hepatitis B and C are transmitted through infected blood or bodily fluids and are among the leading causes of chronic liver disease. While acute hepatitis B infections have been falling steadily since 2006, driven by long-standing vaccination and prevention efforts, an estimated five million people in Europe are still living with chronic hepatitis B or C, and around 60,000 die every year from liver disease linked to these infections, according to the ECDC.
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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 programmes and other prevention measures. Routine screening for hepatitis B in pregnancy is also well established across all 30 European Union and European Economic Area countries, helping to bring down transmission of the virus from mother to child to below 2%, the ECDC said.
Ciancio noted that effective control solutions are already in place. Those include vaccination to prevent hepatitis B, harm reduction and infection control initiatives to reduce transmission, testing to identify infections early, and treatments that can cure hepatitis C and control hepatitis B.
Gaps across Europe have emerged despite these tools. Experts have identified issues with routine childhood vaccination; only a minority of countries have reached the World Health Organization target of fully vaccinating 95% of children against hepatitis B, with others even reporting a decline in coverage in recent years. Harm reduction measures — such as opioid agonist treatment and the provision of sterile needles and syringes — are effective in limiting transmission of hepatitis C, but coverage remains inadequate. Only seven countries meet the WHO target for distributing sterile injection equipment to people who inject drugs.
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Sexual transmission remains a major route of hepatitis B transmission. For hepatitis C, most cases are linked to injecting drug use and sex between men. Yet, the ECDC noted that specific prevention efforts targeting sexual transmission of hepatitis across different populations have not been systematically monitored across countries.
It is often difficult to track transmission patterns in the absence of routine screening. While medical professionals have known for some time that mixing risk factors can accelerate disease spread, the current lack of data makes it hard to prove this link in the European context. This creates a blind spot where prevention resources might be misdirected or insufficient.
“Our collective challenge is to ensure that these life-saving interventions are accessible to everyone who needs them,” Ciancio said.