Viral hepatitis now ranks as the seventh leading cause of mortality worldwide. Although mortality due to communicable diseases has declined globally, the absolute burden and relative ranking of viral hepatitis as a cause of mortality has increased between 1990 and 2013.⁶

In South-East Asia, 100 million people are currently estimated to be living with hepatitis B, and 30 million with hepatitis C.⁷ In India, viral hepatitis is now recognized as a serious public health problem. It places a huge social and economic burden on the affected individuals, families, as well as the health system. Viral hepatitis is a cause for major health care burden in India and is now equated as a threat comparable to the “big three” communicable diseases – HIV/AIDS, malaria and tuberculosis.² Around 400 million people all over the world suffer from chronic hepatitis and the Asia-Pacific region constitutes the epicentre of this epidemic.⁶

As per WHO and the latest estimates, in India, 40 million people are chronically infected with hepatitis B and six to 12 million people are chronically infected with hepatitis C. HEV is the most important cause of epidemic hepatitis, though HAV is more common among children. Most acute liver failures diagnosed are attributable to HEV.² There are many challenges in prevention and eradication of Viral hepatitis in India.¹ Maintaining adequate sanitary and hygienic conditions can help tackle the problem associated with enterically transmitted pathogens like HAV and HEV.²,⁸ Following a multipronged approach of active screening, adequate treatment, universal vaccination against HBV and educational counselling can help decrease the burden of liver diseases associated with HBV and HCV infection in India.²,⁸ WHO’s Draft Global Health Sector Strategy on Viral Hepatitis gives the much needed roadmap and targets to combat hepatitis. It provides realistic targets and action plans to eliminate hepatitis by 2030.² This is planned to be achieved by building capacities in the existing health care delivery system to reach the desired goal.⁹

In May 2016, the World Health Assembly adopted the first global health sector strategy on viral hepatitis, 2016-2021. The strategy highlights the critical role of universal health coverage and sets targets that align with those of the Sustainable Development Goals.³ The strategy aims to eliminate viral hepatitis as a public health problem by reducing new viral hepatitis infections by 90% and reduce deaths due to viral hepatitis by 65% by 2030.¹⁰ For World Hepatitis Day 2021, WHO is focusing on the theme “Hepatitis can’t wait” to highlight the urgency of hepatitis elimination with a view to achieving the 2030 elimination targets.¹⁰

Standard precautions, which encompass both universal precautions and body substance isolation, are appropriate for prevention and spread of all types of viral hepatitis in the healthcare environment.⁴ Vaccines are available for hepatitis A and hepatitis B. There is no vaccine available at the present time to protect against infection of hepatitis C & D virus; however, trials are currently underway. While there is a safe and effective anti-hepatitis E vaccine, at present it is only licensed for use in China. Given the recognition of HEV as a global pathogen, there is a need to develop HEV vaccines for use globally. Vaccines remain an important cornerstone in the battle to achieve dominance over hepatitis A, B, C, D, and E and thereby decrease morbidity and mortality from these infections in a cost-effective manner.¹²,¹³