Every year on July 28, the world focuses its attention on one of the deadliest infectious diseases, viral hepatitis. The World Hepatitis Alliance estimates that 1.34 million people die every year due to viral hepatitis, and nearly two million new cases are added annually, making it deadlier than any other communicable disease.
The tools to stop its spread do exist in the form of vaccines, accurate diagnostics, treatments that can cure hepatitis C, and long-term therapies to manage hepatitis B. Yet, millions around the world still do not have access to any of them.
This gap is what the World Hepatitis Day theme hopes to address this year. The World Health Organisation has named its campaign for 2026 as ‘Hepatitis: Let’s Break It Down’, with a direct call to dismantle the financial, social, and systemic barriers, including stigma, that keep people away from the services that could save their lives.
Why this year’s theme matters
An estimated 287 million people globally are living with chronic hepatitis B or C, and most don’t even know about it. This year’s WHO campaign seeks to make hepatitis elimination a matter of access, calling for stronger commitment from governments, sustained investment, and equitable access to prevention, testing, treatment, and care.
If current gaps in access are not addressed, viral hepatitis is projected to cause more deaths per year by 2040 than malaria, tuberculosis, and HIV/AIDS combined.
The burden closer to home
India carries a significant share of this global burden. According to a review of the WHO Global Hepatitis Report published by the Indian Journal of Medical Research, India has an estimated 29 million people living with chronic hepatitis B and 5.5 million with chronic hepatitis C, placing it second among the ten countries with the highest infection burden worldwide. India’s National Viral Hepatitis Control Programme (NVHCP), which was launched in 2018, suggests the country is home to between 10 and 15 per cent of the world’s total hepatitis B carrier pool.
The gap between infection and diagnosis remains the central problem. According to a recent analysis published in the Indian Journal of Gastroenterology, India’s hepatitis B diagnosis rate is just 2.4 per cent, meaning the overwhelming majority of people carrying the virus have never been tested for it. The same study found that hepatitis B birth dose vaccination, the single most effective way to stop mother-to-child transmission, reaches only around 63 per cent of newborns in India, even though third dose coverage across early childhood has climbed to about 93 per cent. That gap in the birth dose specifically is where a large share of preventable lifelong infections still originate.
The NVHCP’s mandate is to expand vaccination, provide for universal screening of donated blood, and strengthen prevention of mother-to-child transmission. The WHO’s elimination targets for 2030 are a 90 per cent reduction in new hepatitis B infections, a 65 per cent reduction in mortality, and 90 per cent diagnosis coverage among those infected, and we are still a long way from that.
What is viral hepatitis?
Hepatitis is inflammation of the liver, most often caused by one of five viruses: hepatitis A, B, C, D, and E, each with its own transmission route and outcome. Hepatitis A and E typically spread through contaminated food or water and are usually self-limiting, resolving on their own, while hepatitis E can be more serious during pregnancy. By contrast, Hepatitis B and C spread through blood and body fluids and can become chronic, silently damaging the liver over years or even decades. Hepatitis D only occurs in people who already have hepatitis B, and tends to worsen liver damage significantly.
Studies have found that chronic hepatitis B and C together account for more than 90 per cent of all deaths and disability linked to viral hepatitis worldwide, and remain the world’s leading cause of liver cancer. Left unaddressed, these infections progress toward cirrhosis and liver failure. Since the symptoms do not show up easily, hepatitis often progresses silently until liver damage is in its advanced stages.
Recognising the symptoms
Most people with hepatitis B or C have no symptoms in the early stages, which is precisely why the infection so often goes undiagnosed for years. Some symptoms which you must take note of include: persistent fatigue, poor appetite, nausea, abdominal discomfort, dark urine, and jaundice (a yellowing of the skin or eyes). While these can overlap with other liver or digestive conditions, you must seek medical evaluation if they persist.
Breaking down the barriers
This year’s theme asks us to name the barriers explicitly rather than treat them as background noise. A few stand out consistently across the data.
● Low awareness and misinformation – These keep people from recognising their own risk or understanding that testing is quick and often free.
● Stigma – Most people delay testing or treatment because they fear judgment from their community, their workplace, or their own family.
● Health system gaps – In many regions, hepatitis services are simply not integrated into routine primary care. This means that a person can visit a doctor repeatedly without ever being tested.
● Financial barriers – Affordability is a huge challenge as it continues to put treatment out of reach for people who are diagnosed but can’t afford treatments.
None of these barriers are about the disease itself, but about the systems and attitudes around it, which is why they must be broken down.
Testing and diagnosis
Diagnosis for viral hepatitis usually involves a simple blood test to check for markers specific to hepatitis B or C. For someone with risk factors such as use of shared needles, unprotected exposure to blood, a family member with chronic hepatitis, and prior blood transfusion, this test can be life-changing.
Liver function tests and imaging or a liver biopsy, if needed, can help clinicians determine how much damage has occurred and what treatment plans to recommend.
Treatment options:
Hepatitis A and E – These generally resolve on their own with supportive care, rest, hydration, and monitoring, since there is no specific antiviral treatment required in most cases.
Hepatitis B – This virus can cause both acute hepatitis and chronic hepatitis and rarely liver cancer as well. Its outcome depends on how it is treated and on effective surveillance and treatment. Antiviral medication taken consistently keeps the virus suppressed, dramatically reducing the risk of cirrhosis and liver cancer, and allowing patients to live a full and normal life. The hepatitis B vaccine is one of the most effective ways to prevent infections to newborns, when given at birth.
Hepatitis C – Once considered a lifelong condition, it is now curable in the vast majority of cases. This virus was known to cause chronic liver disease in 60 per cent of its victims and liver cancer as well. A major medical breakthrough has given us a cure for this sinister virus. A course of oral antiviral medication, which is typically taken for eight to twelve weeks, clears the virus entirely for most patients. This is one of modern medicine’s genuine success stories.
Prevention still matters
As with any disease or illness, prevention is key to health. Vaccination remains the single most powerful tool against hepatitis A and B. Beyond vaccination, reducing risk comes down to practical steps: avoiding shared needles or razors, ensuring any tattoo or piercing equipment is properly sterilised, practising safe sex, and being mindful of food and water hygiene in areas where hepatitis A and E are more common.
Get tested, especially if you are aware of known risk factors or a family history of hepatitis. If you have been diagnosed with hepatitis B or C and haven’t started treatment, please consult a specialist to start treatment at the earliest.
It is also important to spread awareness about hepatitis, without the discomfort of stigma attached to it. This does more to break down mental and emotional barriers to initiate treatment. Battling the virus head-on is your first step to a secure future.
(The author is a consultant medical gastroenterologist at Narayana Health, Bengaluru)
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
