Category: Uncategorized

Adapting and piloting the integrated comorbid hepatitis test-treat-prevent care of MDR-TB Tuberculosis patients and PLHIV/key population in Pakistan and Malawi.

DURATION Six months


GEOGRAPHIC AREA  Malawi and Pakistan

PARTNER Association for Social Development (ASD)


This project aims to adapt and pilot an integrated hepatitis “test-treat-prevent” care model for a) Multidrug-resistant tuberculosis (MDR-TB) patients as well as People living with HIV (PLHIV)/ key populations in Punjab; and b) PLHIV in Malawi.


Pakistan is the 2nd highest hepatitis C (HCV) burden country in the world, with China having the highest number of people suffering from HCV.

The integrated hepatitis care at the primary health care level in Punjab supported by The Hepatitis Fund (THF), was successfully implemented by the Association for Social Development (ASD) with excellent results and outcomes. It was adapted and expanded through THF support for integrated care at rural health centres.

In Multidrug-resistant tuberculosis (MDR-TB) patients, identifying and managing hepatitis comorbidity (if found) is essential for their overall health and well-being. Hepatitis screening and care have theoretically been a part of MDR-TB care. Still, it is not yet happening because of a lack of comorbid care protocols and linkages for offering “test-treat-prevent” care. This leads to the missed opportunity to screen around 3,000 MDR-TB patients and manage comorbid hepatitis accordingly.

In PLHIV and key populations (i.e., sex workers, people who inject drugs, transgender people, men who have sex with men,  etc.), identifying and treating comorbid chronic HCV/ HBV is a known priority. The Global Fund to Fight AIDS, Tuberculosis, and Malaria has recently created a window for assisting the programmes to implement integrated comorbid hepatitis test-treat-prevent care for known PLHIVs and key populations.


ASD will assist the three programmes (Hepatitis, TB and HIV/ AIDS) to adapt and pilot the integrated hepatitis comorbid care of MDR-TB patients and PLHIV/ key populations in Punjab.

ASD will also provide technical assistance and capacity building to a non-governmental organization in Malawi to adapt and pilot an integrated hepatitis comorbid care of PLHIV in primary settings in Malawi.


An adapted package for integrated comorbid hepatitis care (of DR-TB patients and PLHIV/ key populations) will be created. It will include adapted care products and care linkages for the patients to access ongoing public-funded HCV/HBV care at the ongoing Hepatitis Clinics.

Implementation of the comorbid hepatitis care of ≥1,300 MDR-TB patients at 13 MDR-TB sites and ≥1,000 PLHIV/ key populations in a selected district of Punjab

Expansion of the integrated comorbid hepatitis care of MDR-TB patients at the GFATM-supported MDR-TB sites in Punjab and other provinces of Pakistan.

Partner and programme enabling the implementation of integrated comorbid hepatitis care of PLHIV in other parts of Malawi (preferably through GFATM forthcoming work plans)

The results and the products will be shared with potential stakeholders within and outside Pakistan for the potential application of the pilot model in other settings.

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Eliminating Mother-to-Child Transmission of Viral Hepatitis B in Vietnam

Eliminating Mother-to-Child Transmission of Viral Hepatitis B in Vietnam

Co-funded with Ville de Genève. 

PARTNER PATH, in collaboration with Nghe An Province CDC  – Co-funded with the Ville de Genève.


Mothers who are infected with hepatitis B virus (HBV), HIV, or syphilis can pass these viruses to their babies during pregnancy, childbirth, or while breastfeeding—called mother-to-child transmission.. Every year, more than 180,000 newborns in the Asia-Pacific region become newly infected with HBV. Vietnam is among the countries with a high prevalence of HBV worldwide (8.1%). Since 2019, the country has endorsed the World Health Organization’s global triple elimination initiative, which seeks to eliminate mother-to-child transmission (EMTCT) for HBV, HIV, and syphilis.


With support from the City of Geneva and The Hepatitis Fund, PATH, in collaboration with Nghe An Center for Disease Control (CDC), deployed a decentralized, integrated, and coordinated model of combined universal screening for HBV, HIV, and syphilis in Nghe An—Vietnam’s largest province by area, with a total population of more than 3.5 million people. 

The three-year programme, launched in 2022, is currently being implemented at commune health stations, private health facilities, and district hospitals in two districts of Nghe An, where uptake of HBV, HIV, and syphilis testing among pregnant women is low.


The project will provide a hepatitis-free future to newborn babies in Nghe An, which is Vietnam’s largest province, located in the North Central Coast region of the country, with 3,547,247 people living in 21 districts. 

The project will aim to screen 90% of pregnant women receiving antenatal care, treat 80% of eligible pregnant women with Tenofovir (TDF) prophylaxis or treatment, and vaccinate up to 98% of newborns with the HBV birth dose vaccine at the project sites by the end of the project life. 

Evidence generated from implementing the triple EMTCT model in Nghe An will be used to establish a comprehensive evidence base to advocate for financing and programming toward universal access to HBV, HIV, and syphilis screening and care. This includes integrating HBV, HIV, and syphilis screening as a core part of Vietnam’s MNCH and primary health care services and ensuring its coverage in social health insurance structures.

Grant USD 327,000 for three years.

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PARTNER: Clinton Health Access Initiative (CHAI).  The grant is co-funded by The Hepatitis Fund and the Canton and Republic of Geneva.


The project aims to scale hepatitis B (HBV) screening, diagnosis, and antiviral treatment among pregnant women and demonstrate that the implementation of a timely targeted hepatitis B birth-dose vaccine can prevent mother-to-child transmission (PMTCT) of hepatitis B.


In Rwanda, roughly 10,000 newborns are at risk of being exposed to hepatitis B at birth every year. Transmission risk can be decreased to almost 0% through antenatal HBV screening, a combination approach using antiviral treatment in pregnant women and HBV vaccination for infants. However, service gaps and implementation challenges to delivering prevention of MTCT (PMTCT) services exist at antenatal clinics, and they must be addressed to halt the transmission of HBV between mothers and their newborns.

Rwanda has high-performing antenatal care (ANC) platform. Around 93% of Rwanda’s 350,000 pregnant women per year attend ANC facilities for delivery. Despite this, recent data indicates that only 20% of pregnant women are currently screened for HBV during pregnancy.

Rwanda has achieved 96% HBV vaccination coverage by age 5 for children and has successfully rolled out routine HBV vaccination in adults, but HepB-BD given within 24 hours of birth, a key intervention to eliminate mother-to-child transmission, has yet to be introduced.

To advance HBV eMTCT, Rwanda will build upon existing health system infrastructure established for HCV elimination (human resources, diagnostics and treatment platforms, capacity building and procurement systems) established for HCV elimination, a strong vaccination program and a strong ANC platform to advance the elimination of HBV MTCT. 


CHAI will work with the Rwandan government to address critical barriers to scale HBV screening, diagnosis, and antiviral treatment among pregnant women and demonstrate implementation of timely targeted HepB-BD. Specifically, CHAI will support the Rwandan Government to build upon the backbone of its HIV and HCV programmes to:

  • assess and develop strategies to address HBV PMTCT service implementation challenges in Rwanda;
  • increase uptake, availability and quality of HBV PMTCT services among pregnant women;
  • implement a demonstration project for targeted HepB-BD for infants of high-risk mothers;
  • generate evidence to inform a sustainability plan for HBV services for pregnant women in Rwanda, and inform policies in other AFRO countries.


  • ≥90% of pregnant women presenting at antenatal care receive HBsAg screening  
  • ≥90% of pregnant women with high viral load receive antiviral treatment   
  • ≥90% of infants of high-risk mothers receive targeted timely HepB-BD 
  • ≥90% of all newborns receive a complete HBV vaccine schedule (HepB3 vaccine) 


During the project period, the successful demonstration of HBV BD among newborns of mothers who have high HBV VL levels will be used to advocate for increased government funding to scale HBV BD to all newborns. The implementation of this demonstration project will inform future introduction strategies, generate and leverage evidence to inform the sustainability plan of services in Rwanda and inform policies in AFRO countries. 

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Eliminating Mother-To-Child Transmission of Hepatitis B in Vietnam

DURATION   3 years
STARTING DATE   1st  November 2021
PARTNER     PATH, in collaboration with Nghe An Province CDC and with support from the City of Geneva. 


The purpose of this project is to demonstrate the impact of introducing screening & treatment of hepatitis B in pregnant women within the Maternal & Child Healthcare system as part of Vietnam’s 2030 triple elimination goal (HIV, Syphilis & HBV).


In the Asia-Pacific Region, mother-to-child transmission (MTCT) at birth plays a very important role in hepatitis B epidemiology. Approximately 3% to 5% of infants born in this region will acquire chronic hepatitis B infection at birth if not immunized immediately after the delivery. Each year, over 180,000 new-born babies in the region  are newly infected by hepatitis B through mother-to-child transmission.

According to the World Health Organization, Vietnam has one of the highest HBV prevalence in the world at more than 10%. Viral hepatitis is the third cause of death in the country and HBV claims over 25,000 lives annually (Polaris Observatory, 2016). Chronic carriers of hepatitis B are at risk of developing liver diseases such as cirrhosis and liver cancer. 45% of all liver cancer cases are caused by HBV.

To prevent MTCT of HBV, WHO recommends that all children be vaccinated against hepatitis B as soon as possible after birth, including a first dose of the vaccine within 24 hours after birth. Timely diagnosis and treatment of women living with chronic hepatitis B during pregnancy and hepatitis B vaccination for newborns can reduce and prevent MTCT of HBV by more than 95% and thus break the cycle of transmission across generations. While national birth dose of hepatitis B vaccination rate is at 82.2%, the proportion of pregnant women screened for HBV is very low (55%) and the prophylactic treatment for pregnant women is not yet dispensed in district hospitals in Vietnam.


The project aims to implement a scalable pilot model towards a hepatitis-free future for newborn babies in Nghe An Province through the following objectives:

  • Provide testing for hepatitis B in pregnant women receiving antenatal care (ANC) or delivery services at district health facilities in Dien Chau and Thai Hoa, Nghe An.
  • Facilitate linkage to HBV prophylaxis or treatment for pregnant women living with hepatitis B to prevent mother-to-child transmission of HBV.
  • Promote newborn HBV birth dose vaccination.
  • Provide clinical and operational evidence for policy formulation at both the provincial and national levels

Nghe An is Vietnam’s largest province, located in North Central Coast region of the country, with 3,547,247 people living in 21 districts.


The project aims to screen 90% of pregnant women receiving antenatal care, treat 80% of eligible pregnant women with Tenofovir (TDF) prophylaxis or treatment, and vaccinate up to 98% of newborns with a birth dose HBV vaccine at the project sites.

CATALYTIC IMPACT                                                                

PATH expects that this pilot project will demonstrate promising results which will be endorsed and expanded by the Government of Vietnam. The project will also build capacity for health care workers and local health authorities in Nghe An province to better screen and treat HBV among pregnant women toward reducing MTCT of HBV after beyond the project duration.

This project was made possible by support from City of Geneva.

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Eliminating Hepatitis in the Andean Region: Supporting National Responses

DURATION   18 months
GEOGRAPHIC REACH  The Andean Region of South America, including Bolivia, Colombia, Chile, Ecuador and Peru. 
PARTNER    Pan American Health Organization (PAHO)

The purpose of this project was to raise the level of awareness of hepatitis and hepatitis elimination across Colombia, Ecuador and Peru. This was the first time such a significant hepatitis-specific project had been undertaken in the South American continent. 


South America has a population of 422 million people and is comprised of 13 countries. Between 2016 and 2018, PAHO, together with the Ministries of Health, estimated there to be approximately two million people living with hepatitis B and two million people living with hepatitis C in South America. Approximately half of this burden is found in countries of the Andean sub-region: Bolivia, Colombia, Ecuador, Peru, Venezuela and Chile.

While HBV immunization impact has been strong, efforts beyond immunization – diagnosis and treatment of HBV and HCV – remain insufficient to reach elimination. For example, in 2017, just 2,500 people in this region were treated for HCV, around 0.3% of the total.


  • The 2020 meeting of Regional Health Ministers of Andean countries (REMSAA) endorsed that hepatitis elimination is a public health problem.  
  • The first national elimination plan for viral hepatitis in Peru, where hepatitis B is an important public health problem, was developed.   
  • The Center for Disease Analysis Foundation developed investment cases for HBV and HCV in Ecuador and Peru. The investment cases have provided tools for Ministries of Health to plan their nations’ paths towards elimination, allowing countries to estimate the impact of actions, the cost of expanding them and their effectiveness in reducing acquisitions, cases of liver disease and deaths. These investment cases have become an important tool for technical authorities to advocate for expanding activities related to the prevention and management of hepatitis B and C.  
  • Two assessments of the national health sector response to viral hepatitis were carried out in Colombia and Peru in late 2022.   
  • This project had a strong equity and human rights component, benefitting vulnerable groups living in the Andean subregion, with special emphasis on primary care health personnel who provide primary care to migrants and vulnerable populations and populations with high rates of viral hepatitis. As a result, the Colombian authorities agreed to revise guidelines and simplify health services delivery to close access gaps, particularly for vulnerable populations. 
  • Through the work on national plans and clinical guidelines in Colombia and Ecuador, the project promoted an approach to hepatitis B control beyond vaccination.  


CATALYTIC IMPACT                                                                

Because of the success of the missions in Colombia and Peru, partners decided to carry out similar missions in Ecuador and Bolivia. PAHO and the Organismo Andino de Salud-Convenio Hipolito Unanue (ORASCONHU) will enhance their efforts to eliminate viral hepatitis in the Andean countries. ORAS-CONHU will now develop a plan for the elimination of viral hepatitis in the Andean region – the first such subregional initiative in the Western Hemisphere.  

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Strengthening Capacity for National Hepatitis Planning in WHO Regions

DURATION   15 months

STARTING DATE  February 2021


PARTNER  World Health Organization( WHO)


WHO ran processes to develop costed National Strategic Plans (NSPs) or operational plans in Bangladesh, Nigeria, Sudan and Uganda, building on previous experiences in Nepal. Direct results from the project were: 

  • A fully prioritized new NSP was designed in Nigeria, including current cost-effectiveness and impact projections and a national task force for viral hepatitis.                                   
  • The cost of national diagnostic, treatment and vaccination costs for HBV and HCV was performed in Uganda, Bangladesh and Sudan. The final section of the NSPs now includes a section on financial implications.       


While national plans for viral hepatitis are now numerous, they are often unfocused, and most of them do not contain an adequate monitoring and evaluation log frame, precise targets, workforce needs, costing, budgeting and financing.

In August 2019, in Kathmandu, Nepal, the WHO Regional Office for the South East Asia Region (SEARO), in collaboration with the WHO Secretariat, conducted a workshop with 11 countries of the region to facilitate the development of an outline of national plans that would include quantifications for indicators, targets and costing as well as other resource needs. The workshop was successful and led to the development of planning tools.


The plans will be highly beneficial in supporting funding and donor engagement approaches. The project is particularly timely: Bangladesh, Nigeria, Sudan and Uganda will be able to use the updated NSP and costing and cost-effectiveness projections for building the next round of funding requests to the Global Fund, focusing on co-infection, triple elimination of vertical transmission and key populations.  

Bangladesh will be able to use the costed operational plans for upcoming negotiations of its next five-year health budget plan in 2023-2024. Each country’s extensive strategic and planning work has allowed for a renewed focus on a robust viral hepatitis response.  

The project has supported and accelerated the national response beyond the direct outcomes of the grant, notably by further supporting and highlighting the introduction and extension of timely birth dose in Uganda and Nigeria while developing and updating clinical guidelines and monitoring and evaluation frameworks, as well as trainings of healthcare workers, in Vanuatu, Sudan and Nigeria. 

Thanks to this project, Vanuatu included HIV and STIs as part of one consolidated National Action Plan, including triple elimination of vertical transmission. The country created a task force for viral hepatitis, HIV and STIs, which included national stakeholders and international technical partners.   

The WHO Regional Office and WHO HQ will continue to support Vanuatu as the COVID-19 response and epidemic interrupted some of the work in 2021 and early 2022 on the island. 

The project also catalysed the creation of the new WHO/ECHO-webinar series, “Dialogues for Viral Hepatitis Elimination”, which was designed as a platform to facilitate the country-country exchange to accelerate the viral hepatitis response. It will attract more than 36 WHO Member State participants, with a strong focus on national planning and costing.           

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Accelerating the Hepatitis B Response in Zambia (ACCELERATE)

DURATION   18 months
STARTING DATE   January 2021
PARTNER    University Teaching Hospital HIV AIDS Programme (UTH-HAP)


The project aimed to address fundamental barriers to viral hepatitis in Zambia by implementing a multi-faceted, decentralized, integrated healthcare worker training programme. Accelerating the Hepatitis B Response in Zambia (ACCELERATE) catalyzed substantial increases in hepatitis B testing and treatment in Zambia by cultivating a core group of local hepatitis experts, increasing healthcare professional competency and raising awareness among community health workers.


Zambia is a landlocked country in Southern Africa that has a disproportionately high burden of infectious diseases (ID), including HIV, tuberculosis, and viral hepatitis. 

Our grantee started a “training of trainers” programme on hepatitis as Zambia had very few public health or clinical leaders prepared to train other health workers on viral hepatitis.  

UTH-HAP has also worked with hospital leadership to ensure the decentralization of testing to various points and the orientation of nurses to offering tests. More service delivery points, such as antenatal, sexually transmitted infection (STI) and antiretroviral therapy (ART) clinics and sites doing HIV testing, are now integrating hepatitis into their routine services. When kits are available, hepatitis testing can now be offered at any service delivery point by a trained provider. 

The ACCELERATE programme estimates that a total of 222,000 people are eligible for HBV treatment in Zambia, including 72,000 people for co-infection (HIV and HBV) and 150,000 for HBV mono-infection. The programme estimates, however, that 30.3% of the treatment need is being met. The gap is primarily among people with HBV only and not living with HIV, where only 1.7% of the need is being completed compared with 90% among people with both HIV and HBV. This poses a severe challenge to health equity, which global health donors must address together.  


At the end of this project, 31 doctors were certified as hepatitis expert trainers. Before this programme, there were only five doctor experts in hepatitis in Zambia. This group will spearhead advocacy at the Ministry of Health (MoH) and its facilities. The expert trainers will also be assigned to HIV technical working groups where HBV integration is planned, including by building hepatitis components in Zambia’s application to the Global Fund. As a catalytic result, five project team members have been assigned to lead the national responses, and the MoH recognized hepatitis as a vital area that needs attention. The programme has empowered 81 HIV mentors to drive hepatitis care at hundreds of outlying facilities. 

Leveraging existing healthcare workforce programmes such as the ECHO model and HIV/TB mentorship programme to scale up hepatitis B education and training promises to catalyze strides toward hepatitis B elimination in the entire country.

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Data to inform elimination in Africa

Use of Data to Inform Planning and Financing Hepatitis Elimination in

DURATION   18 months
STARTING DATE  September 2020
GEOGRAPHIC REACH   African continent
PARTNER     Center for Disease  Analysis Foundation, Inc. CDAF



The project aimed to increase domestic and international investments for hepatitis elimination in Africa by providing up-to-date data and analysis on HBV/HCV prevalence, burden, mortality, diagnosis rate and treatment rate by collaborating with country stakeholders and showing the potential impact of action and inaction to drive political will and decision-making at
the national and regional (African continent) level.

The lack of data, conflicting data, underestimation of the magnitude of hepatitis burden, the impact of action and no action, and fear of the cost of elimination programmes prevent countries and international agencies from taking a stand on viral hepatitis elimination. CDAF used data and advanced decision support analytics to help policymakers understand the national burden, the value and the cost of hepatitis elimination.


• Assess hepatitis B and C burden, morbidity and mortality in Africa.

• Provide analytical support to ten African countries to assess hepatitis B & C burden and the corresponding economic impact if countries did nothing or if they eliminated HBV/HCV.

• The results will be used to update/build an HCV and HBV model for every African country with available data. The remaining countries’ data will be extrapolated to estimate HBV/ HCV prevalence, cirrhosis, liver cancer, mortality, diagnosis rate and treatment rate for the African continent.


CDAF’s models and forecasts were developed for 49 African countries for HBV and 23 countries for HCV, and they are published by the Polaris Observatory here. 

• An economic impact & financing analysis to show the cost of different financing strategies (self-funding, patient co-pay, catalytic funding, etc.) and investment cases for national hepatitis elimination programs that can be used in discussions with Ministries of Finance or development banks.

A cost-effectiveness analysis for Egypt showed that the HCV elimination programme was highly cost-effective.  Egypt’s program was unique because it used a loan to fund the national HCV elimination programme.  This paved the way for the government to develop an HBV elimination programme and consider funding that programme through a similar mechanism. 

In Morocco, CDAF found that the national programme would benefit from age cohort screening (40+ expanded to 35+ followed by 18+ year olds) since more than 75% of all HCV cases are in older age cohorts.  The analysis also showed that HBV/HCV elimination has a positive return if the government was willing to negotiate and reduce the price of HCV/HBV diagnostics and treatment.  

In Ghana, the analysis resulted in the MoH appointing a viral hepatitis coordinator. The economic impact analysis showed that under government and commercial pricing, the elimination of HCV will be highly cost-effective as soon as 2026 and could result in a return on investment by 2035. The analysis showed that HCV elimination is cost-saving in Ghana if the government is willing to negotiate diagnostic and medicine prices.    



The analysis in Uganda highlighted that HBV and HCV elimination were cost-saving with modest budget requirements. As a result, the MoH announced that it would provide HBV birth-dose vaccination. A current project (supported by CDAF) is assessing the impact of HBV birth-dose vaccination on infants born to mothers with HBV and the treatment of mothers with high HBV+ loads. If successful, this project will lead to a change in the national guidelines. Uganda has started screening pregnant women for targeted birth-dose delivery.  


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Operational Guide for Action

Unlocking the power of data: Developing an Operational Guide to assist countries
in collecting monitoring and evaluation indicators for viral hepatitis.

DURATION   18 months
STARTING DATE    September 2020
GEOGRAPHIC REACH South East Asia and the Western Pacific regions
PARTNER     WHO Collaborating Centre for Viral Hepatitis, The Doherty Institute.


AIM                                                                                                                                                           The project aimed to catalyse global viral hepatitis elimination efforts by developing an operational manual to guide national approaches to collecting, utilising and analysing strategic information for focused action in the Western Pacific and Southeast Asia regions.

Although awareness of the global burden of viral hepatitis is rising, the mobilisation of the viral hepatitis response has been slow, with far less investment at the regional and global level compared to other diseases with a similar public health burden.

Few countries have established national action plans that provide solutions for affordable and appropriate care and treatment for people living with viral hepatitis. With limited international funding, many countries will not have the capacity to develop specific viral hepatitis strategic information infrastructure or data collection systems.

The WHO’s Global Health Sector Strategy (GHSS) on Viral Hepatitis 2016-2021 identified information for focused action as a priority area for the viral hepatitis response, highlighting the importance of developing a robust strategic information system to understand viral hepatitis epidemics and focus the response. The GHSS recognises that national and subnational data are often lacking or poorly collected.

Strengthening data systems such as disease surveillance and clinical reporting systems is essential to understand disease burden, monitor programme outcomes and track progress towards viral hepatitis elimination.

In addition, data sources and systems vary within and across different countries, making approaches to collecting and analysing these data for reporting against WHO indicators complicated for many countries.

The guide, developed by the Doherty Institute, is aimed at in-country implementation of WHO’s monitoring and evaluation framework with a focus on ten core indicators to assist Member States in monitoring, evaluating and informing the health sector response to hepatitis B and C. 

Country-specific workshops were held in Bangladesh, Fiji, Indonesia and Lao PDR for feedback on the operational guide. These allowed those involved in the hepatitis response to come together for the first time since the pandemic began and mark the re-engagement with viral hepatitis elimination as a key public health action for the decade ahead.  


The grant recipient is committed to assisting WHO in generating and analysing epidemiological and programmatic data to guide public health policy and practice related to viral hepatitis and complications, including liver cancer.  

The development of the guide is a critical catalytic action that will substantially reduce reliance on external experts, WHO staff and repeated missions to each country. The aim is to increase the number of countries reporting against the core indicators. 

The guide will reduce reliance on external experts and give Member States practical, easy-to-follow information and suggestions. Collecting, utilising and analysing strategic information will catalyse viral hepatitis elimination efforts and enable focused action. 

The Doherty Institut, serving on a range of international committees tasked with guiding strategic responses to viral hepatitis, will keep translating the findings of this project into policy and practice globally, sustaining the effectiveness and enduring impact of this work beyond the funded period.

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Accelerating diagnosis in Vietnam

HepLINK: Accelerating HBV/HCV diagnosis and treatment through
community–based screening and linkage to care in Vietnam.

DURATION: 18 months
STARTING DATE: from April 2021 to August 2022
PARTNER: PATH, in collaboration with the Ministry of Health’s (MOH) Vietnam Administration of Medical Services (VAMS)


HepLINK Vietnam aimed to demonstrate the cost-effectiveness of a decentralized and integrated viral hepatitis service delivery. The project engaged populations at risk of viral hepatitis in prevention, awareness raising, case detection and treatment, improved viral hepatitis outcomes and provided evidence for scaling and financing interventions that are integral to the elimination of hepatitis C and B by 2030.

Viral hepatitis is the third cause of death in Vietnam. The country accounts for more than one million HCV infections, more than seven million HBV infections, and 22,900 annual deaths (3 deaths per hour) from HBV and 5,900 annual deaths (16 deaths per day) from HCV.

The government of Vietnam developed the first national plan for viral hepatitis prevention and control for the period of 2015- 2019, and in 2016, released guidelines for the prevention, care, and treatment of hepatitis C. These steps demonstrate Vietnam’s commitment to hepatitis elimination by 2030. However, significant improvements in awareness of, demand for, and delivery of chronic HBV and HCV diagnosis and treatment have so far been minimal.

Awareness of the disease and associated risk factors remains low in Vietnam, even among those most at risk: an HCV situational analysis conducted by PATH among men who have sex with men and people who inject drugs in 2018 found that more than 25% did not know that HCV was curable. Just 41% of respondents were aware of direct-acting antiviral agents (DAAs), a treatment option for people with HCV infection.

The most fundamental challenge to scaling anti-HCV screening, diagnosis, and treatment has been the legacy of expensive, toxic and poor efficacy of chronic HCV treatment in Vietnam. With limited treatment options, there has historically been less impetus among the MOH and donors to test and explore ways to significantly increase case detection, treatment, and cure.

Chronic HBV treatment is also relatively neglected, and much more needs to be done to train primary healthcare clinicians in HBV screening, treatment, and long-term management.



The project’s strategic technical approaches included:

  • Engaging those most affected by viral hepatitis in raising awareness, generating demand and providing anti-HCV screening services.
  • Decentralization of viral hepatitis testing, diagnosis and treatment to the primary care level through the engagement of general practitioners and integration with HIV services in the public and private sectors.
  • Ensure a supportive environment for those diagnosed with chronic HCV to successfully complete treatment and remain HCV-free and for those with chronic HBV to successfully stay on treatment.
  • Generate and leverage strategic learning from HepLINK to facilitate resource mobilization and implementation of the national program toward ending viral hepatitis by 2030.

    HepLINK was implemented in the two biggest cities of the country, Ho Chi Minh City and Hanoi, representing the two regions (Northern and southern regions) of Vietnam and the highest burden of chronic viral hepatitis infection.

  • HepLINK supported the decentralization and integration of viral hepatitis testing at 27 sites across two provinces.  
  • More than 20,000 vulnerable individuals were screened for HBV and HCV. 
  • Approximately 900 people received treatment for HCV, and 500 people were enrolled in HBV treatment. 


PATH provided evidence to the Vietnamese health authorities for scaling up and financing interventions that are integral to elimination. The grantee worked to make diagnosis and treatment more affordable through several key actions, including the promotion of free HCV drugs from the Global Fund, continued advocacy with the Vietnamese administration for medical services and other relevant ministries on the issue to reduce the base co-pay cost, and an assessment of treatment accessibility to inform future action. With evidence generated from HepLINK, PATH is now working with Vietnamese health authorities to further target the key access barriers that hinder diagnosis uptake. 

As a direct, catalytic result of HepLINK, the Vietnamese Ministry of Health now allows social insurance reimbursement for outpatient PCR testing. Beyond direct programme outcomes, PATH supported the introduction of HCV self-testing piloting with complementary funding from Unitaid in 2022. This will be an essential continuation of HepLINK’s effort to expand access to HCV testing.  


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