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Low-income nations need greater health investments to eliminate HBV

Higher-income northern and western European countries ranked the highest on the United Nation’s health-related Sustainable Development Goals index in 2016 regarding the elimination of hepatitis B, according to an analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, or GBD. Countries that ranked the lowest were in sub-Saharan Africa.

“‘Leaving no one behind’ is the cornerstone of the Sustainable Development Goals (SDGs), the international development agenda formally adopted by the UN and its member states in September 2015. To deliver on this aim, it is essential to measure where advances have been achieved — and where challenges or new threats are occurring — through routinely updated, comparable monitoring and evaluation,” the researchers wrote.

The researchers ranked 188 countries according to estimated trends toward individual SDG indices, including vaccine-preventable diseases, from 1990 to 2030.

In 2016, the countries with the lowest rates of HBV incidence included Andorra, Belgium, Chile, Cuba, Cyprus, Denmark, France, Germany, Israel, Luxembourg, Malta, the Netherlands, Poland, Slovenia, Spain, the United Kingdom and Uruguay. Meanwhile, Austria, Finland, Iceland, Norway and Sweden ranked the highest.

The countries ranked in the bottom 15 percentile with the highest rates of HBV incidence included Benin, Burkina Faso, Cambodia, Cameroon, Chad, Côte d'Ivoire, Guinea, Guinea-Bissau, India, Malawi, Mozambique, Niger, Senegal, Sierra Leone, Somalia, Tanzania, Togo and Zambia. Central African Republic and Tonga ranked in the bottom 5 percentile.

Regarding vaccine coverage, 63% of the 188 countries achieved vaccine access or coverage for 90% or more of their respective populations in 2016. By 2030, researchers project that 78% of the countries will reach vaccine access or coverage for 90% or more of their respective populations.

“Notably, performance on vaccine coverage, a new indicator as part of the GBD SDG assessment, was generally high across the development spectrum with the exception of the lowest [socio-demographic index (SDI)] countries; in fact, several middle-SDI countries such as Brazil had among the highest scores,” the researchers wrote.

Projected attainment of SDG targets by 2030, including the elimination of HBV, correlated with the defined socio-demographic index. Countries higher on the socio-demographic index had the highest levels of target achievement.

The researchers projected that absolute levels of overall health spending are likely to remain low among lower-income countries and emphasized that increased development assistance for health and larger allocations toward health to the extent possible will be critical to achieve SDG goals such as HBV elimination.

“It is increasingly clear that the health-related SDG agenda hinges upon markedly accelerating progress, particularly among the world’s poorest populations. Succeeding in this endeavor is not yet an impossibility — nonetheless, it will demand extraordinary financial and political commitment by national and international agencies alike to ensure that truly no one is left behind in 2030,” the researchers concluded. – by Talitha Bennett

Disclosure: Please see the full study for the researchers’ relevant financial disclosures.