Europe is set to fall short of its 2030 goal to eliminate viral hepatitis as a public health threat, according to a new warning from the European Centre for Disease Prevention and Control (ECDC). Despite years of progress in preventing hepatitis B and C, the agency says persistent gaps in childhood vaccination and insufficient harm reduction measures are holding the continent back.
“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, thanks to long-standing vaccination and prevention efforts, an estimated five million people in Europe are still living with chronic hepatitis B or C. Around 60,000 die every year from liver disease linked to these infections, the ECDC reports.
Progress and persistent gaps
Among people younger than 25, 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 EU and EEA countries, helping to bring down mother-to-child transmission to below 2%.
Ciancio noted that effective control solutions are already in place. These 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.
However, experts have identified significant gaps in routine childhood vaccination. Only a minority of countries have reached the World Health Organization (WHO) target of fully vaccinating 95% of children against hepatitis B, with others even reporting a decline in coverage in recent years. This shortfall is particularly concerning given that the continent is also grappling with other health challenges, such as the surge in wildfire frequency that poses hidden respiratory risks.
Harm reduction measures — such as opioid agonist treatment and the provision of sterile needles and syringes — are effective in limiting transmission of hepatitis C. Still, coverage remains inadequate, and only seven countries meet the WHO target for distributing sterile injection equipment to people who inject drugs.
“Our collective challenge is to ensure that these life-saving interventions are accessible to everyone who needs them,” Ciancio said.
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. The ECDC’s warning comes as European health systems face mounting pressures from multiple fronts, including divergent national concerns over healthcare and other public services.
Without a concerted effort to close these gaps, the 2030 elimination target will remain out of reach, the agency cautions. The ECDC urges all member states to prioritise vaccination, expand harm reduction services, and improve testing and treatment access to turn the tide against these preventable diseases.
