It was only during a routine medical examination for a job opportunity abroad that Emmanuel Lutamaguzi, 28, founder of the Hepatitis Aid Organization in Uganda, discovered he was infected with Hepatitis B. His wife and baby boy both tested negative and received a vaccine to prevent them from contracting the disease.

Hepatitis B is the leading cause of death from liver disease and cancer in Uganda, but having experienced no symptoms himself, Lutamaguzi recognized the need to raise awareness and help eliminate the disease. “We can triumph over even the most formidable health challenges,” he says.

 A 2014 World Health Assembly resolution called for governments and populations to take action to prevent, diagnose and treat viral hepatitis. Globally, 90% of people living with viral Hepatitis B and C do not know they have it, leading to an average 3000 deaths every day. WHO’s global hepatitis strategy, endorsed by all WHO Member States, aims to reduce new hepatitis infections by 90%, and deaths by 65%, between 2016 and 2030. 

In Uganda, Hepatitis B is a major contributor to ill-health and death, leading to complications including cirrhosis of the liver and cancer. In 2022, an estimated 1250 Ugandans died of the disease, and around 6% of Uganda’s population remains chronically infected.

The country’s Health Ministry, with technical support from WHO, developed a strategy to control Hepatitis B, including nationwide awareness-raising, testing and treatment. With investments of around US$ 3 million a year, and working in partnership with national stakeholders, Uganda embarked on a massive, free Hepatitis B screening programme in 2015, along with widespread community mobilization and awareness-raising efforts.

“The Ministry of Health took strategic and powerful action to address viral hepatitis infection in Uganda. The government will continue its efforts to provide free testing and treatment for all affected by hepatitis infection,” says Dr Rachel Beyagira, Technical Officer on Hepatitis at Uganda’s Ministry of Health. “Viral hepatitis can no longer be ignored. I, therefore, urge all Ugandans to come forward, test and know their hepatitis status. Mothers and caregivers should also endeavour to have their babies receive the Hepatitis B birth dose and complete their pentavalent vaccine schedule.”

With over four million people screened to date, the programme is having an impact. More than 30% of those infected with hepatitis B are aware of their status and can access comprehensive treatment services, including free medication. Around 90% of all infants receive childhood vaccinations. This success made Uganda the first country in Africa to reach and surpass WHO’s 2020 programme targets of diagnosing 30% of people living with Hepatitis B, ensuring awareness of disease status, and having access to care.

“You can live a full, dignified life with Hepatitis B, but the most important thing is prevention, especially vaccination of newborns. For adults, testing, linking to care, education and treatment as needed are crucial; and lifelong therapy is often needed,” says Kenneth Kabagambe, founder of Uganda’s National Organisation for People Living with Hepatitis B, a key partner in Uganda’s effort to combat viral hepatitis. “The hepatitis community eagerly awaits the new WHO Hepatitis B guidelines that will provide guidance to simplify service delivery and ensure that more people are on treatment.”

Alongside support to the government to develop national strategic plans for hepatitis, WHO together with civil society strongly advocated for earmarked funding for hepatitis activities, and the government responded with dedicated funding for the past five years. WHO also conducted a rapid evaluation of the entire hepatitis programme in Uganda, and provided tailored guidance based on local contexts. It also undertakes periodic reviews and updates to national hepatitis management guidelines and develops training tools to strengthen health worker capacity.

“WHO is proud to support the Government of Uganda, and other national partners, in their efforts to tackle and eliminate viral hepatitis. We commend Uganda for providing free access to hepatitis testing and treatment. It is the only way to ensure health for all and it also requires strengthening adherence to care to reduce mortality,” says Dr Yonas Tegegn Woldemariam, WHO Representative to Uganda.