What It Will Take to Advance Hepatitis B Elimination: Helen Nde, MPH

In the fourth and final segment of her interview with The American Journal of Managed Care^®, Helen Nde, MPH, of the Center for Disease Analysis Foundation, reflected on hepatitis B elimination targets and what fundamentally needs to shift in how the disease is addressed.

Reframing Elimination Goals

Nde framed global elimination targets as aspirational benchmarks rather than rigid deadlines. She said it works better for her sense of hope and possibility to view them as goals to reach toward, ideally within a set timeline, while recognizing the value of getting as close as possible even if the exact target is missed.

Nde argued that the core problem is how stakeholders perceive hepatitis B relative to other chronic and infectious diseases. She emphasized the disconnect between the scale of harm the disease causes, as it kills over 800,000 people annually, and the fact that highly effective tools already exist to prevent it: a vaccine and an effective, though not curative, treatment that stops progression to severe liver disease and death. In her view, there is no real justification for hepatitis B remaining as significant a problem as it is, in the US or anywhere else, because the solutions are already well understood.

Expanding Prevention and Treatment

Nde also outlined the specific interventions needed, including expanding vaccination access, particularly the birth-dose vaccine in regions where it is not yet standard, while preserving what already works well in the US. Efforts should also include screening and treating pregnant women in endemic areas to prevent mother-to-child transmission, along with screening and treating the broader adult population with chronic hepatitis B.

She discussed the clinical rationale for prioritizing early intervention, explaining that adults who contract hepatitis B typically clear the virus, whereas children who acquire it face a much higher risk of developing chronic infection and progressing to serious liver disease by their 30s or 40s.

Addressing Stigma Through Education

Lastly, Nde stressed the importance of education and destigmatization. She said she wants patients to understand that hepatitis B is manageable and not something to fear, noting that stigma, particularly tied to foreign-born populations in the US and in communities globally, remains a barrier to people seeking screening and care.

“Investing in what we already know works, and making sure people have the information that they have, I think that that's the main thing that needs to happen here,” she concluded.