Europe nearly eliminated hepatitis B in young children. It will still miss 2030
ECDC data show near-zero hepatitis B in under-fives and vertical transmission below 2%, alongside five million chronic infections and only seven countries meeting the harm-reduction benchmark.
Two facts published by the European Centre for Disease Prevention and Control at the end of July sit awkwardly together. The prevalence of hepatitis B among children under five in Europe is now at near-zero levels [s1]. And an estimated five million people in the EU and European Economic Area are living with chronic hepatitis B or C, with almost 60,000 dying each year from liver disease linked to those infections [s1].
Both are true, and the distance between them is the whole story. Europe has largely solved the transmission route it built infrastructure for and has not closed the ones it did not.
ECDC's assessment is that uneven implementation of key measures means the region is set to miss the 2030 target of eliminating viral hepatitis as a public health threat [s1]. A commentary in The Lancet Oncology the following week reached the same conclusion about Europe's elimination trajectory [s2].
What worked
The successes are concentrated where a system was built and then run consistently.
Routine screening for hepatitis B in pregnancy is now well established across all 30 EU/EEA countries, and has brought vertical transmission of hepatitis B from mother to child below 2% across the region [s1]. That is a public health programme functioning as designed: universal, uniform, and effectively invisible.
Acute hepatitis B infections have declined steadily since 2006 [s1]. Among people younger than 25, the proportion of acute hepatitis B cases fell from 11% in 2015 to 8% in 2024, which ECDC attributes to childhood vaccination programmes and other prevention measures [s1].
Blood, tissue and cell safety is the third area holding up. Comprehensive screening systems are in place across the region, and an ECDC survey indicates many countries have robust systems to meet the new standards laid out in the EU regulation on substances of human origin [s1].
Bruno Ciancio of ECDC framed the problem this way in the agency's statement: "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" [s1].
Where it stalls
Two gaps account for most of the shortfall, and both are about coverage rather than capability.
The first is childhood vaccination. Only nine out of 25 EU/EEA countries have reached the WHO target of fully vaccinating 95% of children against hepatitis B, and some countries have reported a decline in coverage in recent years [s1]. That is roughly a third of reporting countries meeting a benchmark for a vaccine that has been available for decades, in the wealthiest region of the world.
The second is harm reduction. Injecting drug use accounts for most cases of hepatitis C with a known transmission route [s1]. Opioid agonist treatment and provision of sterile needles and syringes are effective at minimising transmission, but coverage across the EU/EEA remains inadequate — only seven countries meet the WHO target for distribution of sterile injection equipment for people who inject drugs [s1].
Seven countries. Hepatitis C is curable, the tools to prevent its transmission are cheap and well characterised, and the majority of European countries are not deploying them at the recommended level.
ECDC and the European Union Drugs Agency have set out key interventions for preventing and controlling infectious diseases among people who inject drugs, and developed an online toolkit aimed at eliminating viral hepatitis in prisons [s1]. Improving healthcare in those settings, the agency argues, would substantially reduce transmission [s1].
Why the pattern looks like this
The shape of Europe's hepatitis performance follows a familiar rule: interventions delivered through universal, institutionally embedded systems succeed, and interventions requiring engagement with marginalised populations do not.
Antenatal screening reaches everyone because everyone pregnant enters antenatal care. Blood safety works because it operates on the supply side, invisible to the patient. Childhood immunisation depends on parental uptake and has begun to slip in exactly the way other childhood vaccines have. Needle and syringe provision depends on political willingness to fund services for people who use drugs, and it is failing in most of the region.
None of that is a technical problem. It is a distributional one, which is why a decade of improving treatment has not translated into elimination.
What is not in this data
The ECDC statement reports coverage and case trends. It does not report how many people with chronic hepatitis C in Europe have been diagnosed and treated with direct-acting antivirals, which is the other half of the elimination equation — treatment as prevention. The five million chronic infection figure is described as an estimate, and estimates of undiagnosed infection carry substantial uncertainty by construction [s1].
The underlying detail sits in three ECDC publications: a 2026 report on prevention of hepatitis B and C in the EU/EEA monitoring progress towards the Sustainable Development Goals, and the hepatitis B and hepatitis C chapters of the agency's annual epidemiological report for 2024 [s1].
What to watch
Four years remain to 2030. On vaccination the trend to watch is whether the number of countries above 95% coverage rises from nine or falls further [s1]. On hepatitis C the number to watch is the seven countries meeting sterile equipment targets [s1] — that is the figure whose movement would indicate the region is treating elimination as a commitment rather than an aspiration.
Sources
- [s1] World Hepatitis Day 2026: Despite progress towards eliminating hepatitis in Europe, gaps in prevention measures keep 2030 targets out of reach — European Centre for Disease Prevention and Control, 28 July 2026. https://www.ecdc.europa.eu/en/news-events/world-hepatitis-day-2026-despite-progress-towards-eliminating-hepatitis-europe-gaps
- [s2] 2030 hepatitis elimination targets might be missed in Europe — The Lancet Oncology, published online 6 August 2026. https://doi.org/10.1016/S1470-2045(26)00393-1
Sources
- World Hepatitis Day 2026: Despite progress towards eliminating hepatitis in Europe, gaps in prevention measures keep 2030 targets out of reach — European Centre for Disease Prevention and Control (ECDC) , July 28, 2026
- 2030 hepatitis elimination targets might be missed in Europe — The Lancet Oncology , August 6, 2026
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