Executive Summary
In 2024, CFID executed Hepatitis B (HBV) and Hepatitis C (HCV) interventions across 12 of Nigeria’s 36 states, aligning with WHO’s 2030 elimination targets and Nigeria’s National Strategic Framework (2022–2030). We tested 165,300 individuals, linked 100% of diagnosed cases to care within one month, and achieved 100% sustained virologic response (SVR) for HCV patients. Key challenges, including limited state funding and high awareness costs, were met with advocacy and community strategies. This report outlines our efforts to address Nigeria’s hepatitis burden, affecting approximately 20 million people.
Suggested Image: CFID-led hepatitis awareness campaign or community testing event.
Introduction
Nigeria faces a significant hepatitis burden, with adult HBV and HCV prevalence at 8.1% and 1.1%, respectively (NAIIS, 2018). CFID’s 2024 interventions, guided by WHO and national strategies, aimed to reduce new infections by 90% and deaths by 65% by 2030. Operating in 12 states, we prioritized integrated testing, treatment, and prevention, focusing on equitable access for rural and key populations.
Program Overview
CFID’s 2024 interventions encompassed:
- Testing and Diagnosis: Scaled rapid testing and community screening, integrated with HIV/TB platforms.
- Linkage to Care: Ensured rapid treatment access for HBV and HCV using peer navigation.
- Prevention and Vaccination: Enhanced HBV birth-dose and catch-up vaccination, alongside PMTCT efforts.
- Awareness and Stigma Reduction: Ran media and community campaigns to boost awareness and reduce stigma.
Suggested Image: CFID mobile testing unit or vaccination campaign.
Key Statistics
Testing and Diagnosis
- Individuals tested for HBV/HCV: 165,300
- HBV/HCV status awareness: 100%
- New diagnoses: 420 HBV, 122 HCV
Linkage to Care
- Diagnosed linked to care within 1 month: 100%
- HBV treatment initiated: 121
- HCV treatment (DAAs) initiated: 55
- HIV/HCV co-infected linked to care: 100%
Treatment and Viral Suppression
- HBV patients on antiviral treatment: 56%
- HCV patients achieving SVR: 100%
- Adherence support recipients: 176
Prevention Metrics
- Newborns receiving HBV birth-dose vaccine (within 24 hours): 56%
- Adults vaccinated (catch-up): 56,230
- Pregnant women screened for HBV (PMTCT): 133,200
- Harm reduction interventions: 0
Table 1: Hepatitis Elimination Progress
| Indicator | WHO Target (%) | CFID 2024 (%) | Gap to Target (%) |
| HBV Testing Coverage | 90 | 45 | 45 |
| HCV Testing Coverage | 90 | 45 | 45 |
| HBV Treatment Coverage | 80 | 35 | 45 |
| HCV SVR | 80 | 100 | 0 |
| HBV Birth-Dose Vaccination | 90 | 44 | 46 |
Intervention Strategies
- Testing and Diagnosis
- Deployed validated rapid test kits across 12 states, integrated with MCH and HIV services.
- Conducted community screening targeting rural areas and key populations.
- Screened partners/spouses of HBsAg-positive individuals.
Suggested Image: CFID community screening or mobile clinic.
- Linkage to Care
- Utilized HIV infrastructure for hepatitis care in high-prevalence states.
- Employed peer navigators to connect patients to treatment.
- Advocated for subsidized treatment to lower costs.
- Treatment and Retention
- Promoted tenofovir for HBV, integrated with HIV care.
- Expanded affordable DAAs for HCV, inspired by Nasarawa’s $60 model.
- Offered counseling and peer support for adherence.
Suggested Image: CFID treatment center or patient support group.
- Prevention and Vaccination
- Improved HBV birth-dose vaccination timing in facilities.
- Ran catch-up vaccination campaigns for adults and adolescents.
- Integrated HBsAg screening and TDF prophylaxis in antenatal care in Plateau, Zamfara, Nasarawa, and Taraba.
Challenges and Solutions
Challenges
- Limited state support for TDF prophylaxis for pregnant women.
- High costs of awareness campaigns.
- Low awareness (>80% unaware of status).
- Expensive treatment and insufficient funding.
- Inconsistent HBV birth-dose vaccination.
Solutions
- Advocated to state parliament and opinion leaders.
- Engaged First Ladies to champion efforts.
- Launched media and community campaigns.
- Pushed for integration with antenatal/MCH services.
- Trained health workers to enhance systems.
Suggested Infographic: Barriers to hepatitis care and CFID’s responses.
Progress Toward Elimination
CFID advanced elimination goals in 2024. In Nasarawa, HBV testing reached 70%, and HCV SVR hit 100%. Taraba’s HBV birth-dose vaccination rose from 52% to 60%. Gaps persist in testing and treatment coverage across the 12 states.
Suggested Figure: Bar chart of CFID’s 2024 metrics vs. WHO 2030 targets.
Recommendations for 2025
- Scale integrated testing with HIV/TB platforms.
- Push for national subsidies on HBV/HCV treatment.
- Enhance HBV birth-dose vaccination logistics and training.
- Intensify awareness campaigns to reduce stigma.
Conclusion
CFID’s 2024 efforts underscore our dedication to Nigeria’s hepatitis elimination by 2030. By expanding interventions across 12 states, we tackle a major public health issue. Sustained collaboration is vital for success.
Suggested Image: Community event or beneficiaries.
Acknowledgments
We acknowledge the Federal Ministry of Health, WHO, community health workers, and partners: World Hepatitis Alliance, Hepatitis B Foundation, Coalition for Global Hepatitis Elimination, Gilead ALL4LIVER grant, ViiV Healthcare Positive Action, PEPFAR US Embassy Small Grants, SFH, AHNi, and Pfizer Plc.
Partners
- ViiV Healthcare Positive Action
- Gilead Sciences
- Pfizer Plc
- PEPFAR US Embassy
- SFH
- AHNi
References
- Federal Ministry of Health, Nigeria. (2022). National Strategic Framework for Viral Hepatitis Control in Nigeria 2022–2026.
- World Health Organization. (2016). Global Health Sector Strategy on Viral Hepatitis 2016–2021.
- Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS). (2018).