Policy brief — Ethiopian Organization for Cancer Prevention and Research
Infant hepatitis B vaccination coverage reached 81% in 2025 (WHO Global Health Observatory, indicator WHS4_117). Of the 7.66 million Ethiopians living with chronic infection in 2024, 4.93% had been diagnosed and 0.07% were on treatment. Those three are WHO modelled estimates (indicators HEPATITIS_HBV_LIVINGWITH_NUM, HEPATITIS_HBV_DIAGNOSIS_PERINFECTED_PER100 and HEPATITIS_HBV_TREATMENT_PERINFECTED_PER100).
THE ISSUE
The childhood picture has improved substantially: infection in children under five fell from 1.5% in 2015 to 0.6% in 2024, against a WHO African Region average of 1.4% (WHO Global Health Observatory, indicator SDGHEPHBSAGPRV, modelled). Among those infected earlier the position differs: of an estimated 7.66 million living with chronic hepatitis B in 2024, 4.93% had been diagnosed and 0.07% treated.
THE EVIDENCE
Chronic hepatitis B is an established cause of liver cancer (opens in a new tab) on IARC’s classification. Age at infection determines what follows: infection acquired in adulthood becomes chronic in fewer than 5% of cases, in infancy or early childhood about 95% (opens in a new tab) — hence WHO’s recommendation of a dose within 24 hours of birth.
Ethiopian chronic hepatitis B prevalence was 5.80% in 2024 (opens in a new tab) [5.12–6.45], down from 7.76% in 2015, with an estimated 7,656,209 people infected [6,761,451–8,522,781] (WHO Global Health Observatory, indicators HEPATITIS_HBV_PREVALENCE_PER100 and HEPATITIS_HBV_LIVINGWITH_NUM). Ethiopia publishes no programme data on hepatitis B.
The cascade, same series: diagnosis coverage 4.89% of infected people in 2015 and 4.93% in 2024 (HEPATITIS_HBV_DIAGNOSIS_PERINFECTED_PER100); treatment coverage 0.01% and 0.07% (HEPATITIS_HBV_TREATMENT_PERINFECTED_PER100). WHO’s modelled count of people on treatment in 2024 is 5,625 [4,968–6,262] (HEPATITIS_HBV_TREATMENT_NUM). WHO’s 2024 guidance estimates more than half of people with chronic hepatitis B will need treatment at some point; tenofovir and entecavir are off-patent tablets.
Worldwide in 2024, 240 million people were living with chronic hepatitis B and 1.1 million died of it. On the same 2026 fact sheet, 27% globally know their status and 4.3% are on treatment, against Ethiopia’s 4.93% and 0.07%; the Global hepatitis report 2026 (opens in a new tab) carries the series.
Vaccination runs the other way: coverage of one-year-olds rose from 47% at introduction in 2007 to 81% in 2025 (GHO indicator WHS4_117), against a 2030 target of 0.1% infection in children under five.
Liver cancer is the endpoint the treatment gap bears on: an estimated 2,346 cases and 2,143 deaths in 2024 (opens in a new tab), close to one death per new case in the same year. The 7.66 million already infected are the pool the next thirty years of cases will be drawn from.
Hepatitis C is smaller — 0.53% prevalence in 2024 — and curable: direct-acting antivirals cure more than 95% of infections (opens in a new tab) on WHO’s July 2026 fact sheet.
AREAS FOR CONSIDERATION
Ethiopia’s national schedule includes a monovalent hepatitis B dose at birth, followed by pentavalent at 6, 10 and 14 weeks (WHO immunisation schedule data for 2025; 151 countries recorded a birth dose in their 2025 schedules). WHO identifies the birth dose as what determines whether a mother’s infection passes to her child. What is not published is Ethiopian coverage of that birth dose: the 81% recorded for 2025 is third-dose coverage among one-year-olds (indicator WHS4_117), and no separate birth-dose coverage figure for Ethiopia appears in any source used here. The schedule entry establishes the policy; it does not establish how many newborns are reached.
Diagnosis coverage has been static at roughly 4.9% since 2015: 4.89% then, 4.93% in 2024 (indicator HEPATITIS_HBV_DIAGNOSIS_PERINFECTED_PER100). Antenatal contact is where a woman’s infection status determines an action for her infant within its first day of life; closing the gap between that contact and a figure unmoved in nine years is what this evidence bears on.
A person told they have chronic hepatitis B here has no published means of finding out where treatment can be obtained or what it costs. Whether testing, monitoring and a year of tablets long off patent sit inside a funded benefit package, and at what charge, is unsettled; until it is, no one can say what a positive result leads to.
Every figure here is a modelled estimate with intervals wider than a million people; a measured national cascade would replace them.
WHAT WE DO NOT KNOW
The cost and availability of hepatitis B testing, monitoring and antiviral treatment at an Ethiopian facility are undocumented in any source used here. The birth dose is in Ethiopia’s schedule; what share of newborns actually receives it within 24 hours is not published.
The aetiology of Ethiopian liver cancer is unknown: the split between hepatitis B, hepatitis C and aflatoxin exposure among the estimated 2,346 cases in 2024 (IARC, GLOBOCAN 2024) has not been established, so how many liver cancers treatment would avert cannot be estimated. Aflatoxins are Group 1 for liver cancer on IARC’s classification, but no Ethiopian exposure data was verified.
Two dips in the infant vaccination series (indicator WHS4_117) — 62% in 2012 to 59% in 2013, 71% in 2020 to 69% in 2021 — have no documented explanation.
Ethiopian liver cancer counts, like every cancer figure here, are modelled estimates from subnational registry data. Sources disagree on whether Ethiopia has a population-based cancer registry: Ethiopia reported to WHO in 2021 that one exists (indicator NCD_CCS_PBCR), while IARC’s Cancer Incidence in Five Continents and Cancer Over Time contain no Ethiopian registry. Neither position has been reconciled in any published source, and on either account the figures here are modelled.