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Viral Hepatitis Elimination Barometer Among PWID in Europe

As only a few countries are on track to eliminate viral hepatitis as a public health threat among people who inject drugs, greater investment in harm reduction services, testing and treatment is needed.

Eliminating viral hepatitis as a public health threat by 2030 is a target set under the UN Sustainable Development Goal on Health (1). The European Union Drugs Agency (EUDA) released an update of its interactive elimination barometer, a tool designed to help countries monitor their progress towards eliminating viral hepatitis among people who inject drugs.

Chronic viral hepatitis can result in serious liver diseases, such as liver cirrhosis and cancer. Hepatitis C virus (HCV) infection is associated with a high burden of disease among people who inject drugs (PWID), the virus being easily transmitted through the sharing of needles and syringes. Of the estimated 1.8 million people who live with chronic HCV infection in the EU/EEA (2), 12% are attributable to recent injecting drug use. Hepatitis B virus (HBV) infection is also more prevalent among PWID than in the general population.

Despite the availability of highly effective treatments for hepatitis C infection, access to HCV testing and care for PWID remains limited. Moreover, HBV vaccination and treatment, opioid agonist treatment and needle and syringe programmes are still not reaching all those who would benefit from these life-saving and cost-saving prevention measures.

How can the barometer help?

Through the barometer, public health workers, policymakers and other interested users can access data to gauge their country’s performance according to 11 epidemiological indicators. Readers can download data tables and infographics and view which countries have achieved the targets set. Monitoring data suggest that most European countries are lagging behind in meeting the targets.

Some positive developments, thanks to integrated models of care

There are, however, some positive developments. According to the European Drug Report 2025, several cities in Spain, Sweden and Norway have reported a reduction in HCV infections among PWID. The largest reduction was seen in Oslo, where the prevalence of HCV infections decreased from 46% in 2015 to 7% in 2023, thus reaching the 80% reduction target set by the WHO.

These successes were largely achieved through a decentralised and integrated approach to HCV prevention, testing and treatment for PWID. However, this approach, endorsed in the joint EUDA-ECDC guidance, is still lacking elsewhere. Overall, the majority of EU Member States have not reached the WHO elimination targets for viral hepatitis. Achieving these targets requires greater investment in harm reduction services, testing and treatment, as the provision in many countries remains insufficient.

Notes

(1) UN Sustainable Development Goal SDG 3.3.

(2) The European Economic Area (EEA) consists of the 27 EU Member States and three countries of the European Free Trade Association (EFTA) (Iceland, Liechtenstein and Norway; excluding Switzerland). The agreement on the EEA entered into force on 1 January 1994.


Source: European Union Drugs Agency