Voices from the frontline: how global funding cuts are reshaping the viral hepatitis response

Marion Delphina [email protected] ∙ Monica Fambroughb ∙ Jana Manningb ∙ Lindsey Hiebert-Suwondob ∙ Jessica Hicksc ∙ Philippa C Matthewsa,d,e
February 18, 2026 , The Lancet, Gastroenterology & Hepatology

Hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the world's leading infectious threats, together responsible for over a million deaths each year, but these infections remain neglected by global funding.1,2 In 2025, the US Government revised its global health priorities and substantially reduced foreign aid commitments,3–5 including cuts to the US Agency for International Development and the President's Emergency Plan for AIDS Relief, with estimated reductions totalling around US$60 billion.6,7 HIV infrastructure, built and maintained with this funding, has long provided resources that also support interventions for HBV and HCV, including harm reduction, screening, prophylaxis, treatment, clinic space, and staffing. Against this backdrop, reductions in global health funding risk destabilising these interconnected systems, with consequences for HBV and HCV elimination efforts worldwide.

To explore the early real-world consequences of funding reductions on hepatitis elimination efforts, the Coalition for Global Hepatitis Elimination (CGHE), the World Hepatitis Alliance (WHA), and the Hepatitis Elimination Lab (Plan-B) team issued online surveys to researchers, health-care workers, public health practitioners, civil societies, community-based organisations, people living with HBV or HCV, and government and ministry of health representatives, including national hepatitis programme managers (appendix pp 2–30).8 Surveys were shared from March to October, 2025, through social media, emails, and conference presentations. Responses could be submitted anonymously.

These surveys gathered quantitative and qualitative input from 240 individuals and groups working internationally in hepatitis awareness, patient support, vaccination, testing, care, treatment, and research, allowing them to describe how changes in the global funding landscape have impacted their lives and work. In the Plan-B survey, 31% of respondents reported high impact and 37% possible impact of the funding cuts on clinical care, and 40% of respondents reported high impact and 40% possible impact on research. In responses to the CGHE survey, 40% of organisations and 62% of programme managers reported being affected, and half of respondents to the WHA survey indicated that hepatitis services in their country had already been impacted.

The reasons for these disruptions were broadly consistent: participants cited the collapse of the HIV service framework that previously supported viral hepatitis programmes, the direct loss of research funding, and remaining funds being redirected to other health priorities. Respondents highlighted severe staffing losses—among both clinical teams and ministry of health and public health personnel—which led to clinic closures and, alongside the withdrawal of US National Institutes of Health-funded grants, the cancellation of ongoing research studies.

TO CONTINUE: https://www.thelancet.com/journals/langas/article/PIIS2468-1253(26)00014-2/fulltext​

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