Country-level hepatitis B treatment coverage answers a different question from diagnosis coverage or clinical response to antiviral therapy. The WHO indicator used here asks how much treatment initiation has reached the estimated population living with chronic hepatitis B. The latest retained dataset contains 99 countries and areas. Ninety-four observations are dated 2024, while five use another recent year. Restricting the comparison to the 94 observations from 2024 gives a median of 0.585% and an unweighted country mean of 4.83%.
The distribution is strongly skewed. Fifty-five of the 94 same-year observations are below 1%, and 75 are below 5%. At the other end, Cuba is 96.30%, Guyana 42.41%, Bermuda 41.79%, Uganda 38.36%, Eritrea 31.35%, and Botswana 20.99%. A small number of high observations lift the mean well above the median, so the average alone does not describe the typical country in this set.
The denominator also needs careful interpretation. WHO uses the estimated number of people living with chronic HBV as the denominator, while the numerator is the number of people with chronic hepatitis B who were eligible for treatment and have ever initiated treatment. Not every person with chronic HBV meets treatment criteria at the same time. This indicator therefore should not be rewritten as the percentage of treatment-eligible patients who received care, and it is not a measure of drug efficacy.
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The indicator measures treatment reach relative to the total chronic HBV burden
The WHO indicator metadata defines chronic hepatitis treatment coverage as the share of the estimated infected population represented by people who have initiated treatment. For HBV, the numerator is the number of people with chronic hepatitis B ever initiated on treatment among those eligible, while the denominator is the estimated number of people living with chronic HBV. Programme monitoring systems, clinical records, nationally representative biomarker surveys and modelled estimates can contribute to measurement.
That denominator makes the indicator broader than a clinic-based treatment uptake rate. A value of 10% does not mean that only 10% of patients who met treatment criteria were treated. It means that the number ever initiated on treatment is equivalent to about 10% of the estimated total chronic HBV population. People living with chronic HBV who do not currently meet treatment criteria remain in the denominator.
Hepatitis B treatment is also different from hepatitis C treatment. Chronic HBV can be suppressed with potent oral antivirals, but treatment often continues for many years and commonly for life. The purpose is to reduce viral replication and lower the risk of cirrhosis, liver cancer and premature death. This coverage measure is therefore best read as a health-service reach indicator within a long-term care pathway.
The 2024 median is 0.585%, far below the 4.83% unweighted mean
Among the 94 observations dated 2024, the median is 0.585%. Half of the country and area observations fall below that value and half above it. The unweighted mean is 4.83%, but the difference between the mean and median is large because a handful of high values pull the mean upward.
The grouped distribution makes the shape clearer. Twenty-three observations are below 0.1%, 19 are from 0.1% to below 0.5%, 13 are from 0.5% to below 1%, 20 are from 1% to below 5%, 13 are from 5% to below 20%, and only six are 20% or higher. In other words, 55 of 94 are below 1% and 75 are below 5%.
Cuba, Guyana, Bermuda and Uganda lead the 2024 same-year subset
Cuba reports 96.30% in the 2024 subset. Guyana is 42.41%, Bermuda 41.79%, Uganda 38.36%, Eritrea 31.35%, and Botswana 20.99%. Benin is 16.51%, Mongolia 14.62%, Qatar 11.15%, and New Zealand 10.00%. Only six of the 94 same-year observations are at or above 20%.
| Country or area | 2024 HBV treatment coverage |
|---|---|
| Cuba | 96.30% |
| Guyana | 42.41% |
| Bermuda | 41.79% |
| Uganda | 38.36% |
| Eritrea | 31.35% |
| Botswana | 20.99% |
| Benin | 16.51% |
| Mongolia | 14.62% |
| Qatar | 11.15% |
| New Zealand | 10.00% |
These values should not be converted into a simple league table of health-system quality. Treatment coverage depends on the estimated HBV burden, diagnosis coverage, treatment eligibility criteria, the timing and scale of national programmes, and the completeness of patient monitoring and reporting. A country can improve treatment delivery while its percentage changes more slowly if the estimated infected population is revised upward or treatment eligibility expands.
The 2024 WHO HBV guidelines broadened and simplified treatment eligibility. That change is intended to make treatment easier to start and to reduce barriers created by complex staging requirements. As national programmes adopt newer criteria, future coverage can change because both the number considered eligible for treatment and the number actually starting therapy may increase.
Very low values do not mean that hepatitis B treatment is completely absent
At the lower end of the 2024 data, Guinea and Myanmar are 0.01%, Malawi is 0.02%, and Ghana, Lesotho, Madagascar and Papua New Guinea are 0.03%. Somalia and Zimbabwe are 0.04%, while Sri Lanka, Togo and the United Republic of Tanzania are 0.05%. These values indicate that reported treatment initiation is very small relative to the estimated chronic HBV population used in the denominator.
They do not prove that no one in those countries receives antiviral therapy. A national percentage can remain very low when diagnosis coverage is limited, treatment eligibility assessment is difficult to access, programmes are still small relative to the estimated burden, or patient monitoring systems do not capture all treatment initiation. The indicator shows the outcome, not the contribution of each possible cause.
Chronic HBV can remain asymptomatic for long periods, which makes diagnosis an essential step before treatment coverage can expand. Vaccination, prevention of mother-to-child transmission, testing, diagnosis, treatment eligibility assessment and long-term retention in care are separate parts of the hepatitis B response. This article does not infer one stage from another when the required data are not in the verified indicator.
Korea, Australia and Japan are not included in the 2024 ranking
The latest-value map contains 99 observations, but five are not dated 2024. Kiribati is 21.96% in 2025 and Thailand 3.96% in 2025. The Republic of Korea is 22.01% in 2023, Australia 24.46% in 2023, and Japan 19.22% in 2021. These values are retained on the latest-value map because they are the most recent observations in the dataset, but they are excluded from the 2024 ranking and distribution.
Separating the years matters because hepatitis B treatment policy and programme coverage can change over time. The WHO treatment guidelines were updated in 2024, and later observations may reflect a different eligibility environment than a 2021 or 2023 observation. Ranking a 2021 value against a 2025 value to two decimal places would mix real country differences with data recency.
The map therefore answers “what is the latest available observation for each included country?” The 2024 chart and tables answer a narrower question: “how are the observations distributed when the reference year is held constant?” Using both views preserves recency without pretending that mixed-year observations are perfectly synchronized.
The WHO global 2024 figure of 4.3% is not the same as the 4.83% country mean
The WHO hepatitis B fact sheet estimates that 240 million people were living with chronic hepatitis B in 2024 and that about 10 million were receiving antiviral treatment, equivalent to roughly 4.3% of people living with chronic HBV. That global figure is close numerically to the 4.83% unweighted mean across the 94 country observations dated 2024, but the two statistics are not calculated in the same way.
The 4.83% mean gives each country or area one equal vote regardless of the number of people living with chronic HBV. A small country and a very populous country therefore have identical weight. The WHO global estimate is built from the global burden and treatment totals, so countries contribute according to the scale of infection and treatment. Similar numerical values should not be treated as evidence that the two calculations are interchangeable.
For describing the cross-country distribution, the median and band counts are useful. For describing the share of all people living with chronic HBV worldwide who receive treatment, the WHO global estimate is the appropriate figure. Keeping those purposes separate avoids turning an unweighted country summary into a population-weighted world statistic.
Low treatment coverage is not evidence that HBV antivirals are ineffective
The WHO fact sheet states that chronic hepatitis B can be treated with oral medicines such as tenofovir or entecavir. Treatment can slow the progression of cirrhosis, reduce the incidence of liver cancer and improve long-term survival. Most people who start HBV treatment need to continue it for life. Treatment coverage therefore measures reach, not the biological effectiveness of the medicine.
Viral suppression after treatment, adherence, retention in care, monitoring for liver disease and cancer surveillance are separate clinical outcomes. A country with 1% coverage and a country with 20% coverage can differ substantially in how many infected people have reached treatment, but this single indicator does not reveal the treatment response among those already receiving therapy.
The 2024 WHO guidelines for chronic hepatitis B expanded and simplified treatment criteria. WHO notes that with the updated criteria, more than half of people living with chronic HBV may require treatment depending on the setting and eligibility conditions. That context helps explain why a treatment-coverage value calculated against the total infected population can remain far below 100% even in a functioning treatment programme.
Gray areas on the map are missing observations, not zero treatment
The retained table contains 99 countries and areas rather than a complete observation for every country in the world. Gray areas on the map should therefore not be interpreted as 0% treatment coverage. They indicate that no retained observation from this 99-row extract is joined to that polygon.
Small islands and separately reported territories can also have a valid statistical row without appearing as a distinct filled polygon in the low-resolution world boundary layer. Bermuda and Kiribati are examples of places where the statistical observation remains part of calculations even when the global-scale geometry is visually small.
Very small numeric values are kept separate from missing values. A reported 0.01% remains 0.01%; it is not rounded into a missing category, and a missing country is not converted to zero. That distinction is essential when the lower end of the distribution is densely populated with values below 1%.
Data source and calculation method
The statistical source is the WHO Global Health Observatory indicator HEPATITIS_HBV_TREATMENT_PERINFECTED_PER100. Its definition and methods are documented in the WHO indicator metadata, and country observations are available through the WHO GHO OData API. The WHO chronic viral hepatitis data page places treatment coverage alongside infection, diagnosis and mortality indicators.
The latest-value map uses all 99 retained observations. The median, unweighted mean, grouped distribution and 2024 ranking tables use only the 94 rows dated 2024. No older observation is re-labelled as 2024, no missing value is replaced by zero, and no unsupported interpolation is added.
The purpose of the comparison is to show how far treatment has reached relative to the estimated chronic HBV burden across reporting countries and areas. It should not be used as a standalone ranking of national health policy because treatment criteria, burden estimation, diagnosis coverage, programme maturity and reporting systems differ across settings.
Frequently Asked Questions
What does chronic hepatitis B treatment coverage measure?
It compares the number of people with chronic HBV ever initiated on treatment among those eligible with the estimated total population living with chronic HBV.
Is this the percentage of treatment-eligible patients who receive treatment?
No. The denominator is the estimated total chronic HBV population, not only people who meet treatment criteria. It is therefore a broader population-level coverage measure.
Are all observations on the map from 2024?
No. Of 99 latest observations, 94 are from 2024. Kiribati and Thailand are from 2025, Australia and the Republic of Korea from 2023, and Japan from 2021. Same-year statistics use only the 94 observations dated 2024.
Is the 4.83% unweighted mean the global HBV treatment rate?
No. It is a simple mean across 94 country and area observations from 2024. WHO estimates that about 4.3% of people living with chronic HBV worldwide were on antiviral treatment in 2024, using a different global aggregation.
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