On World Hepatitis Day (28 July), a new initiative implemented by PATH and backed by Gavi, the Vaccine Alliance and Unitaid is taking aim at an urgent but overlooked threat to newborn health: hepatitis B.
Each year, an estimated 1.2 million people become newly infected with hepatitis B, a virus that can lead to chronic liver disease and liver cancer. Many of these infections begin early in life – often transmitted at birth. Exposure to hepatitis B is also far more dangerous for newborns than others: most healthy adults who contract the virus will clear the infection on their own, but 90% of infants who are infected at birth go on to develop a chronic, lifelong infection.
And yet, many countries still lack the tools, resources, or systems to identify pregnant women with hepatitis B and protect newborns with a simple vaccine that could change their future.
The SAFEStart+ project, led by PATH with partnership and funding from Unitaid, aims to change that. The new initiative seeks to improve maternal and newborn health by ensuring screening and treatment for transmissible diseases like HIV, hepatitis B, syphilis and Chagas disease are available in antenatal care programs, to ensure quality care for mothers and avoid preventable infections in babies.
For hepatitis B, that means systematically screening pregnant women for the infection and delivering a preventive dose of the hepatitis B vaccine to babies within 24 hours of their birth.
But in low- and middle-income countries, where giving birth outside of health facilities is common, designing systems that can effectively integrate vaccination services that can reach newborns on time is a challenge. In Africa, only 18% of newborns currently receive the hepatitis B birth dose vaccine, despite the region accounting for more than 60% of new infections.
Through an innovative approach to pool resources, Unitaid, Gavi and PATH have partnered to lead research into some of the complex challenges that restrict access to timely birth-dose vaccination.
With funding from Gavi, PATH is engaging communities, health care providers, and health system leaders in Ethiopia and Uganda to design innovative community-based vaccine delivery strategies to ensure newborns receive the hepatitis B vaccine within 24 hours of birth, particularly for babies born at home. In The Gambia and Nigeria, efforts are underway to synthesize lessons learned from over two decades of hepatitis B birth dose implementation experience – learning what has worked and for whom, and where new strategies are needed to reach coverage goals. The research will also identify barriers and enablers to hepatitis B birth dose vaccine introduction and scale up across the four countries, including supply chain considerations and market-based factors.
In addition, leveraging the SAFEStart+ platform, PATH will pilot the prototypes of community-led vaccine delivery models identified in Ethiopia and Uganda, test approaches that allow vaccines to be safely stored and delivered in areas where constant refrigeration is not possible, and investigate methods to improve efficiency and reduce vaccine waste to improve cost-effectiveness.
This is about making it easier for people to get the care they need,” said Dr. Philippe Duneton, Executive Director of Unitaid. “By simplifying access to testing and treatment for hepatitis B and linking it with care for other diseases, we’re helping countries reach more people, earlier, so they can live healthier, longer lives.”
By identifying what works – and what doesn’t – the initiative aims to guide country-level decision-making, support manufacturers with demand forecasting and regulatory clarity, and inform global strategies to scale up access, directly linking with Unitaid’s efforts to strengthen hepatitis B virus screening and treatment for mothers through antenatal care.
 “As countries face increasingly stretched budgets, it’s more critical than ever that they have strong evidence to guide high-impact, cost-effective ways to improve health,” said Dr. Nanthalile Mugala, Chief of Africa Region, PATH. “These learnings will help scale up proven strategies to increase timely access to birth dose vaccines, particularly across Africa where many countries are gearing up to introduce the hepatitis B birth dose.”
The SAFEStart+ project and the Unitaid-Gavi partnership reflects a growing push to bring care into communities, reduce fragmentation, and design services that respond to the needs of women, newborns, and frontline providers.
 “To effectively protect every child from preventable diseases, we need solid evidence on what works, where, and why,” said Dr. Stephen Sosler, Head of Vaccine Programs at Gavi. “Through this learning agenda, Gavi is supporting research that drives action – helping countries scale up hepatitis B birth-dose vaccination and maternal screening and giving more babies a healthier start from day one.”
This work is part of Gavi’s broader mission to ensure access to life-saving vaccines, a mission that depends on continued support from donors. Raising resources is essential to sustain and scale such initiatives to protect the most vulnerable – including newborns at risk of hepatitis – and build healthier futures for all.
On this World Hepatitis Day, it’s a reminder that innovation doesn’t always mean new technology – it often means finding better ways to deliver what we already have and ensure it reaches all those who need it.
And for the millions of children at risk of hepatitis B at birth, those better ways can’t come soon enough.
Kyle Wilkinson
Communications officer
+41 79 445 17 45
wilkinsonk@unitaid.who.int
