Polity, politics, and policy dimensions of viral hepatitis elimination advancements in Africa: A 2-staged narrative review and evidence synthesis
1
Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
2
Department of Political Science, Ebonyi State University, Abakaliki, Nigeria
3
Department of Public Administration, Faculty of Social Sciences, University of Calabar, Calabar, Nigeria
4
Department of Human Psychology, Ebonyi State University, Abakaliki, Nigeria
5
Equality, Diversity, and Inclusion Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Despite Africa's disproportionate burden of viral hepatitis B and C, political attention, policy prioritisation, and sustainable financing for hepatitis elimination remain inadequate across most countries. Understanding the influence of political will, governance structures, and health policy environments is critical to achieving the WHO 2030 elimination targets. Yet, the interconnected dimensions of polity (governance and institutional frameworks), politics (actors, power, and interests), and policy (formal strategies and resource allocation) remain under-examined in the African hepatitis response. This review explored how political commitment, governance structures, and health policy frameworks have shaped hepatitis elimination efforts across Africa.
METHODS:
A two-staged narrative review was conducted between January and July 2025. Searches included peer-reviewed literature published between 2010 and 2025, identified via databases such as PubMed, Scopus, and Google Scholar, using terms including "hepatitis policy Africa", "health governance", & "political will". Grey literature from WHO regional offices, African Union, Ministries of Health, and civil society reports were reviewed. A framework analysis approach was used, guided by the Walt and Gilson policy triangle (context, content, actors, and process).
RESULTS:
The review revealed significant variability in political prioritisation and policy adoption across African countries. Countries such as Egypt, Rwanda, and Uganda demonstrated strong political leadership and dedicated hepatitis strategies, while others lacked national plans or budget lines. Key enabling factors included civil society advocacy, integration of hepatitis into broader UHC and HIV frameworks, and donor-supported policy development. However, major barriers included fragmented governance, competing health priorities, minimal domestic financing, and weak policy implementation mechanisms.
CONCLUSIONS:
Hepatitis elimination in Africa is not solely a technical challenge but a deeply political one. Sustainable progress requires strategic engagement with political systems, evidence-informed advocacy, and policy coherence. Regional bodies such as the African Union can play a catalytic role in harmonising efforts and elevating hepatitis on the continental health agenda.
Despite Africa's disproportionate burden of viral hepatitis B and C, political attention, policy prioritisation, and sustainable financing for hepatitis elimination remain inadequate across most countries. Understanding the influence of political will, governance structures, and health policy environments is critical to achieving the WHO 2030 elimination targets. Yet, the interconnected dimensions of polity (governance and institutional frameworks), politics (actors, power, and interests), and policy (formal strategies and resource allocation) remain under-examined in the African hepatitis response. This review explored how political commitment, governance structures, and health policy frameworks have shaped hepatitis elimination efforts across Africa.
METHODS:
A two-staged narrative review was conducted between January and July 2025. Searches included peer-reviewed literature published between 2010 and 2025, identified via databases such as PubMed, Scopus, and Google Scholar, using terms including "hepatitis policy Africa", "health governance", & "political will". Grey literature from WHO regional offices, African Union, Ministries of Health, and civil society reports were reviewed. A framework analysis approach was used, guided by the Walt and Gilson policy triangle (context, content, actors, and process).
RESULTS:
The review revealed significant variability in political prioritisation and policy adoption across African countries. Countries such as Egypt, Rwanda, and Uganda demonstrated strong political leadership and dedicated hepatitis strategies, while others lacked national plans or budget lines. Key enabling factors included civil society advocacy, integration of hepatitis into broader UHC and HIV frameworks, and donor-supported policy development. However, major barriers included fragmented governance, competing health priorities, minimal domestic financing, and weak policy implementation mechanisms.
CONCLUSIONS:
Hepatitis elimination in Africa is not solely a technical challenge but a deeply political one. Sustainable progress requires strategic engagement with political systems, evidence-informed advocacy, and policy coherence. Regional bodies such as the African Union can play a catalytic role in harmonising efforts and elevating hepatitis on the continental health agenda.
| eISSN: | 2654-1459 |
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