Gavi's impact

Spectacular acceleration

The very first hepatitis B vaccines funded by Gavi were administered to over one million babies in Mozambique in 2001.

Thanks to Gavi's new and underused vaccine support, many other low-income countries quickly introduced the vaccine, spurring a spectacular acceleration of hepatitis B immunisation coverage.

By 2004, 50% of low-income countries had included hepatitis B vaccines in their routine immunisation programmes. This occurred 22 years after the very first introduction in Italy – but only six years after high-income countries had reached the same 50% threshold.

By the end of 2014, all low-income countries had introduced the pentavalent vaccine into their routine immunisation programmes. Gavi, the Vaccine Alliance, now helps to protect roughly half the world’s children against hepatitis B. Since hepatitis B vaccines were first developed in the 1980s, hepatitis B infection rates have fallen dramatically worldwide and there has been a marked drop in liver cancer cases.

Second Gavi Evaluation Report

Gavi's second evaluation report (2010) shows that the average number of country introductions per year of hepatitis B vaccines increased by three-fold following the introduction of Gavi support. Over 80% of countries reached peak coverage within two years of vaccine introduction.  

The report concludes that fewer countries would have introduced these vaccines in the absence of Gavi.

The easy-to-administer five-in-one pentavalent vaccine, which also protects children from diphtheria-tetanus-pertussis (DTP) and Haemophilus influenzae type b, has played a significant part in the increase of hepatitis B vaccine uptake.

The issue

By the late 1990s, the hepatitis B vaccine had been on the market for two decades, but was not reaching enough developing countries


Vaccinating against hepatitis B is an important investment in a country's future. The hepatitis B virus is the leading cause of liver cancer and is 50 times more infectious than HIV. While infections occur mostly in young children, the deadly consequences of the virus usually strike later in life as liver disease, including cirrhosis and liver cancer.

An estimated 240 million people worldwide are chronically infected with the hepatitis B virus, which claims approximately 700,000 lives every year due to acute or chronic liver disease.

Transmission of the virus from mother to newborn infant is a major contribution to disease in regions such as Asia and the Pacific Rim, where infection is widespread. The majority of cases could be avoided through vaccination. The vaccine is 95% effective in preventing infection and the development of chronic disease and liver cancer due to hepatitis B.


By the late 1990s, the hepatitis B vaccine was taking longer than the average 15 years usually required for a new vaccine to reach large numbers of the world's poorest children.

Hepatitis B vaccines had become available in 1982, with Italy becoming the first high-income country to introduce the vaccine into its national immunisation programme only a year later.

Yet it was only in 1985 that Zimbabwe became the first developing country to follow WHO's 1992 recommendation that childhood hepatitis B vaccination be included in all immunisation programmes

By 2000, the infection was claiming an estimated 900,000 lives each year, most of them in developing countries. Yet only 22 low-income countries had access to the hepatitis B-containing vaccine.


Gavi's response

Gavi supports hepatitis B vaccines as part of the five-in-one pentavalent vaccine

As soon as Gavi was established in 2000, hepatitis B vaccine became one of the three vaccines immediately made available for support.


Initially, Gavi provided support for hepatitis B monovalent vaccine. However, in December 2005, the Gavi Board decided only to accept new applications for hepatitis B vaccine support through combination vaccines (tetravalent and pentavalent).

The five-in-one pentavalent vaccine, administered in a three-dose schedule, offers countries the added incentive of providing protection from hepatitis B at the same time as immunising their children against four other diseases: diphtheria, tetanus, pertussis (DTP3) and Haemophilus influenzae type b (Hib).

Pentavalent also brings savings in cost of equipment, delivery and disposal programmes.

How to apply for vaccine support

October 16, 2019

Vaccine support

Gavi supports vaccines against 17 infectious diseases. Learn more about our support for each vaccine.

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