Liberia Faces Challenges Expanding Hepatitis B Prevention and Care

An estimated 13.5 percent of adults and 4.7 percent of children under five in Liberia are living with chronic hepatitis B, highlighting the challenge facing health authorities as they seek to expand prevention, testing and treatment services across the country.

Dr. Jonathan Flomo, Program Manager of the National AIDS and STI Control Program, which also oversees viral hepatitis, says the expansion of services requires more vaccines, testing kits and logistical support, as well as increased government funding.

“We need more of the vaccine because we want to scale up,” Flomo told K-News in an interview, explaining that the current intervention began in Montserrado County, with plans to extend it to other counties.

His comments come as Health Minister Dr. Louise Mapleh Kpoto calls for increased domestic financing in the proposed 2027 national budget, warning that declining support from international partners could threaten essential healthcare services.

Flomo said additional government support would be critical to making hepatitis B services accessible to more people.

“So we think it is important for the government to get involved into this, to ensure that the advocacy that was done by the Minister of Health, ensuring that we can have that support that will ensure that those services can reach the entire country and reach the population, that would be helpful,” he said.

He added that domestic financing is necessary to sustain the response.

“As the minister said, we thought that it's important to rely on domestic resource mobilization because that's where sustainability lies,” Flomo said.

3,741 Healthcare Workers Vaccinated

Flomo disclosed that nearly 4,000 healthcare workers in Montserrado County had received hepatitis B vaccinations as part of the ongoing intervention. According to data accompanying the interview the sprecise number of vacinated personel stands at  3,741 .

He said healthcare workers were prioritized because their duties expose them to potentially infectious blood and body fluids.

“So we say, no, let's look at people who are more at risk. We say healthcare workers because they are the ones interacting with people playing with body fluids. They're doing operations. They're doing other things,” Flomo explained.

He said the vaccination effort is being carried out alongside awareness and screening activities.

“As of today, we have vaccinated almost 4,000 healthcare workers in Monserrato,” he said, noting that some workers were already receiving their second dose of the three-dose vaccine series.

Flomo said the program plans to expand vaccination to other vulnerable groups, including spouses and family members of people living with hepatitis B.

Birth-Dose Vaccine Planned for 2027

Preventing transmission from mother to child is another part of the Ministry of Health's planned response.

Flomo said the Ministry is working toward introducing a hepatitis B birth-dose vaccine through the Expanded Programme on Immunization, with implementation expected to begin in 2027.

“One of the most effective way is to break that barrier the moment the child is born by giving them the birth dose vaccine,” he said.

He explained that infection acquired during infancy is particularly dangerous because children infected at that stage are more likely to develop chronic hepatitis B.

“So we want to approach them from all fronts,” Flomo said, explaining that the planned approach includes screening pregnant women for hepatitis B, HIV and syphilis, while newborns would receive the birth-dose vaccine.

He said the national program also intends to expand vaccination among healthcare workers and other vulnerable groups.

Ministry Working to Procure Antiviral Medicine

While vaccination helps prevent infection, people already living with chronic hepatitis B may require ongoing medical monitoring and treatment.

Flomo said the Ministry of Health is working to procure tenofovir alafenamide (TAF), an antiviral medicine used in the management of chronic hepatitis B. The Health Authory enphasized that the procurement is  TAF is a future step, meaning the antiviral is not yet avaible through the public program.

He explained that people who remain positive after follow-up testing may undergo additional investigations, including tests to assess their liver and measure the amount of virus in their blood.

“When you do that, we'll do some lab for you to check the viral load in you, to check your liver. And then, if you're eligible, we'll say, take the medicine,” he said.

Flomo emphasized that although the medicine does not eliminate hepatitis B, it can help prevent serious complications.

“The medication, when you start to take the medication, what it does is that it's not going to kill the hepatitis B, no,” he said. “But all of those complications that can lead to death, because the hepatitis B alone will not just kill you, but what it will do is that it will cause your liver to be inflamed, it can cause liver cancer.”

He added that appropriate treatment can help people with chronic hepatitis B live healthier lives.

“Meaning, once you take the medicine, you can live, you can live. You can live your life, just continue to take the medicine, and it will prevent all of those complications,” Flomo said.

The planned procurement of TAF remains a future step, and the medicine should not be described as already available through the program.

Misconceptions and Stigma

Flomo identified misinformation and stigma as additional challenges in addressing hepatitis B, saying some people wrongly attribute symptoms associated with complications of the disease to poisoning or supernatural causes.

“One of the misconceptions is that, you know, as far as the complication of Hepatitis B, the main perception is they're poisoning you,” he said, explaining that abdominal swelling can lead some people to believe someone has been poisoned.

He also said some people think a positive diagnosis means there is no hope of recovery.

“Once you're diagnosed, it means that you just wait for you to die. That's another misconception,” Flomo said.

He cautioned against relying on unverified traditional remedies instead of seeking medical evaluation and follow-up care.

“And that is very, very wrong,” he said, referring to the belief that people diagnosed with hepatitis B must rely on herbs rather than medical care.

Flomo explained that some adults naturally clear the infection, while others develop chronic hepatitis B and may need continued monitoring and treatment.

He urged people to seek testing so health workers can determine whether vaccination or further medical care is appropriate.

Government Funding and Public Health

Flomo said the program's expansion depends on sufficient resources to procure vaccines and testing kits, conduct screening and support medical investigations for people who test positive.

“There's a need for more budgetary allocation to the Minister of Health,” he said, adding that investment in health is closely connected to economic growth and development.

“Once you are healthy, you can get everything done,” Flomo said.

As Liberia prepares its proposed 2027 national budget, the program's plans to expand hepatitis B prevention and care highlight the need to sustain vaccination, screening and treatment services.

The interview did not establish the precise amount of additional funding required or the share of the national health budget currently allocated to hepatitis B. However, Flomo's remarks identify vaccines, testing kits, logistics and domestic financing as important requirements for extending the intervention beyond Montserrado County.

For health authorities, the challenge is to turn those planned interventions into services that can reach more people across Liberia.