The world faces “a thundering moral imperative” to prevent people in poor countries dying of viral hepatitis when the cost of treating them is “less than dinner for two”, the pharmaceutical industry and health donors will be told on Wednesday. In a passionate appeal to the international community to avoid repeating the mistakes made early in the HIV and Aids crisis, delegates meeting in Geneva at the first international pledging conference for viral hepatitis will be urged to give $150m (£120m) to ensure that low-cost treatment reaches those who need it. Dr Michel Kazatchkine, the veteran HIV/Aids advocate, will say: “For those of us who have engaged in the fight against HIV and tuberculosis for decades, this sounds familiar. This lack of political and financial commitment is typical for a disease that disproportionally affects the poorest and the most vulnerable. “And this lack of concern is deadly. It leads to millions of unnecessary deaths.” More than 350 million people live with a chronic viral hepatitis infection, with more than 1.1 million deaths each year, predominantly in low and middle-income countries. Experts estimate that if the current trajectory continues, viral hepatitis will kill more people annually than malaria, tuberculosis and Aids combined by 2040. Comparatively low-cost diagnostic tools and generic drugs – as well as a highly effective vaccine – already exist. But there is a lack of funds to get them to the places most in need and, when the cost of treating someone with hepatitis C is as little as $80 (£64) a patient, this is “unforgivable”, according to Kazatchkine. “We have been here before: while cost should not be an obstacle to saving a life, we have seen again and again that it is,” he will say. “But when treatment is this affordable, we face a thundering moral imperative to act. Letting someone die or passing on their infection to their children is unforgivable when the diagnosis and treatment cost less than a dinner for two here in Geneva.” Kazatchkine, the former UN special envoy for HIV and Aids and the ex-director of the Global Fund, has spent decades advocating for more investment in treating Aids, tuberculosis and malaria. But he believes it is “more than absurd” for donors to spend tens of billions on those diseases, “only to see patients die from another easily preventable and treatable disease and frequent co-infection”. In 2016 World Health Organization member states committed to reducing deaths from viral hepatitis by 65% by 2030. Some countries, such as Egypt, Rwanda and Mongolia, are making good progress, but overall the world is off target. According to WHO data, fewer than one in five newborns in Africa receive the hepatitis B vaccine within 24 hours of birth, which is essential because mother-to-child transmission is the primary way the infection is passed on. Before Covid-19, Gavi, the vaccine alliance, committed to supporting a rollout of hepatitis B birth vaccines, but in 2020 announced it had delayed implementation due to disruption caused by the pandemic. Millions of people with chronic hepatitis C infection – which is spread through contact with blood from an infected person and can lead to fatal liver complications such as cancer and cirrhosis – are also yet to see the benefit of scientific breakthroughs. Antiviral medicines can cure more than 95% of cases, but reach just 13% of diagnosed people. Today’s hepatitis resource mobilisation conference will be hosted by Egypt and Saudi Arabia, alongside the Hepatitis Fund and the Clinton Health Access Initiative.