Elimination in the age of retrenchment: what hepatitis reveals about the future of global health

Over the past decade, stand-alone disease programmes have been replaced by integrated delivery models aligned with primary health-care reform. The push for triple elimination of HIV, hepatitis B virus (HBV), and syphilis emerged as a compromise designed to preserve gains from past investments while limiting the long-term costs of sustaining them.1 Viral hepatitis programmes were encouraged to supplement existing HIV platforms, leveraging procurement systems and clinical infrastructure.