By Omboki Monayo
NAIROBI—In a cramped consultation room at Mbagathi Hospital, Dr. Winnie Maithya (name changed) examines yet another patient presenting with advanced liver cirrhosis.
“By the time they reach us, it’s often too late for anything but palliative care,” she says, flipping through a stack of case files. “What’s tragic is nearly all these cases were preventable.”
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This scene plays out daily across Kenya, where hepatitis B and C—largely ignored in global health agendas—are driving an alarming surge in liver cancer cases.
According to the World Hepatitis Alliance (WHA), these two viruses now account for 76% of global liver cancer cases, with hepatitis C carriers 17 times more likely to develop the malignancy than unaffected individuals.
A Crisis Hidden in Plain Sight
Kenya’s 93% hepatitis B vaccination rate for infants, as reported by the World Bank, paints a picture of progress.
But this statistic masks a grimmer reality: the viruses still infect one in twenty Kenyan adults, with prevalence spikes reaching 15% in high-risk groups like healthcare workers and HIV-positive populations.
“Hepatitis is the silent assassin,” explains Dr. James Kamau of the Kenya Medical Association. “Patients can carry the virus for decades without symptoms, only presenting when their livers are already scarred beyond repair.”
The human cost is staggering. A 2025 study in the African Journal of Health Sciences revealed hepatitis A exposure rates of 5.93% nationally, with Mombasa’s fishing communities ad urban population hit hardest.
For hepatitis C—which lacks a vaccine—the outlook is direr: less than 10% of carriers receive life-saving antivirals due to cost and access barriers.
The Prevention Paradox
Medical advances have made hepatitis elimination theoretically achievable. As the WHA notes: “Antiviral treatment for hepatitis B slows cirrhosis progression, while hepatitis C cure reduces liver cancer risk by 75%.” Yet implementation lags catastrophically.
In rural Kilifi County, community health worker Amina Bakari describes the challenges: “We have rapid tests, but no drugs to give when someone tests positive. Telling a mother she has hepatitis but can’t afford treatment—that stays with you.”
The WHA’s 2025 white paper proposes a three-pillar solution:
v Prevention: Expand vaccination to high-risk adults including healthcare workers, HIV-positive individuals, and marginalized communities, and integrate hepatitis C screening into HIV programs to diagnose co-infections early. WAH is emphatic on the need for intensified testing efforts: “Scaling up testing is key to unlocking treatment and should be integrated into national cancer and NCD prevention and control strategies and programmes.”
v Treatment: Negotiate bulk drug pricing and deploy mobile clinics to remote areas. Widespread deployment of rapid diagnostic kits to community health centers could transform early detection rates.
v Monitoring: Equip county hospitals with ultrasound machines for early cancer detection. “People living with hepatitis are a key risk group for liver cancer,” the WHA notes, adding that early detection dramatically improves outcomes: “Those diagnosed with liver cancer at an early stage have a survival rate greater than 70% over 5 years, compared to advanced stage, which has a 20% survival rate.”
The Fiscal Time Bomb
The economic argument for action is compelling. Every $1 (KSh 130) invested in prevention saves $3 (KSh 388) in future treatment costs, per WHA estimates.
Yet Kenya’s 2025/26 health budget proposes cuts that could gut screening programs.
“Without ring-fenced funding, we’re courting disaster,” warns economist Dr. Patricia Kariuki. “Liver cancer treatment costs could bankrupt county health systems within a decade.”
A Global Moment for Local Action
All eyes now turn to the September 2025 UN High-Level Meeting on Noncommunicable Diseases, an event that Kenya is expected to attend.
The East African nation could join other UN member states in the collective push for stronger language on hepatitis C elimination in the political declaration, the establishment and strengthening of funding mechanisms for low-cost antivirals and inclusion of affected communities in hepatitis management policy design.
As the WHA argues: “People living with hepatitis must have seats at the table. Their lived experience is our best roadmap.”
The Choice Ahead
In the Vumilia slum of Tassia, Embakasi, 34-year-old single mother Lillian Awuor represents the crossroads that many Kenyans find themselves in.
Diagnosed with hepatitis C last year, she faces an impossible choice: spend KSh 50,000 on a cure that would save her life, or feed her children.
“I cannot afford to pay for the treatment in cash and my Social Health Authority (SHA) membership is not updated due to financial challenges,” says Lilian, who sells samosas and mandazi to sustain her family of two children and a young adult niece who recently moved in from her rural home.
“This isn’t just about viruses and vaccines,” reflects Dr. Maithya back at Mbagathi Hospital. “It’s about whether we value Kenyan lives enough to act before the morgues fill up.”
With liver cancer cases projected to double by 2035, Kenya’s window for action is closing fast. The tools exist. The blueprint is written. With the required political will, the country can rise to meet this quiet crisis before it explodes into a full-blown catastrophe.
