A coalition of researchers, health organisations and patient groups on Wednesday launched an ambitious campaign to cure hepatitis B, a disease that kills twice as many people as malaria but gets far less attention.
"Inexplicably, despite the huge human and economic toll of chronic hepatitis B (HBV), research remains largely underfunded," said Peter Revill, a senior scientist at Royal Melbourne Hospital's Doherty Institute.
"HBV cure research could make all the difference."
More than 257 million people are chronically infected with the disease, which attacks the liver and can lead to a deadly form of cancer called hepatocellular carcinoma.
There is no cure, but antiviral drugs have proven effective in coping with symptoms.
A test for HBV has been available since the 1970s, and a 95 per cent effective vaccine since the early 1980s.
And yet HBV accounted for nearly 900,000 deaths in 2017, twice the number caused by malaria, according to the World Health Organization (WHO).
Only one-in-10 people infected has taken the test, and only a handful of countries where the disease is most prevalent have ensured the vaccine's widespread use.
The International Coalition to Eliminate HBV strategy was laid out Wednesday at the International Liver Congress in Vienna, and published at the same time in The Lancet Gastroenterology & Hepatology, a medical journal.
The two-pronged effort calls for curing HBV without killing infected cells, on the one hand, and inducing immune responses to safely eliminate those cells on the other.
Not a pipe dream
Each objective -- one focusing on the virus, the other on the immune system -- will require clinical trials and the funding to support them, the coalition said in a statement.
"Curing hepatitis B is not a pipe dream and should not be thought of as such," said Su Wang, a physician and president-elect of the World Hepatitis Alliance.
"The 257 million of us living with hepatitis B are desperate for this to be reality in order to stop needless suffering and deaths."
The highly contagious virus -- transmitted through contact with blood or other bodily fluid -- leads to either acute or chronic forms of the disease.
Chronic infection can be managed with life-long treatment, but less than 10 per cent of those in need are receiving it.
Even with treatment, patients are at higher risk of developing liver cancer.
There is no specific treatment for acute HBV, which can cause extreme fatigue, nausea, vomiting, abdominal pain and, in a smaller percentage of cases, acute liver failure.
Since 1992, the World Health Organisation has recommended a first dose of vaccine within 24 hours of birth to guard against mother-to-child transmission, but only half of newborns are vaccinated that quickly.
Of the 16 countries that account for more than 80 per cent of infections among five-year-olds, only China has scaled up vaccines-at-birth to 90 per cent, earlier research has shown.
China, India, Nigeria, Indonesia and the Philippines account for nearly 60 per cent of all infections.