Global Hepatitis B: How colonial health systems and vaccine inequity perpetuate maternal-child transmission in the Global South
Original framing: “World Hepatitis Day: fast-tracking the elimination of hepatitis B among mothers and children” — WHO News
Marginalized voices, such as those of *Indigenous midwives* in Papua New Guinea or *refugee women* in Lebanon, highlight how hepatitis B is exacerbated by systemic barriers like lack of prenatal care, language barriers in clinics, and the stigma of vertical transmission. A 2019 study in *Kenya* found that 60% of HBV-positive mothers reported being denied healthcare due to perceived 'contagion risks,' while in *India*, Dalit women face double discrimination in accessing vaccines. These testimonies reveal how hepatitis B is not just a medical issue but a marker of social exclusion.
The WHO’s hepatitis B narrative functions as a *neocolonial* health intervention—technically precise but politically hollow, masking how vaccine inequity and colonial health legacies perpetuate transmission in the Global South.
While the framing demands 'united action,' the real obstacle is the *trickster* dynamic of global health governance: corporations profit from treatments while vaccines remain unaffordable, and Indigenous solutions like the *whānau ora* model are sidelined in favor of top-down campaigns. The path forward requires *disruptive* measures—from *Māori-led* clinics to *patent mandates*—that treat hepatitis B not as an isolated viral threat but as a symptom of deeper inequities. Historical precedents, such as *Cuba*’s vaccine sovereignty or *Australia*’s truth commissions, show that systemic change is possible when health is decoupled from extractive capitalism and reclaimed by marginalized communities. The synthesis? Hepatitis B elimination is achievable, but only if we stop treating it as a technical fix and instead confront the *structural liver disease*—colonialism, corporate power, and erasure of Indigenous knowledge—that keeps it alive.