Abstract
Hepatitis B virus infects an estimated 254 million people worldwide and caused 1.1 million deaths in 2022. In the WHO African Region, about 65 million people live with chronic HBV (HBsAg prevalence 5.8%). In Cameroon, pooled HBsAg prevalence was 11.2% among pre-2005 cohorts, born before infant HBV vaccination, versus 0.7% in a hospital-based cohort of children recruited in 2009-2010 among post-2005 births (not nationally representative). Nonetheless, HepB birth-dose coverage was 0% in 2024; infection at birth leads to chronic HBV in 80-90% of cases, with roughly one in four dying prematurely. Completion of the infant series is 68%, with subnational gaps leaving many children unprotected. Cameroon's selective policy restricts the timely birth-dose to infants of known HBsAg-positive mothers, further perpetuating inequities. In hard-to-reach areas, antenatal screening is limited and home deliveries are common; the same children who miss the infant series also miss the birth-dose. Leveraging high-coverage BCG platforms could help close this gap and protect newborns within 24 hours of birth. This commentary reviews global evidence for the birth-dose, analyzes Cameroon's policy gaps, and proposes equity-focused actions for universal birth-dose adoption, strengthened delivery systems and supply chains, and data-driven governance to reach WHO's 2030 elimination targets in Cameroon.