A new study warns that viral hepatitis is now one of the top 10 causes of death in the world, ranking alongside heart disease, road accidents and Alzheimer’s disease in annual deaths. Together, hepatitis C virus (HCV) and hepatitis B virus (HBV) killed 1.34 million people in 2016 alone — more than tuberculosis, HIV and malaria, The Daily Mail reports. 

The latest update on the global epidemic, published by Global Health Metrics, is likely one of the most comprehensive data sets on hepatitis compiled to date. The study analyzed data collected by the World Health Organization’s Global Burden of Disease 2016 Study, tallying reported causes of death from 195 countries between 1985 and 2016.

Researchers say that recent treatment advancements in hepatitis B and hepatitis C treatment have still largely not impacted the number of people killed by the disease, warning that the liver viruses are not a high enough political priority in many countries. The study also warns that recent surges in HCV rates driven in part by the opioid epidemic are making matters worse.

Raquel Peck, CEO of the World Hepatitis Alliance (one of the study’s collaborators) agreed, saying that many countries, including the United States, aren’t making global hepatitis elimination a political priority. In addition, Peck cited stigma, saying “there’s a lot of bias to overcome” around testing for and treating hep B and hep C among both doctors and patients.

Peck also mentioned that hepatitis C is particularly problematic in the United States, where in 2013, deaths caused by the liver virus surpassed those caused by all other infectious diseases combined. The World Health Alliance has organized an international summit hosted by the government of Brazil where countries will discuss strategies to eliminate hepatitis worldwide by the 2030 goal set by WHO. However, the U.S. Department of Health and Human Services has yet to confirm its attendance.