Viral hepatitis elimination by 2030
This Hepatitis Drug Guide could be obsolete by 2030. I’ve often joked that if we do things right, I could be out of work in no time. I would happily welcome that!
In 2016, the World Health Organization made a commitment to eliminate viral hepatitis by 2030. “Elimination” is defined as reducing new infections by 90% and reducing deaths by 65%. It’s a daunting but achievable goal. We have the knowledge and the tools: We can cure hepatitis C (HCV). Harm reduction interventions such as syringe service programs and medication-assisted treatment can help prevent new HCV infections. We can vaccinate to prevent hepatitis B (HBV), and treat people who are already infected until a cure is discovered.
I just don’t know when we will get there.
It won’t be for lack of trying and the hard work of patients, activists and advocates, medical providers, and the many hard-working public health officials across the public sector. Under President Obama, the Department of Health and Human Services released the first “Viral Hepatitis National Strategic Plan” for the U.S., and we just got a new one earlier this year. For an excellent summary, check out Enid Vázquez’s review of it in this issue’s “Briefly” section.
We have the tools. We have a plan. And this year, after four years of silence on the issue, President Joe Biden issued a proclamation on National Hepatitis Testing Day (May 19), reasserting the U.S. commitment to viral hepatitis elimination, calling on “all Americans who are at risk for hepatitis to get tested, and for all health care providers to educate their patients about viral hepatitis.”
The President’s budget flat-funded viral hepatitis at $39.5 million. The CDC estimates that they need $398.6 million to adequately fund the Division of Viral Hepatitis, so this falls very short of what’s needed.
The President’s budget flat-funded viral hepatitis at $39.5 million. The CDC estimates that they need $398.6 million to adequately fund the Division of Viral Hepatitis, so this falls very short of what’s needed.
Nice words, but then a couple of weeks later the President’s budget flat-funded viral hepatitis at $39.5 million. The CDC estimates that they need $398.6 million to adequately fund the Division of Viral Hepatitis, so this falls very short of what’s needed. The U.S. has over 2.4 million people living with HCV and another 860,000 people living with HBV. I’m not very good at math, but I think that’s a little over $12 per person with viral hepatitis. That’s money that needs to go towards surveillance and data collection, prevention, testing, linkage to care, and so on. Now, states and county health departments also put funding into viral hepatitis, as do private foundations and donors, but without a robust federal response and funding behind the Strategic Plan, we cannot make true progress towards elimination.
But don’t just take my word on this—take a look at what my friends and colleagues in the field have to say. I adore and admire these people so much, and through their leadership and work (and that of many, many others who couldn’t be included in these pages), we can get to elimination. They have the ideas and the expertise to make it happen, but we need the funding and political commitment to get there.
I leave you with the words of Dr. Sam So, Lui Hac Minh Professor and Professor of Surgery and Director of the Asian Liver Center at Stanford University:
“Elimination of viral hepatitis in the United States is feasible with a comprehensive prevention and treatment approach and the political commitments at the local, state, and national levels. Put simply, we need primary care providers to screen their adult patients at least once for chronic hepatitis B and C infection, so every adult would know their hepatitis status; and for individuals tested positive, they would be provided with follow-up care according to the national practice guidelines, and they would have access to affordable, unrestricted, curative treatment for hepatitis C, and long-term monitoring and antiviral drug treatment for chronic hepatitis B. Screening and treatment would also need to be coupled with continued efforts to prevent new viral hepatitis infections through hepatitis B and A vaccination and elimination of mother-to-child transmission, needle/syringe exchange, and drug treatment programs.”
Listen to Sam. And listen to my friends. And listen to people living with or at risk for viral hepatitis about their needs. If we adequately fund viral hepatitis and trust the viral hepatitis community to do the work, I will be out of work…and maybe, just maybe, it will be before 2030.