Making the
Finacial Case
for Hepatitis C
Elimination in
Nigeria
By Jessica Hicks
Head of Programmes, WHA
Nigeria is faced with one of the
largest burdens of hepatitis C in
the world, with an estimated 2.5
million people affected across
the country. Despite launching a
national hepatitis programme in
2015, Nigeria’s Federal and State
Governments have yet to secure
sufficient financial resources
to reach the targets set out in
the national programme. The
World Hepatitis Alliance (WHA),
together with partners and WHA
members, has been working
with Nigeria’s Federal Ministry of
Health to create the investment
case for hepatitis C elimination
and, crucially to explore financing
options for this elimination plan.
aggressive scale-up (achieving
elimination by 2026).
All scenarios found projected cost
savings to the healthcare system
compared to taking no action.
The modelling also showed
that despite the need for more
investments at the start, mainly
due to the significant number
of new infections prevented,
the more aggressive elimination
efforts would achieve the most
rapid and highest cost benefit in
later years.
Much of the work to date has
focused solely on the investment
case, leaving countries still facing
the challenge of how to finance
their viral hepatitis programmes.
In addressing this question,
Nigeria has shown global
leadership and demonstrated that
financing does not need to be a
barrier to elimination. Through
the project, a total of four
financing recommendations were
made that were deemed to have
strong short and/or long-term
impact.
This work provides Nigeria’s
Federal Ministry of Health the
foundation from which to explore
how best they can implement
the financing recommendations.
It also provides civil society with
an advocacy tool to ensure that
federal and state government’s
commitment to hepatitis
elimination is translated into real
action.
“All scenarios
found projected
cost savings to the
healthcare system
compared to
taking no action.”
The results were recently
presented at the first ever Nigeria
Hepatitis Summit on 3rd and 4th
December 2018, which brought
together civil society, policy
makers, and medical professionals
to discuss the challenges that
Nigeria faces in eliminating viral
hepatitis and how these could be
overcome. The Summit facilitated
the discussion of financing work
with key stakeholders within
Nigeria’s Federal and State
Governments, with Ministers and
officials attending alongside more
than 60 members of Nigeria’s civil
society.
There were a number of other
positive outcomes from the
Summit, including a meeting
held by WHA for civil society to
discuss the future of our advocacy
for financing projects in Nigeria.
Through consultation with WHA
members and other civil society
organisations, we established
the need to change our focus
to advocacy at the State level,
rather than the Federal level, and
representatives from 11 states
expressed their interest in driving
this work forward.
In 2019, WHA and partners will
be expanding this work and
partnering with more countries
to create the investment case for
hepatitis elimination. WHA will
also be encouraging policymakers
to use the WHA National Viral
Hepatitis Financing Strategy
Template tool launched in 2017.
“the more
aggressive
elimination efforts
would achieve the
most rapid and
highest cost benefit
in later years.”
Previous investment cases for
hepatitis C elimination in other
countries have shown that
elimination is cost-effective,
with savings achieved within a
decade. In Nigeria’s case, WHA
and partners modelled multiple
scenarios, comparing the cost
forecast for maintaining the
current situation to cost models
of a conservative scale-up of
elimination activity (achieving
elimination by the end of 2030),
a moderate scale-up (achieving
elimination by 2028), and an
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