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Are we surprised that the 2030
targets are set to be missed?
By Prof. Dr. Ammal Mokhtar Metwally
A recent study published in the Lancet
has shown that even with an upscaling
of diagnosis, treatment and prevention,
we are set to narrowly miss the 2030
elimination target for the reduction in
mortality set out in 2016 by WHO.
The study, ‘Scaling up prevention and
treatment towards the elimination
of hepatitis C: a global mathematical
model’ estimated the worldwide impact
of scaling up interventions that reduce
risk of transmission, improve access to
treatment, and increase screening for HCV
infection. The mathematical modelling
in the study predicts that the 65% target
for the reduction in the mortality rate can
be achieved by 2032 if a comprehensive
package of prevention and treatment
interventions and an upscaling of screening
and testing is conducted.
That’s a big if. The majority of countries are
not putting in place any form of package of
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interventions, let alone a comprehensive
one.
Currently only 12 countries are on
track to eliminate hepatitis C. Globally,
governments have been slow to create
national strategies for the elimination
of viral hepatitis, the commitment to
elimination set out in 2016 has yet to
be filtered down to the national and
regional level. Yet, we know what needs
to be done to achieve elimination and we
have the tools to do it. We have a cure
available for hepatitis C, we have the global
commitment, and we have a growing
evidence base which demonstrates that
elimination is cost-effective.
if things continue as they are. In addition,
extending harm reduction services to 40%
of people who inject drugs could reduce
the number of new infections by a further 7
percentage points.
The mortality target is the first target that
has become mathematically impossible to
hit, but many more targets are not on track
either.
Work needs to be done to ensure that
hepatitis remains on the health agenda
and that more countries are put on track
to achieve elimination. Successful, scalable
and replicable programmes exist around
the world which can lead the way, including
many examples of micro-elimination
programmes targeting at-risk groups such as
refugees and asylum seekers.
We are seeing some progress. In Europe,
27 countries now have national plans
compared to just 13 five years ago. Generic
versions of the lifesaving cure will start
becoming available in some countries
thanks to the work of the Medicines Patent
Pool (MPP) and the deal with AbbVie, and
more countries are utilising the skills and
experience of civil society to ensure that
no one is left behind as we try to make
elimination a reality.
Never before have we been so close to the
elimination of viral hepatitis, but a lack
of action endangers our ability to see the
elimination of this disease in our lifetime
and future generations will have to bear the
burden of this disease.
The Lancet study also showed the
importance of comprehensive blood safety
and infection control measures, with
the implementation of these estimated
to reduce the number of new hepatitis C
infections by 58% in 2030, compared to
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