Viral hepatitis has become a significant global health burden accounting for 1.34 million deaths in 2015; a figure comparable to tuberculosis-associated mortality and higher than HIV-associated mortality. Around 71 million individuals were living with chronic HCV infection globally in 2015.
The World Health Organization (WHO) has taken up the initiative of 'Elimination of hepatitis C as a major public health threat by 2030'. In May 2016, UK signed up to the WHO Global Health Sector Strategy (GHSS) on Viral Hepatitis, thereby committing to accomplish the goal of 80% reduction in incidence of HCV infection and a 65% reduction in mortality from HCV by 2030.
To fight HCV infection in England, Public Health England (PHE) emphasises the importance of collaborating with partners for improving prevention, raising awareness, increasing uptake of testing and bringing more diagnosed individuals into treatment and care, all this while keeping access to HCV services equitable. This reflects in its vision statement which says, "All people at risk of HCV infection should have access to testing and, once tested, action should be taken to either reduce their risk of infection, prevent further transmission of the virus, or – if they are infected – to place the patient on a treatment pathway."
It has defined 2 key impact areas for monitoring the progress of HCV elimination:
- Reduction in transmission, and subsequently the number of new HCV infections.
- Reduction in morbidity and mortality linked to HCV and its complications.
The 'Hepatitis C in England: 2018 report' has outlined certain public health recommendations with respect to HCV elimination. Those for making improvements and monitoring metrics include:
- The National Strategic Group for Viral Hepatitis to consider if there is a need to define England specific milestones for HCV elimination.
- PHE to develop national indicators and tools for monitoring the progress of the HCV elimination goal.
- Public health professionals in Clinical Commissioning Groups and local bodies to consider having HCV as a part of Joint Strategic Needs Assessments and subsequent health and wellbeing strategies.
With an increased emphasis on monitoring, PHE hopes to continue collaboration with stakeholders for identifying barriers and pushing improvements across the system to attain the 2030 goal.