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Innovative strategies for the elimination of viral hepatitis at a national level: A country case series

Schröeder SE 1 , Pedrana A 1 , Scott N 1 , Wilson D 1 , Kuschel C 1 , Aufegger L 2 Show all authors , Atun R 3 , Baptista-Leite R 4 , Butsashvili M 5 , El-Sayed M 6 , Getahun A 7 , Hamid S 8 , Hammad R 9 , 't Hoen E 10 , Hutchinson SJ 11 , Lazarus JV 12 , Lesi O 13 , Li W 14 , Binti Mohamed R 15 , Olafsson S 16 , Peck R 17 , Sohn AH 18 , Sonderup M 19 , Spearman CW 19 , Swan T 20 , Thursz M 21 , Walker T 22 , Hellard M 1 , Howell J 1

Affiliations 

  • 1 Burnet Institute, Melbourne, VIC, Australia
  • 2 Centre for Health Policy, Imperial College London, London, UK
  • 3 Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
  • 4 Universidade Catolica Portuguesa, Lisbon, Portugal
  • 5 Health Research Union, Tbilisi, Georgia
  • 6 Department of Pediatrics and Clinical Research Center, Ain Shams University, Cairo, Egypt
  • 7 School of Public Health and Primary Care, Fiji National University, Suva, Fiji
  • 8 Aga Khan University, Karachi, Pakistan
  • 9 Ministry of Health and Population, Cairo, Egypt
  • 10 Global Health Unit, University Medical Centre, Groningen, the Netherlands
  • 11 School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
  • 12 Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain
  • 13 University of Lagos, Lagos, Nigeria
  • 14 ZeShan Foundation, Wanchai, Hong Kong
  • 15 Department of Medicine, University of Malaysia, Kuala Lumpur, Malaysia
  • 16 Gastroenterology and Hepatology, Landspitali University Hospital, Reykjavik, Iceland
  • 17 World Hepatitis Alliance, London, UK
  • 18 TREAT Asia/amfAR, Foundation for AIDS Research, Bangkok, Thailand
  • 19 Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  • 20 Treatment Action Group, New York, NY, USA
  • 21 Department of Hepatology, Imperial College London, London, UK
  • 22 Department of Gastroenterology and General Medicine, Calvary Mater, Newcastle, NSW, Australia
Liver Int, 2019 Oct;39(10):1818-1836.
PMID: 31433902 DOI: 10.1111/liv.14222

Abstract

Viral hepatitis is a leading cause of morbidity and mortality worldwide, but has long been neglected by national and international policymakers. Recent modelling studies suggest that investing in the global elimination of viral hepatitis is feasible and cost-effective. In 2016, all 194 member states of the World Health Organization endorsed the goal to eliminate viral hepatitis as a public health threat by 2030, but complex systemic and social realities hamper implementation efforts. This paper presents eight case studies from a diverse range of countries that have invested in responses to viral hepatitis and adopted innovative approaches to tackle their respective epidemics. Based on an investment framework developed to build a global investment case for the elimination of viral hepatitis by 2030, national activities and key enablers are highlighted that showcase the feasibility and impact of concerted hepatitis responses across a range of settings, with different levels of available resources and infrastructural development. These case studies demonstrate the utility of taking a multipronged, public health approach to: (a) evidence-gathering and planning; (b) implementation; and (c) integration of viral hepatitis services into the Agenda for Sustainable Development. They provide models for planning, investment and implementation strategies for other countries facing similar challenges and resource constraints.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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