‘Significantly greater’ numbers of people need to be tested, diagnosed and treated in order to eliminate hepatitis C, according to a report from the All Party Parliamentary Group (APPG) on Liver Health. England needs to agree on a national elimination strategy if it is to make the most of a ‘once in a generation’ opportunity to eradicate the virus, the group stresses.
The report is the result of an inquiry by cross-party MPs and peers, in which expert contributors ‘overwhelmingly agreed’ that England is currently not on track to achieve either the NHS target of eliminating the virus by 2025 or the World Health Organization target of elimination by 2030. ‘The upcoming deal between NHS England and the pharmaceutical industry must include innovative new measures to find those still living with hepatitis C and engage them into treatment,’ says the APPG.
The report urges the government to ‘express its explicit support’ for the elimination agenda, and make sure that the agreement between the NHS and industry includes ambitious national and regional targets, as well as mechanisms to make sure funds are distributed ‘equitably’.
Funding pressures on local authorities are having a negative impact on testing and prevention initiatives, says the report, while levels of awareness among the public and even primary care professionals remain low. Many of the 40-50 per cent of the estimated 160,000 people living with the virus who are still undiagnosed are ‘part of vulnerable populations with chaotic lives’, it adds, while ‘overly complex’ care pathways are still creating barriers to accessing treatment.
The report calls for treatment to be ‘universally accessible’ and available in community settings, as well as the introduction of ‘opt-out’ testing in drug treatment services, with ‘commissioning contracts stipulating clear mechanisms to hold services to account’ for failing to meet targets.
Last month’s Get Connected conference heard how CGL’s hep C strategy was focusing on ‘the huge cohort of people who could benefit from testing and treatment’ in drug treatment services to make the maximum impact (DDN, March, page 6).
‘Much as there has been great progress, as this report makes clear, we all need to up our game,’ said Hepatitis C Trust chief executive Charles Gore. ‘No one should be walking round with a virus that could give them liver cancer. No one should have to wait for treatment. No one should die from this disease when we have these miraculous drugs. We can eliminate this virus so let’s get on with it.’
‘With the exceptional context of a deadly virus now being fully curable with easily deliverable, highly cost-effective medicines, finding those still undiagnosed and living with hepatitis C should be a national ambition,’ added APPG co-chair Sir David Amess. ‘Eliminating a public health issue that disproportionately affects some of the poorest and most marginalised groups in our society is an extraordinary and eminently achievable opportunity which should be seized with both hands.’
Eliminating hepatitis C in England at www.appghep.org.uk