Eliminating Hepatitis C

The Impact of HCV

HCV affects around 71 million people worldwide, but the majority of the burden falls onto low- and middle-income countries. Prior to intervention in 2018, Egypt had the highest HCV burden with 10% of the population aged 15–59 years (equal to up to 10 million people) having chronic hepatitis C virus (HCV) infection.?

It is a seriously devastating disease and high HCV infection rates have led to a high mortality from chronic liver disease, cirrhosis and hepatocellular carcinoma, the most common type of liver cancer. With limited access to testing and treatments, many patients sadly die within 1-3 years from diagnosis.

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A Global Ambition?

The World Health Organization (WHO) has defined international targets toward the elimination of HCV by 2030, including the reduction of new viral hepatitis infections by 90%.?

In 2018 Egypt embarked on an ambitious screening and treatment program, known as ‘100 million healthier lives’, to detect and eliminate HCV by 2023. In 2019 the Pakistani government announced its hepatitis elimination program, with an ambitious goal to screen 138 million people by 2030.

I am extremely proud of Roche’s efforts in this space. As part of our Global Access Program, we work with governments to support sustainable HCV elimination. Following our partnership with the Egyptian Ministry of Health and Population (MOHP) to support their HCV elimination program and provide dependable HCV diagnostic solutions, almost 50 million people were screened for antibodies within just six months in 2018.?

The World Health Organization has reported that Egypt has become the first country to achieve gold tier status on the path to elimination of hepatitis C, after diagnosing 87% of those living with the virus and providing curative treatment to 93%. It was inspiring to hear about this in more detail from Mohamed Hassany and Gamal Shiha at the Hepatitis Elimination Symposium as they showcased details of the processes involved, including screening and outreach programmes.?

The learnings from this have since been translated to support Pakistan’s national hepatitis elimination program as well as delivering health economic research.?

In Pakistan, over 460,000 people were screened using Roche systems just one year after targeted disease elimination programmes were put in place.

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Foundations for Success

I should state that Roche didn’t?generate this success alone and it is thanks to so many of our other health system partners that these advances have been made.

In Egypt, as Hassanin et al point out, the campaign's success was driven by: (1) a robust public health care infrastructure and surveillance system; (2) political commitment to sustainable chronic hepatitis C virus elimination (3) inclusive care that reached all sectors of society; and (4) use of information technology and innovative scientific research.

The lessons learned from the experience in Egypt and Pakistan ought to be applied to other low- and middle-income countries where important progress can be made on HCV elimination.?

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