Theme: Epidemiology & Public Health Research Year: 2017
Background: Modelling suggests WHO targets for hepatitis C virus (HCV) elimination by 2030 can be achieved if treatments are targeted towards people who inject drugs (PWID). In Australia, universal access to direct-acting antivirals (DAAs) for all patients chronically infected removes key policy impediments making elimination targets achievable. However, to achieve these targets a major shift from tertiary- to community-based services is required to reach and treat PWID. This shift requires an integrated approach from providers, policy makers, community organisations and drug user networks.
Methods: The ‘Eliminate Hepatitis C (EC) Partnership’ is implementing an elimination program utilising a health systems framework, delivered through five key components; health promotion and demand generation activities, training and education, clinical pathways, data systems and surveillance and research and evaluation (including financing), with a governance structure to provide leadership and strategic direction. Community-integrated hepatitis C nurses are central to achieving the population coverage needed to realise elimination targets by providing support and outreach services within high-caseload community sites and prisons. The scale-up of key interventions, including rapid point-of-care testing and pharmacy-led treatment will ensure enough treatment demand for treatment-as-prevention to be effective and sustainable. A surveillance system will allow ongoing monitoring and assessment of achieving elimination targets.
Results: Between 2017-2021, the EC Partnership will provide tailored support to 28 community and prison services, to maximise the quality, efficiency and uptake of HCV treatment among PWID. Treating a minimum of 4500 PWID with HCV over a three-year period will provide meaningful reductions in community prevalence (21%) and incidence (12%). If successful this approach will enable the State of Victoria to meet WHO’s 2030 elimination targets.
Conclusion: Australia is uniquely placed to demonstrate impact of an innovative model that will strengthen local health systems and provide real-world evidence for HCV elimination aspirations.Download abstract