Many European Countries Are Not Ready to Stop Viral Hepatitis

Many European countries lack a comprehensive policy to eliminate viral hepatitis as a major public health threat, according to a patient group-based survey implemented in 25 countries. The Hep-CORE study was coordinated by ISGlobal – an institution supported by the “la Caixa” Foundation - and led by the European Liver Patient's Association.   

In 2016, viral hepatitis caused more deaths than HIV, malaria or tuberculosis. In the European Region, 18 and 15 million people live with chronic HBV and HCV infection, respectively. Due to widespread HBV vaccination, HBV infection is seen more in older Europeans or migrants from countries with high HBV prevalence. Regarding HCV – for which there is no vaccine –transmission is now mainly due to unsafe drug injection practices. New, highly effective direct‐acting antiviral drugs have made HCV much easier and safer to cure, but they are costly and their availability remains a concern.

The World Health Organization (WHO) has called for the elimination of viral hepatitis as a major public health threat by 2030. But to reach this target, governments around the world must first consider whether they have the necessary policies and programmes in place.

A research team based at ISGlobal and the University of Copenhagen performed two rounds of surveys (in 2016 and 2017) with patient groups in 25 European countries, in order to assess policies and programmes that support elimination efforts.

Overall, the results indicate that many European countries have shortcomings across a wide range of elements, including national coordination, public awareness, disease surveillance, and treatment. In 2017, 72% of the countries were reported to have national HBV strategies and only half (52%) had national HCV strategies. Comparing 2016 and 2017, progress in government collaboration with civil society, disease registers, and access to direct-acting drugs for HCV was observed.

According to lead author Jeffrey Lazarus, who presented the study at the International Liver Congress 2018: “the patient‐led Hep‐CORE study offers a unique perspective on the readiness of these countries to undertake comprehensive viral hepatitis elimination efforts”. The authors recommend that viral hepatitis monitoring should incorporate civil society perspectives, as has been done with global HIV monitoring. 

Reference

Jeffrey V Lazarus  Samya R Stumo  Magdalena Harris, et al.Hep‐CORE: a cross‐sectional study of the viral hepatitis policy environment reported by patient groups in 25 European countries in 2016 and 2017.J Int AIDS Soc. 2018 Apr;21 Suppl 2:e25052. doi: 10.1002/jia2.25052.

See also: Lazarus JV, Safreed-Harmon K, Stumo SR et al. Restrictions on access to direct-acting antivirals for people who inject drugs: The European Hep-CORE study and the role of patient groups in monitoring national HCV responses. Int J Drug Policy. 2017 Sep;47:47-50. doi: 10.1016/j.drugpo.2017.05.054.