VH-COMSAVAC

Duration

01/11/2022 - 31/10/2024

Coordinator

Jeffrey Lazarus

Funded by

EU4H European Commission

 In 2016, the World Health Organization (WHO) published a global strategy with the goal to eliminate viral hepatitis as a major public health threat by 2030 and set targets to reduce viral hepatitis cases by 90% and hepatitis-related deaths by 65%. The strategy also called for health systems to improve outreach and testing, such that 90% of those unaware of their status are diagnosed and, of these, 80% of people living with HBV and HCV be on treatment by 2030.

Europe’s Beating Cancer Plan was updated in 2021 and sets out specific objectives to reduce cancer-related morbidity and mortality across Europe. The objective to prevent cancers caused by HBV and HCV infections is included in this renewed Plan.

Photo: Candelaria Nazar

The objective of this project is to scale-up and adapt community-based viral hepatitis (HBV and HCV) testing and HBV vaccination models of care among migrant and refugee populations with documented high HBV and HCV incidence and prevalence using simplified diagnostic tools and person-centred referral processes to reduce liver cancer-associated mortality. This project will be carried out in Italy, Greece, and Spain and is coordinated by ISGlobal. 

The project will have a 2-year duration and includes partners in Spain (Salud Entre Culturas), Italy (the Fondazione IRCCS Ca’ Granada Ospedale Maggiore Policlino, Milan; Hospital San Raffaele, and Università Cattolica del Sacro Cuore, Milan), and Greece (Prometheus; Athens).
 

ISGlobal peer-navigators explaining to community members the importance of viral-hepatitis testing. Photo: Candelaria Nazar

External Advisory Board Members 

• World Health Organization (WHO)
• European Centre for Disease Prevention and Control (ECDC)
• European Association for the Study of the Liver (EASL)
• Hepatitis B and C Public Policy Association (HBCPPA)
• Viral Hepatitis Prevention Board (VHPB)
• European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
• International Liver Cancer Movement (ILCM)
• International Coalition to Eliminate HBV (ICE-HBV)

Associated Partners 

• European Liver Patient’s Association (ELPA)
• European Public Health Association (EUPHA)
• World Federation for Public Health Associations (WFPHA)
• Generalitat de Catalunya - Departament de Salut

Total funding 

€1 million 

Academic Publications

• Picchio CA, Kwakye DN, Rando-Segura A, et al., Lazarus JV. Community-based screening enhances hepatitis B virus (HBV) linkage to care among West African migrants in Spain. Communications Medicine 2023.
• MacKinnon MJ, Picchio CA, Kwakye DN, et al., Lazarus JV. Chronic conditions and multimorbidity among West African migrants in greater Barcelona, Spain. Frontiers Public Health. 2023.
• Picchio CA, Kwakye DN, Gómez Araujo S, et al., Lazarus JV. A novel model of care for simplified testing of HBV in African communities during the COVID-19 pandemic in Spain. Scientific Reports. 2021.

Related blogposts 

• VH-COMSAVAC: A Living Case for Universal Health Coverage Through Meaningful Impact (2024)
• Picchio, C. Bridging the Knowledge Gap in Viral Hepatitis (2024)
• Nicolas A, et al. Hepatitis B Immunization: a Strategy for Liver Cancer Prevention in Underserved Migrant Populations (2023)
• Dagiada E, et al. Breaking Barriers, Building Health: Reaching Vulnerable Communities to Eliminate Viral Hepatitis (2023)
• World Hepatitis Day 2021: Vulnerable Populations Cannot Wait- Decentralising Hepatitis B and C Care (2021)

Abstracts presented at conferences

A total of 11 abstracts relating to the VH-COMSAVAC, and its earlier pilot projects (e.g., HBV-COMSAVA) have been presented at national and international conferences including the European Association for the Study of the Liver (EASL) International Liver Conference, the World Hepatitis Summit, the International Viral Hepatitis Elimination Meeting, the European Public Health Association Annual conference, American Association for the Study of the Liver (AASLD) The Liver Meeting®, and the Conference on Liver Diseases in Africa (COLDA). Additionally, two abstracts will be presented at the World Hepatitis Summit in April 2024, and three additional abstracts have been submitted to the EASL Congress in 2024. The 14 abstracts are:

• Picchio CA, Nicolas A, Kalamitsis G et al. Community-based interventions to increase hepatitis B and hepatitis C virus infection screening among at-risk migrant and refugee populations in Italy, Greece, and Spain: 1 year results of the VH-COMSAVAC project. EASL International Liver Congress 2024. Milan, Italy (Winner of Best Public Health Poster). [VIEW]
• Picchio CA, Nicolàs A, et al., Lazarus JV. Community-based interventions for HBV and HCV screening and linkage to care among migrants in Spain (Poster presentation) World Hepatitis Summit (WHS), Lisbon (2024) – to be presented
• Picchio CA, Nicolàs A, et al., Lazarus JV. Community-based HBV screening for migrants to reduce missed opportunities in primary care (Poster presentation) World Hepatitis Summit (WHS), Lisbon (2024) – to be presented
• Picchio CA, Nomah DK, Rando-Segura, et al., Lazarus JV. A community-based intervention to reduce missed opportunities in primary care for viral hepatitis screening among at-risk African migrants in Catalonia, Spain (Oral presentation) Global Hepatitis Summit (GHS), Paris (2023).
• Picchio CA, Nomah DK, Rando-Segura, et al., Lazarus JV. Differences in hepatitis B prevalence and linkage to care rates between male and female African migrants participating in a community-based screening program in the greater Barcelona area, Spain. (Poster presentation) International Viral Hepatitis Elimination Meeting (IVHEM), Amsterdam (2022).
• Picchio CA, Nomah DK, Rando-Segura, et al., Lazarus JV. Community-based screening increases hepatitis B linkage to care among African migrants in Spain. (Poster presentation) European Public Health Association (EUPHA) Annual conference, Berlin (2022). 
• Picchio CA, Nomah DK, Rando-Segura A, et al., Lazarus JV. Resultados de un proyecto comunitario para aumentar la vacunación y vinculación al cuidado de la hepatitis B en inmigrantes del África occidental en Cataluña: el modelo HBV-COMSAVA. (Oral presentation) Jornadas Catalanas de Salut Internacional, Barcelona (2022).
• Picchio CA, Rando-Segura A, Fernández, et al., Lazarus JV. HBV screening in West African migrant community and faith-based organizations increased HBV vaccination among this high-risk population in greater Barcelona, Spain. (Poster presentation), EASL International Liver Conference, London, UK (2022).  
• Picchio CA, Nomah DK, Rando-Segura A, et al., Lazarus JV. Community-based HBV testing among west African migrants in greater Barcelona, Spain increases linkage to specialist care and vaccination: the HBV COMSAVA model. (Poster presentation), EASL International Liver Conference, London, UK (2022).
• Picchio CA, Araujo SG, Nomah DK, et al., Lazarus JV. Community-based HBV screening increases linkage to care among west African migrants in greater Barcelona, Spain: preliminary data from the HBV-COMSAVA model of care. (Poster presentation) AASLD The Liver Meeting®, [Hybrid, Anaheim, CA] (2021).
• Picchio CA, Fernández E, Araujo SG, et al., Lazarus JV. Decentralized HBV vaccination in west African community centres in greater Barcelona, Spain to accelerate viral hepatitis elimination: preliminary data from the HBV-COMSAVA model of care. (Poster presentation) Conference on Liver Diseases in Africa (COLDA), [Virtual due to COVID-19] (2021)
• Picchio CA, Nomah DK, Rando-Segura A, et al., Lazarus JV. HBV-COMSAVA: Preliminary results from a novel community-based hepatitis B screening and linkage to care programme for west African migrants in greater Barcelona, Spain. (Oral presentation) Global Hepatitis Summit, Taipei [Hybrid due to COVID-19] (2021).
• Picchio CA, Nomah DK, Rando-Segura A, et al., Lazarus JV. Simplifiación del cribado de hepatitis B en Cataluña en población migrante procedente de África occidental: datos preliminares del modelo de cuidado HBV-COMSAVA. (Poster presentation) Asociación Española del Estudio del Higado (AAEH) Congreso [Virtual due to COVID-19] (2021).
• Picchio CA, Buti M, Kwakye Nomah D, et al., Lazarus JV. Eliminating hepatitis B virus infection in west African migrants in Barcelona: a community-based testing and vaccination model of care to link patients to liver specialists. (Poster presentation) International Viral Hepatitis Elimination Meeting (IVHEM), Amsterdam [Virtual due to COVID-19] (2020).
• Picchio CA, Kwakye Nomah D, Lazarus JV. HBV awareness and self-reported testing and vaccination in Ghanaian migrants living in the greater Barcelona area participating in a community-based intervention. (Poster presentation) Conference on Liver Diseases in Africa, Dakar [Virtual due to COVID-19] (2020)

Awards and Recognitions 

The VH-COMSAVAC project has won the 2024 Hepatitis “Elimination in Action” Photo Contest, organized by the Coalition for Global Hepatitis Elimination (CGHE). The annual contest received 159 submissions from 24 organizations across 17 countries, highlighting global efforts to eliminate viral hepatitis. A panel of four experts—Danjuma Adda (Past President, World Hepatitis Alliance), Annemarie Wasley (Epidemiologist, Division of Viral Hepatitis, US Centers for Disease Control and Prevention), Piper Hale (Associate Director of Communications, Public Health Informatics Institute), and Victoria Mainardi (Internist and Hepatologist, Hospital Central de Las Fuerzas Armadas de Uruguay, CGHE Elimination Champion)—selected the winning photos based on their powerful depiction of the work in action.

Additional information

VH-COMSAVAC has been featured in the Financial Times in November 2021 and in the HepCast podcast series in October 2022. Further, the project has been publicly presented in webinars and talks hosted by the European Center for Disease Control (ECDC), the International Coalition to Eliminate HBV (ICE-HBV), Liver Patient’s International (LPI) and the Ministry of Health in Argentina, among others:

• Webinar panelist: “Webinar on testing and care of hepatitis B and C among migrant populations in the EU/EEA” Organized by the European Center for Disease Control (ECDC), European AIDS Clinical Society (EACS) and Centre of Excellence for Health, Immunity, and Infections (CHIP) – 18 Oct 2022.
• Invited talk: “HBV-Cure research 101 [HBV and migrants in Europe: the HBV-COMSAVA project]” Organized by the International Coalition to Eliminate HBV (ICE-HBV) and Liver Patient’s International (LPI) – 24 Nov 2021.
• Invited talk: “Call to action for HCV elimination: what is left?” at the XV International Symposium on Viral Hepatitis and Liver Diseases – 01 October 2021. 
• Invited talk: “Nuevas estrategias en la simplifiación del diagnóstico. Experiencia con población migrante” [New strategies for the simplification of diagnosing. Experience of migrant populations]. World Hepatitis Day 2021 event held by the Ministry of Health of Argentina. – 28 July 2021

The project will also be presented at the in-person technical meeting “Addressing Viral Hepatitis Among Europe's Migrant and Refugee Population: lessons learnt and the way forward” organized by the Viral Hepatitis Prevention Board (VHPB) on March 2024 in Antwerp, Belgium.