The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations

Jeffrey V. Lazarus; Kelly Safreed-Harmon; Mark R. Thursz; John F. Dillon; Manal H. El-Sayed; Ahmed M. Elsharkawy; Angelos Hatzakis; Michel Jadoul; Tullio Prestileo; Homie Razavi; Jürgen K. Rockstroh; Stefan Z. Wiktor; Massimo Colombo

doi:10.1055/s-0038-1666841

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2018; 38(03): 181-192
DOI: 10.1055/s-0038-1666841

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations

Authors

Jeffrey V. Lazarus

¹Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
Kelly Safreed-Harmon

¹Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
Mark R. Thursz

²Department of Surgery and Cancer, Imperial College, London, United Kingdom
John F. Dillon

³Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
Manal H. El-Sayed

⁴Department of Pediatrics, Ain Shams University, Cairo, Egypt
Ahmed M. Elsharkawy

⁵University Hospitals Birmingham, Mindelsohn Way, Birmingham, United Kingdom
Angelos Hatzakis

⁶Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens Medical School, Athens, Greece
Michel Jadoul

⁷Department of Nephrology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
Tullio Prestileo

⁸Infection Diseases Unit and Centre for Migration and Health, ARNAS, Civico-Benfratelli Hospital, Palermo, Italy
Homie Razavi

⁹Center for Disease Analysis Foundation, Lafayette, Colorado
Jürgen K. Rockstroh

¹⁰Department of Medicine I, University of Bonn, Bonn, Germany
Stefan Z. Wiktor

¹¹Department of Global Health, University of Washington Schools of Medicine and Public Health, Seattle, Washington
Massimo Colombo

¹²Department of Medicine, Clinical and Research Center, Humanitas Hospital, Rozzano, Italy

Abstract

The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV, and it can build momentum by producing small victories that inspire more ambitious efforts. The micro-elimination approach encourages stakeholders who are most knowledgeable about specific populations to engage with each other and also promotes the uptake of new models of care. Examples of micro-elimination target populations include medical patients, people who inject drugs, migrants, and prisoners, although candidate populations can be expected to vary greatly in different countries and subnational areas.

Keywords

health policy - hepatitis C - micro-elimination - health systems - models of care

Full Text

References

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114 National Hepatitis C Treatment Programme. Ireland's Health Service. https://www.hse.ie/eng/about/who/primarycare/hepcprogramme.html . Accessed April 24, 2018