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Liver Int. 2019 Aug 21. doi: 10.1111/liv.14222. [Epub ahead of print]

Innovative strategies for the elimination of viral hepatitis at a national level: A country case series.

Author information

1
Burnet Institute, Melbourne, VIC, Australia.
2
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
3
Centre for Health Policy, Imperial College London, London, UK.
4
Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.
5
Universidade Catolica Portuguesa, Lisbon, Portugal.
6
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
7
Health Research Union, Tbilisi, Georgia.
8
Department of Pediatrics and Clinical Research Center, Ain Shams University, Cairo, Egypt.
9
School of Public Health and Primary Care, Fiji National University, Suva, Fiji.
10
Aga Khan University, Karachi, Pakistan.
11
Ministry of Health and Population, Cairo, Egypt.
12
Global Health Unit, University Medical Centre, Groningen, the Netherlands.
13
Medicines Law & Policy, Amsterdam, the Netherlands.
14
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
15
Health Protection Scotland, Meridian Court, Glasgow, UK.
16
Barcelona Institute for Global Health (ISGlobal), Hospital Clinic, University of Barcelona, Barcelona, Spain.
17
University of Lagos, Lagos, Nigeria.
18
ZeShan Foundation, Wanchai, Hong Kong.
19
Department of Medicine, University of Malaysia, Kuala Lumpur, Malaysia.
20
Gastroenterology and Hepatology, Landspitali University Hospital, Reykjavik, Iceland.
21
World Hepatitis Alliance, London, UK.
22
TREAT Asia/amfAR, Foundation for AIDS Research, Bangkok, Thailand.
23
Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
24
Treatment Action Group, New York, NY, USA.
25
Department of Hepatology, Imperial College London, London, UK.
26
Department of Gastroenterology and General Medicine, Calvary Mater, Newcastle, NSW, Australia.
27
School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
28
Hepatitis Services, Department of Infectious Diseases, The Alfred Hospital, Melbourne, VIC, Australia.
29
Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
30
Department of Gastroenterology, St Vincent's Hospital, Melbourne, VIC, Australia.
31
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia.

Abstract

Viral hepatitis is a leading cause of morbidity and mortality worldwide, but has long been neglected by national and international policymakers. Recent modelling studies suggest that investing in the global elimination of viral hepatitis is feasible and cost-effective. In 2016, all 194 member states of the World Health Organization endorsed the goal to eliminate viral hepatitis as a public health threat by 2030, but complex systemic and social realities hamper implementation efforts. This paper presents eight case studies from a diverse range of countries that have invested in responses to viral hepatitis and adopted innovative approaches to tackle their respective epidemics. Based on an investment framework developed to build a global investment case for the elimination of viral hepatitis by 2030, national activities and key enablers are highlighted that showcase the feasibility and impact of concerted hepatitis responses across a range of settings, with different levels of available resources and infrastructural development. These case studies demonstrate the utility of taking a multipronged, public health approach to: (a) evidence-gathering and planning; (b) implementation; and (c) integration of viral hepatitis services into the Agenda for Sustainable Development. They provide models for planning, investment and implementation strategies for other countries facing similar challenges and resource constraints.

KEYWORDS:

developing countries; disease elimination; hepatitis B; hepatitis C; investment case; organizational case studies

PMID:
31433902
DOI:
10.1111/liv.14222

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