2016 is a watershed year in the reduction of the burden of hepatitis C in Australia, with new direct-acting antiviral drug treatments available, and globally with the ambitious elimination targets set by the World Health Organization (WHO).
Burnet Institute will be taking a leading role in the elimination of the blood-borne virus in Australia and through our international harm reduction activities in many countries in the Asia-Pacific region.
Today at a sell-out Elimination Hep C Symposium in Melbourne, Burnet Institute launched its own ambitious, but achievable Eliminate Hep C strategy.
The comprehensive strategy addresses the WHO’s important global elimination call and builds upon groundbreaking basic biomedical research, modelling and analysis, which has demonstrated both the feasibility and public health benefit of eliminating hepatitis C.
Head of Burnet’s Centre for Population Health, Professor Margaret Hellard and Deputy Head of the Centre for Biomedical Research, Associate Professor Heidi Drummer, are among the key researchers and HCV experts who are driving Burnet’s comprehensive Eliminate Hep C strategy.
Globally, there are an estimated 130-150 million infections and each year half a million deaths are caused from hepatitis C. Only 50 per cent of those infected with hepatitis C are aware of their infection status, so the prevalence and incidence is likely to be
underestimated. Currently there is no vaccine to prevent infection. An estimated 230,000 Australians are living with chronic hepatitis resulting in more than 600 deaths from liver cancer and liver failure each year.
Australia’s and the global response to hepatitis C requires the dual approach of preventing new infections and stopping hepatitis C-related deaths, and it is now a recognised health priority. Key to successfully halting transmission in Australia requires treating people who inject drugs, a highly marginalised population. If hepatitis C treatment can be delivered effectively to this group then significant reduction in future cases is possible. Elimination of a public health threat becomes a genuine possibility within a generation.
The World Health Organization has proposed a set of global elimination targets, including an 80 per cent reduction in hepatitis C incidence [new infections] and a 65 per cent reduction of hepatitis C-related deaths by 2030 compared with 2010.
The Way Forward: Four Pillars of Elimination
Elimination will require four ‘pillars’ of intervention, namely harm reduction, vaccines, testing and treatment strategies. Cross cutting these interventions will also be awareness raising, education and training, reducing stigma, and strengthened surveillance.
Burnet will be working with the Victorian Government, particularly the Department of Health and Human Services, and the Department of Justice, to establish an elimination program. This will involve a community-based treatment program using nurse-led models of care in the community and the prison system; assessing the feasibility of sufficiently scaling-up treatment; measuring impact; and using results to inform hepatitis C elimination models in Australia and globally.
Of course, treatment must be supported by important existing interventions such as opioid substitution therapy and needle-syringe programs, which have already been shown to help reduce transmission and other harms. Importantly, a preventative vaccine will provide significant additional benefit towards elimination and allow elimination targets to be reached more rapidly and cost-effectively. A preventative vaccine will be
essential for a global hepatitis C elimination program.
With Victorian Government support, we have developed an innovative surveillance program to enable us to evaluate the impact of the elimination program.
Download Burnet’s Eliminate Hep C Strategy.