The case for simplifying and using absolute targets for viral hepatitis elimination goals

Homie Razavi*, Sarah Blach, Polaris Observatory Collaborators, Devin Razavi-Shearer, Faisal Abaalkhail, Zaigham Abbas, Ayat Abdallah, Paulo Abrao Ferreira, Laith Jamal Abu Raddad, Danjuma Adda, Kosh Agarwal, Alessio Aghemo, Aijaz Ahmed, Said A. Al-Busafi, Waleed Al-hamoudi, Saad Al-Kaabi, Hamad Al-Romaihi, Badr Aljarallah, Khalid AlNaamani, Saleh AlqahtaniKhalid Alswat, Ibrahim Altraif, Tarik Asselah, Bruce Bacon, Fernando Bessone, Abdul Rahman Bizri, Tim Block, Ferruccio Bonino, Carlos Eduardo Brandão-Mello, Kimberly Brown, Philip Bruggmann, Maurizia Rossana Brunetto, Maria Buti, Joaquín Cabezas, Jose Luis Calleja, Erika Castro Batänjer, Henry Lik Yuen Chan, Henry Chang, Chien Jen Chen, Peer Brehm Christensen, Wan Long Chuang, Laura Cisneros, Chari Cohen, Massimo Colombo, Brian Conway, Curtis Cooper, Antonio Craxi, Esther Croes, Stephanie Popping, Mehlika Toy, David Van de Vijver

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

25 Citations (Scopus)
25 Downloads (Pure)

Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.

Original languageEnglish
Pages (from-to)12-19
Number of pages8
JournalJournal of Viral Hepatitis
Volume28
Issue number1
Early online date26 Sept 2020
DOIs
Publication statusPublished - Jan 2021

Bibliographical note

Funding information:
John C Martin Foundation, Grant/Award Number: G01 , G02, G11 and G24

Publisher Copyright: © 2020 John Wiley & Sons Ltd

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