Hepatitis C elimination among people who inject drugs: Challenges and recommendations for action within a health systems framework

TY - JOUR

T1 - Hepatitis C elimination among people who inject drugs

T2 - Challenges and recommendations for action within a health systems framework

AU - Day, Emma

AU - Hellard, Margaret

AU - Treloar, Carla

AU - Bruneau, Julie

AU - Martin, Natasha K.

AU - Øvrehus, Anne

AU - Dalgard, Olav

AU - Lloyd, Andrew

AU - Dillon, John

AU - Hickman, Matt

AU - Byrne, Jude

AU - Litwin, Alain

AU - Maticic, Mojca

AU - Bruggmann, Philip

AU - Midgard, Havard

AU - Norton, Brianna

AU - Trooskin, Stacey

AU - Lazarus, Jeffrey V.

AU - Grebely, Jason

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The burden of hepatitis C infection is considerable among people who inject drugs (PWID), with an estimated prevalence of greater than 40%, representing an estimated 5.6 million people who have recently injected drugs living with hepatitis C infection. As such, PWID are a priority population for enhancing prevention, testing, linkage to care, treatment and follow-up care in order to meet World Health Organization (WHO) hepatitis C elimination goals by 2030. There are many barriers to enhancing hepatitis C prevention and care among PWID including; poor global coverage of harm reduction services, restrictive drug policies and criminalization of drug use, poor access to health services, low hepatitis C testing, linkage to care and treatment, restrictions for accessing DAA therapy, and the lack of national strategies and government investment to support WHO elimination goals. On 5 September 2017, the International Network of Hepatitis in Substance Users (INHSU) held a roundtable panel of international experts to discuss remaining challenges and future priorities for action from a health systems perspective. The WHO health systems framework comprises six core components; service delivery, health workforce, health information systems, medical procurement, health systems financing, and leadership and governance. Communication has been proposed as a seventh key element which promotes the central role of affected community engagement. This review paper presents recommended strategies for eliminating hepatitis C as a major public health threat among PWID and outlines future priorities for action within a health systems framework. This article is protected by copyright. All rights reserved.

AB - The burden of hepatitis C infection is considerable among people who inject drugs (PWID), with an estimated prevalence of greater than 40%, representing an estimated 5.6 million people who have recently injected drugs living with hepatitis C infection. As such, PWID are a priority population for enhancing prevention, testing, linkage to care, treatment and follow-up care in order to meet World Health Organization (WHO) hepatitis C elimination goals by 2030. There are many barriers to enhancing hepatitis C prevention and care among PWID including; poor global coverage of harm reduction services, restrictive drug policies and criminalization of drug use, poor access to health services, low hepatitis C testing, linkage to care and treatment, restrictions for accessing DAA therapy, and the lack of national strategies and government investment to support WHO elimination goals. On 5 September 2017, the International Network of Hepatitis in Substance Users (INHSU) held a roundtable panel of international experts to discuss remaining challenges and future priorities for action from a health systems perspective. The WHO health systems framework comprises six core components; service delivery, health workforce, health information systems, medical procurement, health systems financing, and leadership and governance. Communication has been proposed as a seventh key element which promotes the central role of affected community engagement. This review paper presents recommended strategies for eliminating hepatitis C as a major public health threat among PWID and outlines future priorities for action within a health systems framework. This article is protected by copyright. All rights reserved.

KW - elimination

KW - health systems

KW - people who inject drugs

KW - viral hepatitis C

U2 - 10.1111/liv.13949

DO - 10.1111/liv.13949

M3 - Article

C2 - 30157316

SN - 1478-3223

VL - 39

SP - 20

EP - 30

JO - Liver International

JF - Liver International

IS - 1

ER -