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

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)181-192
Number of pages12
JournalSeminars in Liver Disease
Volume38
Issue number3
Early online date9 Jul 2018
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • health policy
  • health systems
  • hepatitis C
  • micro-elimination
  • models of care
  • Delivery of Health Care, Integrated/legislation & jurisprudence
  • Global Health/legislation & jurisprudence
  • Prevalence
  • Hepatitis C/ethnology
  • Humans
  • Models, Organizational
  • Risk Factors
  • Cooperative Behavior
  • Disease Eradication/legislation & jurisprudence
  • International Cooperation
  • Vulnerable Populations
  • Stakeholder Participation
  • Interdisciplinary Communication
  • Antiviral Agents/therapeutic use
  • Health Policy/legislation & jurisprudence
  • Policy Making

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  • Cite this

    Lazarus, J. V., Safreed-Harmon, K., Thursz, M. R., Dillon, J. F., El-Sayed, M. H., Elsharkawy, A. M., Hatzakis, A., Jadoul, M., Prestileo, T., Razavi, H., Rockstroh, J. K., Wiktor, S. Z., & Colombo, M. (2018). The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations. Seminars in Liver Disease, 38(3), 181-192. https://doi.org/10.1055/s-0038-1666841