World Hepatitis Day 2021

Today we mark World Hepatitis Day, taking the opportunity this year to reflect on the successful completion of our 3-year Hepatitis C Elimination through Access to Diagnostics (HEAD-Start) project that has been supported by Unitaid. HEAD-Start accelerated the development of 9 new diagnostic technologies for hepatitis C, and has enabled us to get closer to the global goal of reaching hepatitis elimination by 2030 – 10-year projections of the impact of this project in just four countries indicate that our work will have saved over 1,600 lives and saved health systems nearly US$48 million, as a result of bringing diagnosis to just 154,000 people so that they can know their status.

Finding the missing millions of people with hepatitis C so that they can be linked to care remains a critical objective. Progress is being made: while there were 71 million people living with HCV in 2015, this number has decreased to 58 million in 2019 as per the Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021, published earlier this year.

But as with so many health priorities, progress against hepatitis C has also been negatively impacted by the COVID-19 pandemic, as this paper on the impact of COVID-19 on global HCV elimination efforts highlights.

To expand the reach of hepatitis C testing, we have most recently been focusing on self-testing – learning lessons from HIV in particular. Earlier this month, the World Health Organization (WHO) released the first guidelines on hepatitis C virus self-testing, as the world moves towards more decentralized approaches for the diagnosis of this often-silent disease. These recommendations followed work that we did with WHO to understand the evidence gaps that needed to be filled so that self-testing technologies could be evaluated; we then worked to generate the evidence that was missing. HCV self-testing is the next step to ensure equity of access, offering a route to reach those who may be missed by facility-based testing. It could also be a tool to combat the barriers to testing that COVID-19 has presented to hepatitis C, allowing people to know their status without visiting the overburdened health facilities.

Building on their leadership in tackling hepatitis C, this week Malaysia will become one of the global forerunners in using this innovative new technology, in one of the first-ever hepatitis C self-testing impact studies. To coincide with this milestone, we were pleased to co-host a virtual event with DNDi, entitled Hepatitis C can’t wait, Malaysia isn’t waiting, which was webcast yesterday – the recording can be viewed on our website here. The event was arranged with support from WHO, the Ministry of Health Malaysia and the Malaysian AIDS Council (MAC).

While our HEAD-Start project is coming to an end, our commitment to improving testing to help combat hepatitis C remains as strong as ever. Today we announced a new partnership with DNDi, Médecins Sans Frontières (MSF), and Treatment Action Group (TAG) to tackle public health injustice with regards to hepatitis C. The Hepatitis C Partnership for Control and Treatment, or Hepatitis C PACT, will foster an enabling environment for testing and treatment for HCV in low- and middle-income countries by rolling out all-oral cures, scaling up community-based testing to find the missing millions of undiagnosed people, and addressing domestic financial challenges that prevent the launch of national programmes.

This year’s World Hepatitis Day theme is hepatitis can’t wait. We have shown through HEAD-Start that improving access to diagnostics can have a significant impact on tackling hepatitis C – and we’re impatient to build on that progress.

Sonjelle Shilton, Hepatitis Lead