Disease elimination depends upon societal and political commitment.
Elimination and eradication are the ultimate goals of public health. The only question is whether these goals are to be achieved in the present or some future generation.
We are in the World Health Organization’s decade for disease elimination.
This decade is the countdown to achieving the disease elimination targets as outlined in the 2030 Agenda for Sustainable Development and the Global Health Sector Strategies on HIV, Viral Hepatitis and STIs.
The World Health Organization has defined the goal for eliminating viral hepatitis.
The elimination of viral hepatitis as a public health threat means achieving globally a 90 per cent reduction in new chronic infections and a 65 per cent reduction in mortality.
Australia is committed to the elimination of hepatitis B and hepatitis C as a public health threat.
Australia is one of 194 World Health Organization member states who voted unanimously to adopt the Global Hepatitis Elimination Strategy’s commitment to eliminate viral hepatitis as a public health threat by 2030. This commitment informs our National Hepatitis B, Hepatitis C, and Aboriginal and Torres Strait Islander BBV/STI Strategies, and is pivotal to the design of national hepatitis 2030 elimination targets.
Australia’s progress towards elimination is a mixed bag.
The national response to hepatitis B and hepatitis C includes significant achievements (such as hepatitis B childhood vaccination coverage already exceeding 2022 targets), promising progress (such as the roll out of direct-acting antiviral medicines for hepatitis C), and areas of under-achievement (including very slow progress towards hepatitis B diagnosis, in-care, and treatment targets).
It is possible to eliminate viral hepatitis in Australia.
Hepatitis B has a vaccine and hepatitis C has a cure. With investment in hepatitis as a national health priority, elimination is possible.
Australia needs to increase testing and treatment rates for hepatitis B and C if we are to reach elimination targets.
Linking people living with hepatitis B to appropriate care is paramount to saving lives.
In 2020 more than 222,000 people were living with chronic hepatitis B in Australia. It is estimated that 73% of those people have ever been diagnosed. The national target is 80% by the end of 2022 and the 2030 elimination target is 90%.
People who are living with chronic hepatitis B need regular health monitoring to help prevent the longer term impacts of the condition, including progression to serious liver disease or liver cancer. This includes treatment administered at the correct time.
Small-scale projects have shown that where communities are resourced and mobilised to act on hepatitis B, we achieve much more effective results. By investing well and intensifying our responses to hepatitis B, particularly in partnership with communities, we can take examples of success and transform the response to hepatitis B for all Australians.
Now is the right time to modify and scale-up approaches to engage people who have not been adequately reached in the hepatitis C response to date.
By the end of 2020, an estimated 47.0% of people living with chronic hepatitis C at the start of 2016 had received treatment.
Highly effective medicines are available to cure hepatitis C. They are easy to take with as little as one tablet a day, no injections and most people experience few to no side effects.
Uptake of these cures has declined significantly in recent years. Reinfection rates are also problematic, especially in settings where people have no access to suitable prevention measures.
With proper investment, we can achieve a cure for hepatitis B and a vaccine for hepatitis C.
Australia is at the forefront of hepatitis medical research.
A cure for hepatitis B is achievable this decade. There are already several medications in clinical phase testing which show promise of achieving a functional cure in the next few years.
Recent achievements in COVID-19 vaccinations have shown the timeline for vaccine development can be significantly shortened. A vaccine for hepatitis C would prevent risk of re-infection and enable people at high risk of infection to better protect themselves.