ASHM Report Back
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Where are we now? Progress on the 2012 Auckland Statement on viral hepatitis
Helen Tyrrell, Hepatitis Australia, provided a progress report on the targets from the 2012 Auckland statement on viral hepatitis. Helen Tyrrell described the “national shame”, that 1,000 people will die from hepatitis related liver disease in Australia in 2014. These rates are higher than those at the height of the HIV/AIDS mortality in 1994 in Australia. Viral hepatitis requires the same action and response which HIV/AIDS mortality rates elicited in order to reverse the “rising death toll from viral hepatitis”.
Target 1: by 2016, halve the incidence of hepatitis C infections by doubling the amount of new injecting equipment distributed in the general community and implementing NSPs in prisons.
Limited progress has been made in achieving this target thus far. In 2012 the ACT announced a trial of the distribution of sterile injecting equipment in a prison, however the trial has not yet commenced. Contrary to this target, the 4th National Hepatitis C Strategy does not include a priority action area which encourages trial needle and syringe programs (NSPs) in prisons. This is a backwards step as this priority action area was included in the previous strategy. Veering off the path of prioritising the need for NSPs in prisons undermines the development of an enabling policy environment to assist with preventing HCV transmission in high HCV prevalence settings.
Target 2: Apply consistent funding of Hepatitis B vaccines for all those at greatest risk
A national policy commitment to this target is reflected in the 2nd National Hepatitis B Strategy. Tyrrell highlighted that there has been inequitable access to funded vaccination programs for key populations.
Target 3: Ensure at least 80% of people living with Hepatitis B and C are diagnosed
April 2014 saw the announcement of $4.6 million in funding to increase the uptake of hepatitis B testing and treatment, however the planned distribution of this funding has not been publicised. This target largely related to hepatitis B as estimates suggest that 80% of people living with hepatitis C have been diagnosed.
Target 4: Ensure 5% of people living with hepatitis C receive anti-viral medication each year
This target is reflected in the 4th National Hepatitis C Strategy. This target requires accelerated PBAC and Cabinet approval process for new HCV drugs and promotion of new treatment options.
Target 5: Guarantee that 10% of people living with hepatitis B receive antiviral treatment each year
This target is again reflected in the 2nd National Hepatitis B Strategy target, aiming for 15% of people living with hepatitis B to be on treatment.
Whilst there has been some progress in the target areas, significant prioritisation of viral hepatitis will be required to meet the targets by 2016. The minimal progress is a call to action for state and federal governments to upscale the response required to both meet targets and reduce numbers of avoidable viral hepatitis related liver deaths.