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Overcome Health Inequities to Eliminate Viral Hepatitis
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Download the PDF here
Ronald O. Valdiserri, MD, MPH1; Howard K. Koh, MD, MPH2; John W. Ward, MD3,4
Viewpoint
JAMA. Published online April 17, 2023
See full paper attached. Extracts...
The recently proposed program to eliminate HCV in the US, included in the administration’s fiscal year 2024 budget proposal, is, without doubt, a welcome development.7 The proposed program’s stated focus on persons with poor access to health care who experience social inequities and are likely to be encountered in high-impact settings such as correctional facilities and substance use treatment clinics evidences a clear emphasis on addressing health disparities. But, as noted by others who have worked to engage high-risk populations in HCV care-in this instance, persons who inject drugs-even when low-threshold care is made available, structural variables such as homelessness and lack of social support can pose substantial barriers to engagement and retention in treatment.8
Raising concerns about the social, economic, environmental, and structural barriers that can affect hepatitis elimination outcomes does not mean we are dismissive of efforts to expand prevention, treatment, and care for HBV and HCV. Instead, we seek to emphasize the critical importance of addressing those nonclinical factors that can substantially influence an individual’s willingness to engage in hepatitis prevention and treatment services.9 Developing multipartner coalitions and working closely with affected communities will help to resolve viral hepatitis prevention shortfalls and close the current gaps found in HBV and HCV care cascades. The 2011 action plan set the nation on course to improve viral hepatitis outcomes. Now it is time to end the silent epidemic of viral hepatitis by an all-out effort to dismantle health inequities.
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