Viral Hepatitis Action Plan Update

Ronald Valdiserri

Dr. Ronald Valdiserri

Recently, I had the pleasure of participating in the National Viral Hepatitis Technical Assistance Meeting where there was significant focus on realizing the potential of the Viral Hepatitis Action Plan.  Organized by the National Alliance for State and Territorial AIDS Directors Exit Disclaimer and the National Viral Hepatitis Roundtable Exit Disclaimer , the meeting brought together Adult Viral Hepatitis Prevention Coordinators from state health departments across the nation with hepatitis advocates, community leaders and representatives from Federal government and industry.

Overview of Implementation and HHS Commitment
During a plenary session, I shared an update on Federal actions underway to implement the Viral Hepatitis Action Plan. I focused on our efforts to better coordinate viral hepatitis programs and activities across Federal government, which are being advanced with the support of a cross-government working group known as the Viral Hepatitis Implementation Group (VHIG).  Comprised of representatives of agencies and offices from across the Department of Health and Human Services (HHS) as well as colleagues from the Department of Veterans Affairs and the Department of Justice’s Bureau of Prisons, the VHIG is charged with improving coordination, identifying opportunities for new collaborations, and making the best use of all the available resources to achieve better outcomes related to the prevention, diagnosis and treatment of viral hepatitis.

In another session, Dr. Howard Koh, Assistant Secretary for Health, discussed highlights of the progress made since the release of the Action Plan almost six months ago, highlighting the World Hepatitis Day event held at the White House. Dr. Koh also reaffirmed the commitment of his office—which includes, among others, my office as well as the Office on Minority Health and National Vaccine Program Office—to pursuing the Plan’s goals. Dr. Koh thanked the participants for their efforts in support of the Plan and the essential work they do in states and communities to help advance it.

Hepatitis Priorities of Federal Agencies
During another session, colleagues from several agencies within HHS shared highlights of the efforts underway to implement the Action Plan, including:

  • Health Resources and Services Administration—Dr. Sarah Linde-Feucht, Chief Public Health Officer, discussed how the Health Resources and Services Administration’s (HRSA) is supporting implementation of the Action Plan in several ways, particularly by facilitating access to health care through the health center and Ryan White programs, and operating training programs for the health care workforce. She noted that HRSA’s HIV/AIDS Bureau recently updated its resource guide Hepatitis and HRSA’s Ryan White HIV/AIDS Care Exit Disclaimer and is now administering the $1.6 million Hepatitis C Treatment Expansion Initiative which supports 15 projects around the nation in implementing effective, focused interventions designed to increase access to and completion of Hepatitis C (HCV) treatment for HIV-positive patients.
  • HRSA’s Bureau of Primary Health Care—Addressing how HRSA’s health center program supports implementation of the Viral Hepatitis Action Plan, Dr. Seiji Hayashi, Chief Medical Officer of HRSA’s Bureau of Primary Health Care (BPHC), noted that the program serves over 19 million patients at over 8,100 service sites across the nation providing significant capacity for prevention, diagnosis and treatment of viral hepatitis.  BPHC supports and promotes the use of evidence-based guidelines and practices including hepatitis B screening and immunizations, HCV testing guidelines, harm reduction efforts, and hepatitis treatment guidelines. Dr. Hayashi also highlighted several BPHC-supported national technical assistance centers available to assist health centers with improving their services for specific populations disproportionately impacted by viral hepatitis such as Asian and Pacific Islander Americans, persons with a history of drug use, and the lesbian, gay, bisexual and transgender populations.
  • Centers for Disease Control and Prevention—Dr. John Ward, Director of CDC’s Division of Viral Hepatitis (DVH), reported that CDC is continuing to develop its “Know More Hepatitis” education campaign and is in discussions with partners about the development of a National Hepatitis Testing Day that would be observed in May. He also shared that DVH is examining the evidence base for a recommendation for one-time universal HCV testing of all “Baby Boomers” (i.e., those born between 1946 and 1964) because of the higher prevalence among that population. Finally, Dr. Ward reminded us that despite declines in transmission of hepatitis C since the 1990s, HCV transmission “is alive and well in the United States.” He pointed, in particular, to a concerning resurgence in new infections among young people (15-24 years old) documented by several state surveillance programs and supported by data from the Youth Risk Behavior Survey that shows a significant increase over time in injection drug use among that demographic in several states and cities.
  • Substance Abuse and Mental Health Services Administration—Mr. Warren Hewitt of SAMHSA’s Center for Substance Abuse Treatment (CSAT) discussed efforts underway within the agency to support implementation of the Action Plan including work by the Addiction Technology Transfer Centers Exit Disclaimer to update their viral hepatitis continuing education curriculum and intensify dissemination of evidence-based viral hepatitis prevention, testing, and treatment practices among providers of substance abuse treatment services. SAMHSA is also exploring ways to place greater emphasis on viral hepatitis prevention, intervention and treatment with grantees in both their block and discretionary grant programs. Finally, Mr. Hewitt shared that CSAT’s Division of Pharmacologic Therapies is distributing the Action Plan to its grant program officers and will be providing training about it in 2012 so that these key liaisons are able to encourage and support grantees in working to better integrate viral hepatitis into their work.

As these several updates illustrate, agencies across the government are actively working to pursue the positive health goals of the Viral Hepatitis Action Plan. I look forward to continuing the collaborations with my Federal and non-Federal colleagues as we work in the months and years ahead to become a nation fully committed to combating the silent epidemic of viral hepatitis.

What activities are unfolding in your community to support implementation of the Action Plan? Join in the national discussion by the posting a comment below.