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Seizing Opportunities in Viral Hepatitis Can Save Lives

Summary: Dr. Richard Wolitski describes federal opportunities for addressing viral hepatitis.

Early this month, I had the pleasure of speaking to Viral Hepatitis Prevention Coordinators from state health departments across the nation, sharing highlights of federal activities that complement and support their vital work at the state level. The Coordinators had assembled in Washington, DC, for the 2016 National Hepatitis Technical Assistance Meeting Exit Disclaimer convened by National Alliance of State and Territorial AIDS Directors (NASTAD) Exit Disclaimer.

With a focus on leveraging the important tools and opportunities available to us, I joined colleagues from CDC for a conversation on the role of public health in hepatitis elimination. We have the potential of making great strides in the years ahead by building on models and innovations developed by state and local health departments and leveraging curative treatment for hepatitis C virus (HCV) infection.

Recent Federal Actions

During my remarks, I reviewed several significant recent federal actions supporting movement toward hepatitis elimination that the Coordinators can, hopefully, build upon in their work at the state and local levels. Among the highlights:

  • Guidance on Use of Federal Funds for Syringe Services Programs – In March 2016, the U.S. Department of Health and Human Services (HHS) issued guidance for HHS-funded programs regarding the use of federal funds to implement or expand syringe services programs (SSPs) for people who inject drugs. Such programs have been shown to be an effective component of a comprehensive approach to prevent HIV and viral hepatitis among people who inject drugs, and do not increase drug use. The guidance details how communities can request a determination of demonstrated need to use federal funds for the operational components of syringe services programs. Subsequently, CDC, HRSA [PDF 330 KB] and SAMHSA [PDF 88.8 KB] published agency-specific guidance for their respective grantees.  As of late October, 21 jurisdictions had made requests to CDC, and 17 of those had been approved.
  • Improving Access to HCV treatment – The advent of curative treatments for HCV hold great promise for millions of Americans. Over the past year, expanding access to such treatments has been an important focus. In November 2015, the Centers for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid Directors to advise states on the coverage of these drugs for Medicaid beneficiaries living HCV. Earlier this fall, my office convened a consultation on improving access to early HCV treatment. Experts from various sectors discussed barriers to accessing the new curative HCV treatments, gaps in economic and scientific data and policies, health care delivery models that have been effective in expanding access to HCV treatment. A summary of the key issues and possible strategies is forthcoming.
  • Curing HCV among People Living with HIV – We’ve also made progress in increasing the proportion of people with HIV-HCV coinfection who are cured of HCV. This year, the Secretary’s Minority AIDS Initiative Fund invested $10 million for a three-year initiative to develop jurisdictional models for eliminating HCV coinfection among Ryan White HIV/AIDS Program clients. HRSA’s HIV/AIDS Bureau is leading the initiative and had provided resources to three jurisdictions (Hartford, CT; New York City; and Philadelphia) as well as an evaluation and technical assistance center, physician consultation services, and technical assistance for participating state health departments.
2017-2020 National Viral Hepatitis Action Plan

Our work to develop the next iteration of the National Viral Hepatitis Action Plan will soon come to fruition. I shared with the Coordinators that the cross-agency group comprised of representatives from 23 federal agencies and offices is working to finalize a new Action Plan that will update and extend our collaborative and focused work through 2020. We anticipate that the updated plan will be released early in the New Year.  That will be followed by a Federal Work Plan detailing action items each of those federal agencies and offices has committed to implementing to achieve the vision and goals of the updated Action Plan.  I reinforced that that we will only achieve our national vision for viral hepatitis prevention, care and treatment, if we all do our parts at the federal, state, and local levels to work collaboratively and strategically to make the best use of the unprecedented viral hepatitis knowledge and tools now available to us.

Read more about the CDC-supported Viral Hepatitis Prevention Coordinators Program.