In 2016, Australia joined with 194 World Health Organization member states to unanimously vote to adopt the Global Hepatitis Elimination Strategy’s commitment to eliminate viral hepatitis as a public health threat by 2030. As we near the middle point for this ambitious goal, the likelihood of it being met domestically and internationally are under question.
Australia’s progress towards hepatitis C elimination Annual Report for 2022, a joint project from the Kirby Institute and Burnett Institute called for new models of care and more financial investment, highlighting the potential of point-of-care testing for hepatitis C.
The report also reveals declines in testing and in the number of people treated each year, with an estimated 117,800 Australians still living with hepatitis C at the end of 2020 and as a result are at serious risk of liver disease, cancer, and premature death.
The facts are just as concerning in First Nations communities, with the hepatitis B notification rate for Aboriginal and Torres Strait Islander people 1.5 times the rate for non-Indigenous Australians. In addition, while First Nations Australians comprise up to 3% of the population, they accounted for approximately 14% of newly reported notified cases of hepatitis C in 2019.
The most recent draft of Australia’s sixth National Hepatitis C Strategy 2023-2030 and the fourth National Hepatitis B Strategy 2023-2030 are not shying away from these issues, stating:
“By 2030, hepatitis [B or C, depending on publication] will be eliminated as a public health threat in Australia. Everyone will have equitable access to safe, affordable, and effective prevention, harm reduction, education, testing, and treatment including appropriate person-centred care and support. People impacted by hepatitis [B or C] are active decision makers in their care, live free from stigma, discrimination, and racism, and lead healthy and productive lives.”
This year’s theme for World Hepatitis Day on July 28 is ‘Hepatitis Can’t Wait’. Ahead of the day, London Agency spoke with Hepatitis Australia CEO Carrie Fowlie, to discuss Australia’s ongoing work to combat this disease.
London Agency: How big of an issue is hepatitis in Australia?
Carrie Fowlie: It’s estimated that 1 in 75 people in Australia live with hepatitis B or hepatitis C (viral hepatitis) and many don’t know they have it. In fact, a quarter of people living with hepatitis B and 1 in 5 people living with hepatitis C have not been diagnosed and are unaware of their infection.
Many people living with viral hepatitis have few or no symptoms until their liver is already damaged.
Hepatitis B and hepatitis C are among the most common risk factors for liver cancer, the fastest growing cause of cancer deaths in Australia.
There is a vaccine along with effective treatments for hepatitis B. Despite this nearly 1 in 100 people in Australia are living with chronic hepatitis B.
While there is now an effective and affordable cure for hepatitis C, more than 115,000 people were estimated to be living with hepatitis C in Australia at the end of 2020.
How are we progressing towards the elimination of hepatitis by 2030?
Progress towards the elimination of hepatitis B and hepatitis C by 2030 is ongoing. Australia has set ambitious goals to reduce the incidence and impact of viral hepatitis. Strategies have been implemented to enhance prevention efforts, increase testing rates, and ensure timely access to effective treatments. These strategies also focus on reducing stigma and discrimination associated with hepatitis, as it can hinder testing and treatment uptake. While progress has been made, there are still challenges to overcome, including reaching marginalised populations, addressing barriers to testing and treatment, and ensuring sustainable funding for comprehensive hepatitis programs. Continued efforts, collaborations, and resource allocation to support the community response are crucial to achieving the goal of eliminating hepatitis by 2030.
The theme for this year’s World Hepatitis Day is “Hepatitis Can’t Wait”. Can you explain why?
The theme “Hepatitis Can’t Wait” highlights the need to accelerate hepatitis B and hepatitis C elimination efforts, especially following the COVID-19 pandemic. It emphasises the need for immediate action to prevent new infections, improve testing and diagnosis, and ensure access to life-saving treatments. Hepatitis B and hepatitis C are silent epidemics that affect millions of people worldwide. Delaying interventions and neglecting the urgency of hepatitis B and hepatitis C can result in the worsening of the disease burden, increased healthcare costs, and loss of lives. The theme encourages governments, healthcare professionals, and individuals to prioritise hepatitis B and hepatitis C elimination efforts and work together to accelerate progress in preventing and treating this global health challenge.
What is Hepatitis Australia’s view on the current drafts of the National Hepatitis Strategy?
Hepatitis Australia fully supports the current drafts of the National Hepatitis B Strategy and the National Hepatitis C Strategy, as they set the national policy framework to achieve the elimination of hepatitis B and hepatitis C by 2030. We are pleased to see the extensive input from the 2022 targeted stakeholder consultation process reflected in these documents. Both strategies were drafted in partnership with key stakeholders, following targeted consultations with jurisdictions, sector peak bodies, national community organisations including Hepatitis Australia and national research centres of excellence.
The Australian Health Department has also consulted with the Blood Borne Viruses and Sexually Transmissible Infections Standing Committee (BBVSS) (a subcommittee of the Australian Health Protection Principal Committee), which includes state and territory governments and national peak body representation.
Hepatitis Australia urges the federal and state and territory governments to take the urgent action as committed to in the strategies and advocates for sustained funding to fully implement them. Elimination by 2030 is achievable, we have the tools, we have the infrastructure, and we have the roadmap to get there, what we now need is the funding to be able to get on with the work.
As this strategy forms part of the broader National Blood Borne Viruses (BBV) and Sexually Transmissible Infections (STI) Strategies, how is Australia faring in our work to combat BBV and STI?
The National Hepatitis B Strategy and the National Hepatitis C Strategy are two of five strategies that make up Australia’s national BBV and STI policy framework, they guide Australia’s national response through target settings, and they outline priority populations, priority settings and priority actions across a range of different domains to achieve those targets. Australia has implemented comprehensive prevention programs, education campaigns, and initiatives aimed at increasing testing, diagnosis, and treatment rates.
Strategies focus on harm reduction measures, such as needle and syringe programs, as well as promoting safe sex practices and vaccination campaigns. While progress has been made, challenges persist, including reaching marginalised populations, reducing stigma and discrimination, and ensuring equitable access to prevention, testing, and treatment services.
We are at a crucial stage in the journey to elimination by 2030. The National Hepatitis B Strategy 2023–2030, and the draft National Hepatitis C Strategy 2023–2030, which recently underwent a public consultation process, position the community-led response as a central part of reaching the 2030 elimination goal. If Australia is to meet this goal, then it is critical that the community are resourced to be able to support the implementation of these strategies and deliver the appropriate, respectful and responsive supports and services they provide to affected communities.
