The recent announcement by Assistant Secretary for Health Dr. Howard Koh that the federal government’s Action Plan for the Prevention, Care and Treatment of Viral Hepatitis will be renewed for another three years is welcome news, as is the invitation from HHS for stakeholders to offer input on what should be included, expanded, or changed in the 2014-2016 extension of the Plan.
The 2011 launch of the original Action Plan signaled an unprecedented level of focus and coordination among federal agencies committed to responding to the challenges of the viral hepatitis epidemic. Despite significant progress on a wide range of actions outlined in the Action Plan, more work remains as we enter a critical juncture in the fight against hepatitis B and hepatitis C. The voices, ideas, and engagement of community stakeholders, advocates, and people living with chronic viral hepatitis will be critical in shaping this next chapter.
At the time of the release of the first Action Plan, the Patient Protection and Affordable Care Act (ACA) was barely a year old and its provisions had just begun to be implemented. As we look ahead to 2014, hundreds of thousands of people with chronic viral hepatitis will have new opportunities to access insurance and health care through expanded Medicaid eligibility in participating states and subsidized premiums for plans purchased through health insurance marketplaces. As of January 1, 2014, insurers cannot discriminate against people with pre-existing conditions. These expansions in coverage, coupled with transformations in health care delivery designed to improve care coordination for people with chronic conditions, offer tremendous opportunities to improve access, quality, and outcomes for people living with chronic hepatitis B and/or hepatitis C. The renewal of the Action Plan challenges us to envision creative strategies to harness and maximize these opportunities.
Changes in the viral hepatitis landscape over the past two years also warrant reflection on new opportunities and challenges. While CDC and partners work to implement new guidelines calling for a one-time hepatitis C screening of all baby boomers (those born between 1945 and 1965), a recent technical consultation convened by HHS highlighted growing concern of reports of a new wave of acute hepatitis C infections among young people who inject drugs, linked to the epidemic of prescription drug misuse. At the same time, researchers, clinicians, and advocates eagerly predict the arrival of all-oral, interferon-free regimens for hepatitis C treatment, with a growing number of studies of investigational treatments touting cure rates in the 90-100 percent range in as little as 12 weeks. Moreover, Hep B United, a strong national network of community coalitions addressing hepatitis B, has launched efforts to share strategies, best practices, and resources. However, much work remains in building a culturally and linguistically competent clinical workforce, and to eliminate perinatal hepatitis B transmission.
Amidst all of these changes, two things are clear: federal leadership has had a galvanizing effect in bringing new focus and coordination to the response to viral hepatitis, and the federal agencies cannot bring an end to these epidemics alone. Federal initiatives must be complemented by state and local innovations. They must also be informed by and responsive to the needs and insights of local communities, clinicians, and people at risk for and living with chronic hepatitis B or hepatitis C. We all have a stake in ending the viral hepatitis epidemic; so as stakeholders, we should take advantage of the opportunity to contribute to the development and implementation of the next phase of the Viral Hepatitis Action Plan.
The HHS Office of HIV/AIDS and Infectious Disease Policy, which coordinates and supports cross-agency efforts to implement the Action Plan, has issued a Request for Information (RFI) to solicit stakeholder input on the extension of the Action Plan. To share your ideas and feedback – including suggestions for how federal agencies can better collaborate with non-governmental stakeholders – review the RFI and send responses by July 5, 2013. (For background, read the current Action Plan [PDF 672KB] and the first year Implementation Progress Report [PDF 588KB].)
Your input can strengthen the renewal of the Viral Hepatitis Action Plan and enhance national efforts to achieve its long-term goals of increasing the proportion of persons aware of their hepatitis B or hepatitis C infection infections, reducing the number of new cases of hepatitis C infection, and eliminating mother-to-child transmission of hepatitis B.
Daniel Raymond is the Policy Director of the Harm Reduction Coalition. This article was originally published at AIDS.gov.