EMCDDA launches new resources to help European countries beat viral hepatitis

On World Hepatitis Day, the EU drugs agency (EMCDDA) is launching a new set of resources to help European countries meet health targets to eliminate viral hepatitis. The resources, presented in an online toolkit, are part of a wider EMCDDA harm-reduction initiative supporting countries in their efforts to prevent and control infectious diseases among people who inject drugs (PWID).

Eliminating hepatitis as a public health threat by 2030 is a target set under the UN Sustainable Development Goal on Health (SDG 3) (¹). The focus of World Hepatitis Day this year is ‘Hep can’t wait!’.

Hepatitis C virus (HCV) infection is the most common infectious disease among PWID, being easily transmitted through the sharing of needles and syringes. While HCV antibody prevalence in the EU general population is below 2%, studies conducted among PWID show it can exceed 50%, making this a key target group for programmes to eliminate the virus. Data collected from those entering drug treatment in Europe show HCV testing rates to be low in this group.

Today’s toolkit includes an interactive elimination barometer for mapping countries’ progress in eliminating viral hepatitis among PWID and a manual to facilitate a participatory hepatitis diagnostic process at national or local level. It also showcases innovative models of care in some countries that have increased access to HCV testing and treatment through drug services.

Interactive hepatitis elimination barometer to help countries map progress

The updated interactive version of the EMCDDA’s hepatitis elimination barometer is designed to help countries (EU 27, Turkey and Norway) assess their progress in eliminating viral hepatitis as a public health threat among PWID by 2030. Through this tool, public health workers, policymakers and other interested users can access data to gauge their country’s performance according to 10 epidemiological indicators (²). Users can download data tables and infographics and view which countries have achieved the targets set.

Monitoring data suggest that most European countries are lagging behind in meeting goals, underlining the need to scale up access to stigma-free hepatitis prevention, testing and care in this population (³).

Step-by-step manual to boost HCV testing and access to care

The new EMCDDA manual aims to help improve access to hepatitis C testing and care for PWID via drug services. Hepatitis testing services tend to be mainly located in hospitals or specialist clinics that are often ‘out of reach’ for this group. The manual focuses on bringing HCV screening closer to this population by prioritising testing in harm-reduction and drug treatment settings.

Targeted at drug services and at professionals planning and managing infectious diseases, the manual proposes a practical three-step diagnostic process (mapping, consulting, monitoring) involving a variety of stakeholders to identify problems and areas for improvement (⁴). The manual also presents user-friendly checklists, templates and links to a knowledge questionnaire, designed to help drug service staff refresh their knowledge on viral hepatitis, identify training needs and advise PWID on testing and risks.

EMCDDA Director Alexis Goosdeel says: ‘Although preventable and curable, hepatitis C virus infection is highly prevalent among people who inject drugs in Europe, yet HCV testing in this group remains low. Staff working in drug services play a vital role in reaching people at risk of hepatitis infections and in linking them to HCV testing, treatment and care. The EMCDDA hepatitis toolkit provides practical instruments to improve existing practice and help eliminate viral hepatitis as a public health threat in our communities. Bringing health services to those who need them is part of ensuring a people-centred approach to health’.

Notes

(¹) To incorporate the SDG health target into a global operational policy framework for hepatitis, the World Health Assembly (May 2016) endorsed the global health sector strategy on viral hepatitis. This aims to eliminate hepatitis as a public health threat by reducing the incidence of chronic infections by 90% and mortality by 65% by 2030. The same year a hepatitis action plan set important milestones and corresponding targets for 2020.

(²) These fall under five ‘building blocks’: context and needs (prevalence); inputs (policies); prevention (harm reduction and vaccination); testing and linkage to care (diagnosis to cure); and impact (incidence).

(³) The EMCDDA is conducting monitoring in this area with its drug-related infectious diseases (DRID) network, in close collaboration with the European Centre for Disease Prevention and Control (ECDC).

(⁴) The three steps are: 1. Mapping and needs assessment for HCV testing in drug services; 2. Conducting a multi-stakeholder consultation; and 3. Monitoring and evaluating results.