Lessons Learned From Global Hepatitis C Elimination Programs

Area of Science:

• Public Health
• Infectious Diseases
• Global Health

Background:

• The World Health Organization set 2030 targets to eliminate hepatitis C virus (HCV) as a public health threat.
• Despite progress, only 23% of global HCV infections were diagnosed in 2020, highlighting a critical gap in testing and care access.
• Decentralized and integrated healthcare models offer a promising approach to overcome testing barriers.

Purpose of the Study:

• To examine how decentralized and integrated models have improved access to HCV testing in global health programs.
• To highlight successful strategies implemented in Georgia, Rwanda, and Nigeria for HCV testing and linkage to care.
• To inform future strategies for achieving the 2030 HCV elimination targets.

Main Methods:

• Analysis of hepatitis C program data and strategies from Georgia, Rwanda, and Nigeria.
• Focus on the implementation of decentralized testing and integrated service delivery models.
• Inclusion of specific testing technologies like HCV core antigen and point-of-care (POC) HCV RNA testing.

Main Results:

• Georgia achieved high screening rates (80% of adults) and treatment initiation through simplified testing and POC utilization.
• Rwanda met its screening target and initiated treatment by rapidly decentralizing and integrating HCV services.
• Nigeria's integrated near-POC testing approach expanded HCV viremia testing access, enabling same-day testing and treatment initiation.

Conclusions:

• Decentralized and integrated HCV testing models are effective in increasing access and linkage to care.
• Successful implementation in Georgia, Rwanda, and Nigeria provides valuable insights for other countries aiming for HCV elimination.
• These strategies are vital for meeting the global 2030 hepatitis C elimination goals.