Hepatitis C Elimination in Rwanda: Progress, Feasibility, and Economic Evaluation

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Rwanda initiated a national hepatitis C virus (HCV) elimination program in 2018.
• The World Health Organization (WHO) has set 2030 as the target for HCV elimination.
• Assessing the program's impact and identifying effective strategies are crucial for achieving these goals.

Purpose of the Study:

• To evaluate the impact of Rwanda's national HCV elimination program.
• To identify optimal strategies for achieving WHO's HCV elimination targets by 2030.
• To model the long-term effects and cost-effectiveness of HCV elimination strategies.

Main Methods:

• A microsimulation model was developed to simulate Rwanda's HCV epidemic from 2015 to 2050.
• The model evaluated trends in HCV infection, prevalence, mortality, and costs under various elimination scenarios.
• Key performance indicators included screening and treatment rates, projected elimination timelines, and economic impact.

Main Results:

• Between 2018 and 2022, over 7 million people were screened and 60,000 treated for HCV.
• Projected HCV elimination by 2027 is feasible with an annual screening rate of 15% and 100% treatment rate.
• The strategy is projected to avert 4,900 liver cancer cases and 6,700 HCV deaths, with cost savings of $25.33 million.

Conclusions:

• Rwanda is positioned to be a global leader in HCV elimination.
• The national program's success provides a scalable model for other African nations.
• HCV elimination is feasible and cost-saving in low-income settings through scaled-up interventions and drug price negotiations.