Scotland announces hepatitis C elimination strategy

The Scottish Government’s long-awaited hepatitis C strategy, written in partnership with Health Protection Scotland, was published on 31st July 2019.

The Scottish Government first expressed its intention to produce a national hepatitis C elimination strategy back in February 2018. Its recent publication follows the announcement of an ambitious new target aiming for elimination of hepatitis C in Scotland by 2024, one year ahead of NHS England’s aim of 2025 and six years ahead of the World Health Organisation’s goal of 2030.

The report, titled Scotland’s Hepatitis C Action Plan: Achievements of the First Decade and Proposals for a Scottish Government Strategy (2019) for the Elimination of both Infection and Disease, reflects on previous strategies and policy developments to explore how these have contributed to Scotland’s successes in hepatitis C care, before setting out their vision for achieving elimination by 2024.

In particular, the report focusses on the Hepatitis C Action Plan (2006-2011), Sexual Health and Blood Borne Virus Framework (2005-2015), and Sexual Health and Blood Borne Virus Framework 2015-2020 Update, which were considered models of international good practice when they were first released. While the arrival of more effective antiviral treatments in 2015 will undoubtedly have added to Scotland’s successes, these strategies certainly cleared the way for the significant increases in numbers of people diagnosed and treated in Scotland over the past decade.

Although predominantly highlighting past achievements, the report also briefly outlines how Scotland should progress to achieve its elimination targets in the next few years: 

•  As has been previously announced, Scotland should treat a minimum of 2,500 people during 2019/20, and 3,000 people in each year following.

•  Scotland should intensify efforts to find people living with an undiagnosed infection of hepatitis C, guided by the recommendations made by the Short Life Working Group on Hepatitis C Virus Case Finding and Access to Care.

•  Scotland should ensure that people who inject drugs have access to and take up optimal harm reduction services and treatment.

These recommendations are not accompanied by any detail, funding or specific indicators to track progress; however, encouragingly, the report does mention the establishment of an Elimination Strategy Implementation Group and an Elimination Strategy Project Management Team.

Rachel Halford, Chief Executive of The Hepatitis C Trust, said: “The publication of Scotland’s hepatitis C strategy is a welcome step towards tackling hepatitis C and achieving Scotland’s ambition of elimination by 2024. We hope that more detail will be released soon regarding specific plans and funding to treat the 21,000 people in Scotland estimated to be infected with hepatitis C.

“While Scotland’s past achievements in this field are rightly praised, it is crucial that we do not rest on previous successes in the last few years running up to the elimination target. Recent figures have revealed that while testing rates have remained the same, diagnosis levels are at their lowest in more than 20 years. This indicates that we need to do more to find the 10,500 people estimated to be living with hepatitis C undiagnosed. The recently launched #BeHepCFree social media campaign is an example of a welcome initiative which we would like to see more of.

“Eliminating hepatitis C as a public health threat within the next five years will have an untold effect on the lives of those who are put at greater risk of fatal cirrhosis and liver cancer as a result of having hepatitis C. It is essential Scotland has a detailed plan of action including financial support in order to achieve this.”

Read the strategy in full here.