The Welsh Government has published a public health circular by Chief Medical Officer for Wales Sir Frank Atherton on the need for increased action towards hepatitis C elimination.
The circular primarily addresses senior figures in health boards and Public Health Wales, and sets out the measures needed to accelerate elimination progress ahead of 2030.
The circular recommits to eliminating hepatitis C in Wales by 2030 and outlines 13 action points for 2022-23 and 2023-24 for progressing this agenda. It notes that around 4,000 people in Wales have been treated for HCV since 2015, with an estimated 8,000 people left to find and treat. However, hepatitis C treatment targets were not being reached in Wales pre-pandemic and the health circular notes that the pandemic further stalled progress, with notable reductions in the number of people using substance misuse services and the proportion of service users being offered BBV testing.
Without further action the 2030 target could be missed, with elimination in Wales potentially not being achieved until 2040.
Atherton identifies the challenges of reaching those that are currently not engaged with traditionally delivered healthcare services. While he recognises the importance of supporting these services, he notes that testing must take place in whichever setting is best for the individual, including primary care, harm reduction services, and prisons. This will help reach at-risk populations such as people from high prevalence countries or those who are currently, or have ever, injected drugs. To achieve this, an increase in peer workers and patient navigators is anticipated, with treatment being increasingly undertaken by non-specialists.
In order to galvanise the new push towards elimination, the Welsh Government has established a Hepatitis B and C Elimination Programme Oversight Group. The group reports to the Chief Medical Officer and the Minister for Health and Social Services, while its membership includes representatives from the Welsh Government, Public Health Wales, clinical services in NHS Wales, and the third sector.
In addition to summarising the actions taken so far towards Welsh elimination (including The Hepatitis C Trust’s Peer-to-Peer ‘Follow Me’ scheme in Cardiff), the circular outlines 13 actions for progressing the elimination agenda.
he first and primary action is the mandated development of Joint Recovery Plans by health boards before 31st March 2023, in conjunction with the Area Planning Boards and Public Health Wales, that outline how the board will get back on track towards elimination. Other actions include: preventing infection through increased needle and syringe programmes; increasing case finding through better outreach with defined demographics; expanding the settings where BBV testing is available; and providing funding for meeting the elimination targets.
Rachel Halford, Chief Executive of The Hepatitis C Trust, commented: “It is good to see Wales taking important steps to get back on track towards eliminating HCV by 2030. The pandemic presented many challenges to the elimination agenda but even prior to this Wales was falling behind. The 13 actions set out by the Welsh Government are a welcome plan to accelerate progress and we look forward to playing our part as members of the Hepatitis B and C Elimination Programme Oversight Group.”
You can read the full circular here, with more statistics and the full list of actions. Another circular is due for publication in 2023.