Updated Viral Hepatitis Action Plan Released
By: Dr. Howard K. Koh
Assistant Secretary for Health
U.S. Department of Health and Human Services
The Huffington Post
April 3, 2014
Today we are pleased to release an updated version of the nation's first comprehensive cross-governmental action plan to combat chronic viral hepatitis, initially launched in 2011. The Action Plan for the Prevention, Care and Treatment of Viral Hepatitis (2014-2016) builds upon the substantial progress accomplished over the past three years by agencies and offices across the Department of Health and Human Services - as well as within the Departments of Justice and Veterans Affairs. (Read a brief factsheet about the updated plan.)
Chronic viral hepatitis (hepatitis B [HBV] and hepatitis C [HCV]) is a largely preventable and treatable disease. Yet it affects between 3.5 and 5.3 million Americans, most of them unaware of their infection. As a result, untreated chronic viral hepatitis represents the leading cause of liver cancer and the most common reason for liver transplantation in the United States. In addition, it is a leading infectious cause of death in the U.S., claiming the lives of 12,000-18,000 Americans each year.
But we are making progress against this "silent epidemic." The release of the first Action Plan has galvanized progress on many fronts. Here are just 10 of the recent accomplishments in the field:
1. Establishment of National Hepatitis Testing Day. The original Action Plan called for the establishment of this annual observance, which we've now observed on May 19th each year since 2012. National Hepatitis Testing Day raises greater awareness among both health care providers and communities and we look forward to another outstanding observance next month.
2. New hepatitis C testing recommendations. Both the CDC and the U.S. Preventive Services Task Force have issued recommendations to test all individuals born between 1945 and 1965. As these so-called "Baby Boomers" are five times more likely to be infected with hepatitis C, this single recommendation could save over 120,000 lives. The alignment of these CDC and USPSTF recommendations and their widespread dissemination were called for in the 2011 Action Plan.
3. Expanded, culturally appropriate hepatitis B outreach and educational materials. Produced by CDC in partnership with community organizations, the Know Hep B campaign materials, available in several Asian languages, enable health care providers and community organizations to reach more individuals at risk about the importance of testing for HBV.
4. Greater attention to hepatitis C among persons who inject drugs (PWID). Of new cases of HCV infection reported to the CDC, injection drug use represents the most commonly identified risk factor. An estimated 64 percent of PWID are chronically infected with HCV, and 2.7-11 percent are chronically infected with HBV. Recent consultations and research funding announcements are strengthening our understanding of this problem. We are identifying better ways to prevent new infections in this vulnerable population.
5. Opposing discrimination against health care professionals and students with chronic hepatitis. In a great example of the cross-agency collaboration fostered by the Action Plan, the Offices of Civil Rights from the Departments of Justice, Education, and Health and Human Services sent a joint letter last year to health professions schools. The letter highlighted new CDC guidance on the management of health care professionals and students with chronic HBV and outlined steps to eliminate discrimination against those infected.
6. Greater attention to the elimination of perinatal hepatitis B transmission. We have the tools to further reduce the number of infants perinatally infected with HBV. Motivated and active partners have engaged to ensure the administration of a dose of HBV vaccine to all newborns before discharge from hospitals or birthing centers.
7. New hepatitis C treatments. Late last year, the FDA approved two new HCV treatments, which are simpler to use, require a shorter treatment duration, and have fewer side effects than earlier treatment regimens. These treatments lead to a cure in more than 90 percent of patients who complete them - a major advance. Our FDA colleagues are working along with the pharmaceutical industry to make new HCV therapies available safely and as quickly as possible by using the Fast Track program. This special designation facilitates development and review of drugs with the potential to address unmet medical needs in those with serious conditions.
8. Affordable Care Act. The Affordable Care Act is contributing to efforts to combat chronic viral hepatitis in the U.S. For example, because the law prohibits most plans from denying health coverage based on preexisting conditions, those with chronic viral hepatitis who had previously been uninsured will now have the opportunity to get covered and obtain access to needed prevention, care and treatment services. Moreover, hepatitis vaccinations and testing for HBV for pregnant women are among the covered preventive services that must be offered free of cost-sharing or co-pays. Later this year, one-time HCV screening for persons born between 1945 and 1965 will be added to this list. In addition, the law calls for a substantial investment in the HHS community health center program, which is a vital partner in delivering viral hepatitis prevention, diagnosis, care and treatment to vulnerable populations.
9. World Hepatitis Day proclamations from the President. President Obama has lent his support to the global observance of World Hepatitis Day for the past three years, issuing annual proclamations. The White House has also hosted events to commemorate these observances, helping to raise awareness and mobilize action to address viral hepatitis not only in the U.S. but around the globe.
10. An updated Action Plan for the Prevention, Care, & Treatment of Viral Hepatitis. Now, the updated Action Plan will build upon all the important advances noted above, and identify further opportunities for public and private sector stakeholders. So many can engage in efforts to break the silence surrounding viral hepatitis and improve prevention, diagnosis, care and treatment.
New partners have joined in launching the updated Action Plan. We are pleased that from the federal government, the Department of Housing and Urban Development and the White House Office of National Drug Control Policy have joined our efforts along with the HHS Office of Disease Prevention and Health Promotion, Office of Population Affairs, and our Regional Health Administrators. Many others can join as well. As my colleague Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases observes, "Active involvement by a broad mix of partners from various sectors, both public and private, is essential to fully realizing the potential of this plan. The updated plan provides a framework around which all of us can engage in aligned and focused action."
I hope you, too, will join us in this important moment. It is a critical time. We have the potential to save many lives. The era of health care reform provides a historic setting to strengthen the rapid progress we're making in the diagnosis and treatment of chronic hepatitis. Working together, we can successfully leverage all of our resources to help the nation become fully committed to combating the silent epidemic of viral hepatitis.
Share your ideas about how you or your organization can contribute to this national effort in the comments section below or on social media using the hashtag #ViralHepAction.
Follow Dr. Howard K. Koh on Twitter: www.twitter.com/@HHS_DrKoh