In response to the recent National Academies of Sciences, Engineering, and Medicine’s (NASEM) release of A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report, the National Association of State and Territorial AIDS Directors (NASTAD) has issued a Call to Action and accompanying Blog Post for an urgent response to the hepatitis C epidemic. The Call to Action proposes the following set of recommendations to prevent new infections; reduce deaths and adverse health outcomes; address disparities; coordinate action among federal, state, and local agencies and health systems; and ultimately reduce health care costs.

1. Focus on Prevention, Care, and Treatment for Priority Populations: The opioid epidemic is pervasive in rural, urban, and suburban America. HCV prevention, care, and treatment must be part of a comprehensive strategy to address the epidemic. People of color, Native Americans, homeless individuals, incarcerated populations, and people co-infected with HIV and HCV are disproportionately impacted by HCV and need to be engaged in efforts to end this epidemic.
2. Address the Opioid Epidemic and Drug User Health: The most cost effective strategy to prevent new HCV infections is to ensure a robust drug user health service infrastructure, with harm reduction strategies at the center, is in place in states and localities, and supported by federal resources.
3. Screening, Diagnosis, and Link to Care: Effort must be made to reach those most vulnerable for HCV by implementing screening and related services within the community, which often means outside of the clinical care setting. Improving the hepatitis C surveillance infrastructure, including making more resources available to support states and cities, is also critical.
4. Treatment and Follow Up: In response to the high initial cost of direct-acting antiviral HCV medications, many private and public health insurance payers responded by restricting access to these relatively new medications to those with the most advanced disease and who were not actively using drugs. With elimination as the goal, treatment must be accessible and affordable to everyone, and especially those living with HCV who have been subject to discriminatory, arbitrary sobriety requirements.

NASTAD’s vision is that new HCV infections in the United States are rare, and when they do occur, every person, regardless of substance use status, age, gender, race/ethnicity, sexual orientation, gender identity, disability, socio-economic status, incarceration status or geographic location, will have access to quality, affordable health care including comprehensive screening, care, and treatment leading to cure, without stigma and discrimination.

NASTAD believes that eliminating HCV should be a top public health priority. Unless we act boldly and urgently, we will continue to lose ground against the hepatitis C epidemic. For more information on NASTAD’s Call to Action, hepatitis program or policy activities, please contact Chris Taylor, Senior Director, Hepatitis.