The Micro-Elimination Approach to Eliminating Hepatitis C: Strategic and Operational Considerations

• Published in: Seminars in liver disease Vol. 38; no. 3; p. 181
• Main Authors: Lazarus, Jeffrey V, Safreed-Harmon, Kelly, Thursz, Mark R, Dillon, John F, El-Sayed, Manal H, Elsharkawy, Ahmed M, Hatzakis, Angelos, Jadoul, Michel, Prestileo, Tullio, Razavi, Homie, Rockstroh, Jürgen K, Wiktor, Stefan Z, Colombo, Massimo
• Format: Journal Article
• Language: English
• Published: United States 01-08-2018
• Subjects: Antiviral Agents - therapeutic use; Cooperative Behavior; Delivery of Health Care, Integrated - legislation & jurisprudence; Delivery of Health Care, Integrated - organization & administration; Disease Eradication - legislation & jurisprudence; Disease Eradication - organization & administration; Global Health - legislation & jurisprudence; Health Policy - legislation & jurisprudence; Hepatitis C - ethnology; Hepatitis C - prevention & control; Hepatitis C - transmission; Humans; Interdisciplinary Communication; International Cooperation; Models, Organizational; Policy Making; Prevalence; Risk Factors; Stakeholder Participation; Vulnerable Populations
• ISSN: 1098-8971
• DOI: 10.1055/s-0038-1666841

The introduction of efficacious new hepatitis C virus (HCV) treatments galvanized the World Health Organization to define ambitious targets for eliminating HCV as a public health threat by 2030. Formidable obstacles to reaching this goal can best be overcome through a micro-elimination approach, which entails pursuing elimination goals in discrete populations through multi-stakeholder initiatives that tailor interventions to the needs of these populations. Micro-elimination is less daunting, less complex, and less costly than full-scale, country-level initiatives to eliminate HCV, and it can build momentum by producing small victories that inspire more ambitious efforts. The micro-elimination approach encourages stakeholders who are most knowledgeable about specific populations to engage with each other and also promotes the uptake of new models of care. Examples of micro-elimination target populations include medical patients, people who inject drugs, migrants, and prisoners, although candidate populations can be expected to vary greatly in different countries and subnational areas.