Dr Sunil Solomon’s talk about the ‘Final Frontier’, alluding to the high prevalence of hepatitis C and other blood-borne viruses, painted a very grim picture and highlights the need to utilise all our resources and strategies if we are to meet the global WHO hepatitis elimination goals. An ongoing theme throughout the talks was the need to simplify the diagnostic process. Currently a number of tests need to be performed to diagnosis hepatitis C and determine the genotype, before treatment can be commenced. This can be a major barrier especially for the most marginalised populations who have chaotic lives, making it difficult to follow up. Recent advances have led to a pan-genotype medication which would mean a more stream-lined process from diagnosis to treatment. Ideally there would be a point-of-care hepatitis C testing assay such that treatment can be initiated with minimal delay.
Accessibility to services is paramount in furthering the reach of hepatitis C healthcare to the most difficult-to-reach communities ensuring that ‘no one is left behind’. This requires a multi-faceted approach to ensure that barriers to access are not preventing the most marginalised communities from receiving the necessary healthcare. Clearly there are still myths floating about the community about the transmission of hepatitis C and the burden of treatment which deters some from seeking treatment as highlighted in Anne Mitchell’s revealing speech.
It is also important that more proximal factors are not forgotten in exciting and rapidly changing world of hepatitis C treatment. For example, needle exchange programs are known to be effective in reducing the spread of hepatitis C and other blood-borne viruses. These simple yet effective measures are an essential component of the overall strategy to eliminate hepatitis C.
Chi is a GP working in Northern Sydney.